Abstract A153: Patient-informed patient navigation for colorectal cancer screening among racial and ethnic minorities: A qualitative work
Authors: Schubel Laura C. , Rivera Jessica Rivera , AuBuchon Katarina , Tran Jennifer , Locke Marjorie , Arem Hannah 
Published: September 2024

Abstract
INTRODUCTION: Black individuals experience higher mortality from colorectal cancer (CRC) compared to non-Hispanic White individuals, and the incidence of CRC, while increasing among all minority populations, has increased the most among Hispanic/Latinx individuals. Furthermore, minority populations have significantly lower likelihood of being up to date with CRC screening, due in part to unaddressed social determinants of health. These disparities suggest room for evidence-based interventions such as patient navigation to address barriers and facilitate screening among these populations. To understand perceptions of a referral-based patient navigation program for CRC screening, we conducted interviews with Black/African American and Hispanic/Latinx patients to understand the challenges, preferences, and considerations of CRC screening and navigation. METHODS: We recruited English- and Spanish-speaking patients who were due for CRC screening in the electronic health record (EHR). Patients were either Black/African American and/or Hispanic/Latino and between the ages of 45-75. Interviews lasted 60 minutes and topics included preferences, barriers, and facilitators to screening, and preferences for patient navigation. Data were transcribed and analyzed for emergent themes. RESULTS: 15 interviews were conducted between January to April 2024. Approximately half of all participants identified as women (n=8, 53%), ethnically as Hispanic/Latino (n=8, 53%), and racially as Black/African American (n=8, 53.3%). Most patients had received some form of CRC screening within their lifetime. Awareness of CRC varied: Many participants were aware of CRC from family history or friends diagnosed with the condition, whereas others did not associate CRC screening with CRC. At least one patient sought screening outside of the US due to differences in colonoscopy prep requirements. When asked about barriers to screening, common themes included fear of the colonoscopy process (specifically regarding social image, preparation, and cancer diagnoses), education (lack of awareness of CRC and the importance of screening), and social needs (cost, transportation, and flexibility with work). Finally, when inquiring about preferences for patient navigation, participants requested help with transportation and expressed preferences including simple language and tailoring conversations to patient’s literacy levels, accommodating language preferences, and avoiding medical jargon. Patients also suggested navigators should be prepared to explain things to patients in-depth (e.g., what will happen during the procedure), providing patients options, talking about public figures who have battled CRC, and speaking about the benefits and the risks of screening. CONCLUSION: This work explores patient needs, concerns, and perceptions of navigation for CRC screening among historically marginalized groups. Results from this work will be used to tailor navigation strategies, ensuring equitable navigation and promoting the importance of CRC screening.
Citation Format: Laura C. Schubel, Jessica Rivera Rivera, Katarina AuBuchon, Jennifer Tran, Marjorie Locke, Hannah Arem. Patient-informed patient navigation for colorectal cancer screening among racial and ethnic minorities: A qualitative work [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A153.