A Community-Engaged Process for Adapting a Proven Community Health Worker Model to Integrate Precision Cancer Care Delivery for Low-income Latinx Adults With Cancer

被引：5

作者：

Wood, Emily H. ^{[1
]}

Leach, Maria ^{[2
]}

Villicana, Gerardo ^{[2
]}

Goldman Rosas, Lisa ^{[1
]}

Duron, Ysabel ^{[3
]}

O'Brien, Dale G. ^{[4
]}

Koontz, Zachary ^{[2
]}

Patel, Manali I. ^{[1
,5
]}

机构：

[1] Stanford Univ, Sch Med, Stanford, CA USA

[2] Pacific Canc Care, Monterey, CA USA

[3] Latino Canc Inst, San Jose, CA USA

[4] Canc Patients Alliance, Pacific Grove, CA USA

[5] Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA

来源：

HEALTH PROMOTION PRACTICE | 2023年 / 24卷 / 03期

关键词：

advance care planning; community health; worker; lay health worker; goals of care; REAIM framework; Latinx; underserved; DISPARITIES; INTERVENTION; AGREEMENT; NAVIGATOR; CENTERS;

D O I：

10.1177/15248399221096415

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Introduction. Disparities in precision cancer care delivery among low-income Latinx adults are well described. In prior work, we developed a community health worker-led goals of care and cancer symptom assessment intervention. The objective of this study was to adapt this intervention for a community setting, incorporating precision cancer care delivery. Methods. We used a two-phased systematic approach to adapt an evidence-based intervention for our community. Specifically, we used the Reach, Effectiveness, Adop-tion, Implementation, and Maintenance (RE-AIM) framework to identify barriers and facilitators to precision cancer care delivery via 1-hr interviews with Latinx adults with cancer, Latinx caregivers, community leaders, primary care and oncology clinicians, and community health workers. Interviews were recorded, transcribed, and analyzed using the constant comparative method and grounded theory analysis. Phase 2 involved interviews with key community advisors using the Expert Panels Method to decide on final adaptations. Results. Using this community-engaged approach, we identified specific intervention adaptations to ensure precision cancer care delivery in a community setting, which included: (a) expansion of the intervention inclusion criteria and mode of delivery; (b) integration of low-literacy precision cancer care intervention activities in Spanish in collaboration with community-based organizations; (c) ensuring goals reflective of patient and community priorities. Conclusions. This systematic and community-engaged approach to adapt an intervention for use in delivering precision cancer care strengthened an evidence-based approach to promote the needs and preferences of patients and key community stakeholders.

引用

页码：491 / 501

页数：11

共 31 条

[21] The effect of a lay health worker intervention on acute care use, patient experiences and end-of-life care: Results from a randomized clinical trial. [J].