Abstract 4898: Factors influencing implementation of a breast cancer screening intervention for women with food insecurity in a community setting: An application of the Implementation Research Logic Model
Authors: Charlotte L. Kerber, Julie H. Dang, Daniel J. Pasillas-Pablo, Jocelyn T. Canty, Laura Fejerman
Journal: Cancer Research (2025)

Among individuals and communities with low-income, the experience of food insecurity is associated with greater delays in recommended mammography screening and late-stage breast cancer at diagnosis. Community-based interventions that address barriers to promoting breast cancer screening among diverse communities of women with food insecurity in real-world safety-net settings have been limited. In partnership with Sacramento Food Bank and Family Services (SFBFS), the largest non-profit provider of social services in Sacramento County, this study aimed to (1) identify factors influencing implementation of a breast cancer screening intervention in a food distribution setting and (2) identify mechanisms through which factors impact implementation outcomes. As part of a larger participatory-based mixed methods project with SFBFS, we conducted semi-structured interviews (n=10 staff; n=10 clients) and collected observations from direct food distribution events during the pre-implementation phase. The Consolidated Framework for Implementation Research (CFIR) guided the rapid iterative content analysis to identify barriers and facilitators of implementation. Then as part of the Implementation Research Logic Model (IRLM), we developed a matrix using CFIR, Expert Recommendations for Implementing Change (ERIC), and the Behavior Change Wheel (BCW) to identify mechanisms linked to these factors and to assess implementation outcomes of acceptability, appropriateness, and feasibility. Overall, there was consensus that promoting breast cancer screening in the food distribution setting was beneficial and welcomed by all stakeholders. Key determinants related to the general theme of sustainability were identified including financing, the availability of resources, and the process of engaging with clients while they are at the food distribution event. Characteristics of individuals, specifically the clients’ capability and motivation to receive a breast cancer screening intervention in this context, must also be considered. An active and sustained partnership with food bank leaders is crucial to facilitate these outcomes. Intervention format should include tailored messaging that is culturally appropriate and empowers individuals to obtain recommended screening. Content of the intervention should provide interactive assistance that facilitates local support for screening eligibility and services. This IRLM can be adapted for future breast cancer screening interventions in novel community-based food distribution settings. Citation Format: Charlotte L. Kerber, Julie H. Dang, Daniel J. Pasillas-Pablo, Jocelyn T. Canty, Laura Fejerman. Factors influencing implementation of a breast cancer screening intervention for women with food insecurity in a community setting: An application of the Implementation Research Logic Model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4898.