No abstract

No abstract

Introduction: American Indian (AI) people have protective factors embedded in cultural teachings that buffer against high-risk behaviors. This study applies a qualitative, grounded theory approach to identify cultural assets for a Diné (Navajo) mother-daughter intervention aimed at preventing substance abuse and teen pregnancy. Method: Focus groups and in-depth interviews were conducted with 28 AI females’ ages 8 years and older from the Navajo Nation. Results: Key themes were (a) preserving the Diné way of life, (b) cultural assets related to being a healthy Diné woman, (c) matrilineal networks as a source of strength/pride, (d) historical trauma as a source of resilience, (e) male influences as protective health factors, (f) Western education as a measure of success, and (g) integrating different belief systems. Discussion: Study findings may be applied as foundational elements for culturally grounded AI substance abuse and teen pregnancy prevention strategies, as well as culturally safe nursing practice.

Introduction: Large segments of the United States population do not receive quality cancer care due to pervasive and systemic inequities. Disparate cancer care is associated with increased morbidity and mortality. Multi-component, multi-level interventions can address inequities and improve care, but only if they reach populations of interest. Intervention studies often under-enroll populations of interest, despite having an adequate eligible pool. Procedures: The Alliance to Advance Patient-Centered Cancer Care supports six grantees across the US to implement diverse multi-component (e.g., access, symptom monitoring, wellness, survivorship), multi-level (e.g., patients, clinicians, caregivers) intervention programs with the shared goals of reducing disparities, increasing patient engagement, and improving the quality of cancer care. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework informs the evaluation efforts across the six sites. An important first step is to reach and enroll individuals who are most in need of cancer screening or access to cancer treatment. Target populations across sites include underrepresented minorities (e.g., Black and Latinx persons), those who speak English as a second language, and rural residents. Each participating site defined the target population(s) for their program. The sites used four key strategies to reach their target populations, which included: lay and clinical navigators, community advisory boards, data algorithms to conduct eligibility screening from the electronic health record, and dynamic community-based participatory research approaches. For years 2018-2019, we evaluated the demographic characteristics of participants recruited to program interventions compared to the overall demographic characteristics of each site’s pool of potentially eligible participants. Summary data: Of 4,692 potentially eligible participants, the six sites have enrolled 1,880 participants to date. Below we report the proportion of individuals with selected characteristics from the total enrolled: Black adults: 39% enrolled, (n=733), Latinx adults: 23% enrolled, (n=432), English as second language speakers: 19% enrolled, (n=357), and rural residents: 25% enrolled, (n=470). These proportions were similar or exceeded the proportions observed across the entire pool of eligible persons. Specifically, of 4,692 eligible persons across all sites, 35% were Black adults, 19% were Latinx adults, 15% spoke English as a second language, and 23% resided in rural areas. Conclusion: The Alliance to Advance Patient-Centered Cancer Care grantees have met or exceeded target enrollments from underserved groups to patient-centered intervention programs. Intentional strategies that include human resources, technology, and community engagement are needed and can be successful in improving access to high-quality cancer screening, treatment, and supportive care. Citation Format: Debra L. Barton, Bidisha Ghosh, Heidi A. Hamann, Sanja Percac-Lima, Adrian S. Dobs, Michelle J. Naughton, Roland P. Matthews, Sheryl Gabram-Mendola, Melissa A. Simon, Yvonne Bueno, Beverly Moy, Electra D. Paskett, Sankirtana M. Danner, Bingxin Chen, Robert J. Ploutz- Snyder, Christopher R. Friese. Strategies to improve the reach of interventions to address inequities in cancer care: Results from a six-site initiative [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-076.