Lasprilla-Pallares Maria A, Soriano Carmen C, Sanchez-Feliciano Abizairie, Ponce Carla, McClelland Shearwood
Department of Radiation Oncology.
Case Western Reserve University School of Medicine, Cleveland, OH.
Am J Clin Oncol. 2025 Jul 4. doi: 10.1097/COC.0000000000001226.
The Hispanic-American population is the nation's second-largest racial/ethnic group and the second most rapidly growing population. Radiation therapy (RT) is an indispensable, highly effective treatment for cancer; therefore, any barriers impairing RT access may yield deleterious consequences for Hispanic-Americans. The Navigator-Assisted Hypofractionation (NAVAH) program was developed to optimize RT access for all cancer patients. A key component of NAVAH is the use of culturally sensitive surveys to assess the impact of patient navigation before and after RT. We present initial findings from a Spanish-language cancer support group comprised of Hispanic-American patients as a baseline before implementation of NAVAH at our institution.
A previously validated, Spanish-language, culturally sensitive survey was implemented to identify barriers to cancer care among Hispanic Americans. Participants were recruited to complete interviewer-administered surveys between monthly group visits. Surveys assessed several domains, including acceptability, accessibility, accommodation, affordability, and availability.
Eight cancer survivors completed surveys in person. Interviewees reported a positive but variable assessment of the availability, accommodation, and accessibility domains, suggesting that services may adequately meet patients' needs and preferences. However, responses in the acceptability domain reflected a strong perception of disparities and ethnic bias. In addition, feedback in the affordability domain indicates a heightened vulnerability to financial toxicity within this population.
These initial findings from the NAVAH program underscore the persistent challenges faced by Hispanic-American cancer patients, particularly in the realms of perceived discrimination and financial toxicity. These insights emphasize the necessity for culturally sensitive interventions, such as bilingual patient navigation programs, to address and mitigate the multifaceted barriers encountered by Hispanic-American patients. The NAVAH program's approach of incorporating culturally attuned surveys and support mechanisms represents a promising step toward optimizing equity in cancer treatment. Moreover, these early impressions pave the way for further investigation involving patients actively receiving RT.
西班牙裔美国人是美国第二大种族/族裔群体，也是增长第二快的人口群体。放射治疗（RT）是癌症治疗中不可或缺的高效治疗方法；因此，任何阻碍获得放射治疗的障碍都可能给西班牙裔美国人带来有害后果。导航辅助大分割放疗（NAVAH）项目旨在优化所有癌症患者获得放射治疗的机会。NAVAH的一个关键组成部分是使用具有文化敏感性的调查来评估患者在放疗前后接受导航服务的影响。我们展示了一个由西班牙裔美国患者组成的西班牙语癌症支持小组的初步调查结果，作为在我们机构实施NAVAH之前的基线数据。
实施一项先前经过验证的、具有文化敏感性的西班牙语调查，以确定西班牙裔美国人在癌症护理方面面临的障碍。在每月的小组访问期间，招募参与者完成由访谈员进行的调查。调查评估了几个领域，包括可接受性、可及性、适应性、可承受性和可得性。
八名癌症幸存者亲自完成了调查。受访者对可得性、适应性和可及性领域的评价积极但存在差异，这表明服务可能充分满足患者需求和偏好。然而，在可接受性领域的回答反映出对差异和种族偏见的强烈感受。此外，在可承受性领域的反馈表明该人群对经济毒性的脆弱性更高。
NAVAH项目的这些初步调查结果凸显了西班牙裔美国癌症患者面临的持续挑战，特别是在感知到的歧视和经济毒性方面。这些见解强调了采取具有文化敏感性的干预措施的必要性，如双语患者导航项目，以解决和减轻西班牙裔美国患者遇到的多方面障碍。NAVAH项目纳入文化协调调查和支持机制的方法是朝着优化癌症治疗公平性迈出的有希望的一步。此外，这些早期印象为进一步研究积极接受放疗的患者铺平了道路。
