Purpose Latinx adults with cancer, as compared with non-Latinx White adults, are diagnosed with more advanced stages and experience worse quality of life. Identifying barriers in cancer care among low-income Latinx adults is crucial to designing and implementing culturally appropriate interventions. The objective of this study was to explore the specific barriers encountered by Latinx adults after a cancer diagnosis and perspectives on the use of community health workers (CHWs) to address these barriers. Methods We conducted semi-structured qualitative interviews with low-income Latinx adults with a past or current history of cancer and/or their caregivers in a community oncology clinic located in an agricultural community in California. Analysis was based in grounded theory and performed using the constant comparative method. Results Sixteen interviews were conducted with patients alone ( n = 11), a caregiver alone ( n = 1), and patient-caregiver pairs ( n = 4 patients; n = 4 caregivers). Four major themes emerged: (1) low cancer health literacy including cancer diagnosis and treatment, cancer fatalism, navigating next steps after diagnosis, advance directives, and precision medicine; (2) challenges in communicating and receiving supportive services due to language barriers; (3) stress and anxiety regarding financial hardships related to job loss, insurance barriers, and the COVID-19 pandemic; (4) the need for supportive, bilingual, and bicultural personnel to assist in overcoming these challenges. Conclusions Low-income Latinx adults with cancer and their caregivers experience health literacy, communication, and financial barriers that impede quality cancer care delivery. Embedding CHWs in the care team could be one way to address these barriers to culturally concordant, accessible care.

105 Background: Cancer remains the number one cause of death among the Latino population despite the decrease in cancer incidence and mortality in the United States. Latino patients experience worse quality of life, more advanced stages of disease, and longer times to definitive diagnosis and treatment initiation. Yet there are few interventions that leverage clinical and community-based approaches to address these disparities. The aim of this formative qualitative study was to explore the specific care needs and barriers encountered by Latino patients to refine a community-based intervention delivered by community health workers (CHWs). Methods: We conducted semi-structured, in-depth, one-on-one qualitative interviews with low-income, Latino adults with a past or current history of cancer and/or their caregivers in a county comprised of 80% Latino populations in California. Interviews were conducted in Spanish, audio-recorded, transcribed and translated. Analysis was based in grounded theory and performed using the constant comparative method. Results: Fourteen interviews were conducted with a total of 18 participants; 9 involved the patient, 4 involved the patient and a designated caregiver, and 1 involved a caregiver only. Four major themes emerged that included: 1) lack of overall understanding of all aspects of cancer including their cancer diagnosis, significance of advance directives, precision medicine, and cancer care plans; 2) severe challenges in communicating cancer care needs and receiving support services due to language barriers; 3) stress and anxiety regarding financial hardships related to job loss and insurance barriers; 4) the need for supportive, bilingual and bicultural personnel to assist in overcoming these challenges. Conclusions: Latino patients with cancer and caregivers described major barriers they encounter after a cancer diagnosis. Participants described important approaches to address these cancer specific needs and reduce cancer disparities among these populations.