Abstract PO-015: An examination of the implementation of a navigation patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women
Authors: Lewis-Thames Marquita W. , Tom Laura S. , Leung Ivy S. , Yang Anna , Simon Melissa A. 
Published: January 2022

Abstract
Background: In 2020, national breast cancer rates for female breast cancer and cervical cancer for all races were 72.8% and 81%, respectively. Chinese Americans have lower breast and cervical cancer screening rates than the national average. For example, breast and cervical cancer screening rates for Chinese American women from Chicago's Chinatown are 60% and 47%, respectfully. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer navigation programs and their implementation among Chinese Americans are limited. To address this gap, we used the Consolidated Framework for Implementation Research (CFIR) to examine facilitators and barriers to implementing the Chicago-based Chinatown Patient Navigation Program (CPNP) for breast and cervical cancer screening, follow-up, and treatment. Methods: Between February and April 2019, stakeholders from a local safety-net hospital, supportive care services, and a community-based organization were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to program implementation. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including 1) intervention characteristics; 2) outer setting; 3) inner setting; and 4) the implementation process. We interviewed 16 stakeholders. Results Findings suggest that perceived program benefits, such as patient navigators preparing Chinese-speaking patients for their clinic visits, providing interpreter services, being accessible to patients and stakeholders, and consistently providing high-quality flexible services facilitated stakeholder engagement in the CPNP. However, barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement and in the early stages of the program, limited awareness among some clinical staff on navigators' roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials. Conclusions: Lesson's to apply to future patient navigation programs are that patient navigators should be able to guide patients at all points of care—from scheduling to follow-up, navigator services should be high quality and complement the existing clinical workflow, clinical partners and end-users need regular and frequent communication about the navigator's responsibilities before the program's implemented, and limitations with practice-level supports (e.g., infrastructure, administration) can pose challenges to implementing the navigation program. These findings provide valuable information on the implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations.
Citation Format: Marquita W. Lewis-Thames, Laura S. Tom, Ivy S. Leung, Anna Yang, Melissa A. Simon. An examination of the implementation of a navigation patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-015.