Abstract B005: Development of a multi-component implementation strategy to deliver reproductive health care to Latina and geographically remote AYA cancer survivors on the US-Mexico border
Authors: Hoyt Helina , Palomino Helen , Carlson Beverly , Su H. Irene 
Published: September 2020

Abstract
Introduction: Reproductive health is a major issue for adolescent and young adult (AYA) cancer survivors because of the higher risks of adverse reproductive outcomes, including infertility, spontaneous abortion, and preterm birth. Multiple barriers prevent implementation of reproductive health care to mitigate risks, especially in Latina and geographically remote communities. The objective is to develop a multi-component implementation strategy for this context. Methods: An investigator team including complementary research, community engagement, and healthcare workforce training experts was formed. Investigators reviewed published barriers and facilitators to reproductive health care in AYA survivors, candidate implementation strategies, inclusive of mobile health strategies, and community specific needs to generate candidate implementation tools. An implementation science framework was chosen to evaluate strategies and the context for improving reproductive health care for cancer survivors in Imperial County, a medically underserved and rural US-Mexico border region. Results: A collaboration was formed among the nursing school at San Diego State University, the community-based patient navigation program Cancer Resource Center of the Desert, and the comprehensive cancer center at the University of California San Diego, in order to pool expertise in community engagement, nurse workforce training, Imperial Valley patient navigation, medical oncology, reproductive medicine and implementation science. The investigators selected three implementation strategies to address known barriers in this region: 1) a culturally appropriate reproductive risk summary and survivorship care plan in English and Spanish to meet AYA survivor and healthcare provider knowledge gaps; 2) facilitation of care across health care systems via patient navigation; and 3) changing the location of clinical service sites, connecting rural, community based-setting with specialized care, via telehealth reproductive consultation. Guided by the Consolidated Framework of Implementation Research (CFIR), a mixed methods approach has been planned to evaluate the implementation interventions, the inner context at clinical sites, individuals (AYA survivors, navigators, nurses, physicians), and outer context (insurance coverage, community philanthropy). Conclusion: A systematic evaluation guided by an implementation science framework will generate a multi-component implementation strategy to deliver reproductive health care to Latina and geographically remote AYA cancer survivors.
Citation Format: Helina Hoyt, Helen Palomino, Beverly Carlson, H. Irene Su. Development of a multi-component implementation strategy to deliver reproductive health care to Latina and geographically remote AYA cancer survivors on the US-Mexico border [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B005.