Abstract LB169: Assessing the facilitators and barriers of a novel cancer care delivery model adapted for the care coordination of LGBTQ+ cancer survivors
Authors: Adebayo Nihmotallahi , Dunne Will , Danner Sankirtana , Rivera Juan A. , Molina Elena , Ekong Abbey , Adetoro Elizabeth , Blum Cori , Osei Cassandra , Trosman Julia , Weldon Christine , Simon Melissa 
Published: June 2022

Abstract
Background: Lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals experience health disparities at disproportionate rates that drive reduced cancer screenings and late-stage cancer diagnoses. Community health centers play critical roles in providing primary care services to LGBTQ+ patients with cancer. Patients diagnosed with cancer and referred to specialty care outside health centers, however, often experience disruptions to their primary care services due to gaps in communication between primary and oncology care providers. The © 4R Oncology Model (Right Information and Right Care for the Right Patient at the Right Time) is a novel, patient-centric care coordination tool developed to facilitate cancer planning and serves as a longitudinal primary care checklist for use by patients and their care team. Our project aims to assess the facilitators and barriers of 4R as a component of primary and specialized care delivered to LGBTQ+ cancer survivors.
Methods: We conducted semi-structured interviews with patients and their caregivers (n =12) and stakeholders (n=12) to assess facilitators and barriers to 4R implementation as a component of care delivered to LGBTQ+ cancer survivors. Research team members deductively identified initial themes from interview transcripts. Preliminary coding schemes were compared among three team members and refined by inductive coding to produce a higher-level study codebook. With this codebook, team members ultimately utilized ATLAS.ti, a qualitative data analysis software, to independently analyze interview transcripts, with discrepancies in coding resolved through team-wide discussions.
Results: Patients, their caregivers, and stakeholders agree that the 4R model shows potential for use as a first-step intervention to address primary care gaps caused by inadequate care coordination. Suggested improvements to the model include a reduction of textual information and an increased emphasis on mental and emotional support resources on the model’s sequence of care form.
Conclusions: Interim findings indicate that a lack of adequate research on solutions to the disruption of primary care services caused by the initiation of cancer care for LGBTQ+ cancer survivors is a significant barrier for this patient population. The 4R Oncology Model thus shows promise as a solution for initiating and sustaining more continuous communication between primary care and cancer care delivery for LGBTQ+ cancer survivors. Continued analysis of study interviews will further elucidate facilitators and barriers to cancer care coordination for LGBTQ+ individuals, while further informing iterations to the 4R model for the development of a national protocol aimed at improving access to care and outcomes for LGBTQ+ individuals and other underserved groups.
Citation Format: Nihmotallahi Adebayo, Will Dunne, Sankirtana Danner, Juan A. Rivera, Elena Molina, Abbey Ekong, Elizabeth Adetoro, Cori Blum, Cassandra Osei, Julia Trosman, Christine Weldon, Melissa Simon. Assessing the facilitators and barriers of a novel cancer care delivery model adapted for the care coordination of LGBTQ+ cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB169.