Purpose To evaluate the barriers and facilitators to taking anti-hormonal medications among medically and historically underserved breast cancer survivors within the first five years post chemotherapy, radiation, and/or surgery. Methods The current study was framed within The National Institutes of Health Centers for Population Health and Health Disparities Model (NIHCPHHD Model). Twenty-five historically or medically underserved breast cancer survivors participated in an in-depth interview, in either English or Spanish. Interviews were audio recorded and transcribed verbatim. Interview data were analyzed using content analysis. Results Anti-hormonal medication adherence was facilitated in several ways, including establishing a routine of medication taking, leaving the medicine in a visible or easily accessible place, taking the medication with other medications, reducing the cost of medicine, using a pillbox, understanding the negative consequences of lack of adherence, and having positive interactions with physicians. Side effects were the most commonly mentioned barrier to medication adherence. Conclusions Similar to other research, this qualitative study of medically and historically underserved breast cancer survivors in the United States found that side effects are the most frequently endorsed barrier to anti-hormonal medication adherence. Conversely, there were a number of facilitators of correct and consistent anti-hormonal medication use. The management of side effects is critically important to increase adherence to anti-hormonal medications. Health care providers, support providers, and caregivers can encourage breast cancer survivors to better adhere to anti-hormonal medications using a number of approaches that have been successful for other women.

Despite the proliferation of patient navigation programs designed to increase timely receipt of health care, little is known about the content and delivery of patient navigation training, or best practices in this arena. The current study begins to address these gaps in understanding, as it is the first study to comprehensively review descriptions of patient navigation training in the peer-reviewed research literature. Seventy-five patient navigation efficacy studies published since 1995, identified through PubMed and by the authors, were included in this narrative review. Fifty-nine of the included studies (79%) mentioned patient navigation training, and fifty-five of these studies additionally provided a description of training. Most studies did not thoroughly document patient navigation training practices. Additionally, several topics integral to the role of patient navigators, as well as components of training central to successful adult learning, were not commonly described in the research literature. Descriptions of training also varied widely across studies in terms of duration, location, format, learning strategies employed, occupation of trainer, and content. These findings demonstrate the need for established standards of navigator training as well as future research on the optimal delivery and content of patient navigation training.

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Purpose Research investigating facilitators of survivorship care among underserved breast cancer survivors (BCS) is sparse. This study aimed to explore facilitators of survivorship care among underserved BCS within the first five years following chemotherapy, radiation, or surgery for breast cancer. Methods In-depth interviews were conducted, using a semi-structured interview guide, with underserved BCS exploring survivorship care experiences. Content analysis of the verbatim transcripts was applied, and results were summarized according to themes related to facilitators of breast cancer survivorship care. Results Interviews were conducted with 25 BCS. Eight main themes were identified: Coordination of care; positive perceptions of health care providers; communication between patient and health care providers; financial and insurance facilitators; information, classes, and programs provided; assistance provided by organizations and health care professionals; transportation facilitators; and job flexibility. Conclusions This study provides a comprehensive look at facilitators of survivorship care among underserved BCS. BCS endorsed several facilitators of their survivorship care, mainly at the interpersonal, organizational, and societal level. Implications for Cancer Survivors This study adds to the research literature on catalysts of care among underserved BCS. Results from this study are currently being used to inform a patient navigation intervention to facilitate care among this population.

Background: In response to the ten recommendations of the Blue Ribbon Panel for the Cancer Moonshot, the National Cancer Institute (NCI) Center to Reduce Cancer Health Disparities (CRCHD) introduced the national Screen to Save (S2S): NCI Colorectal Cancer Outreach and Screening Initiative. The S2S intervention aimed to increase colorectal cancer (CRC) screening rates among racially and ethnically diverse communities nationwide. To carry out this initiative, the CRCHD called upon NCI-funded Community Health Educators (CHEs) from the Partnerships to Advance Cancer Health Equity (PACHE) to deliver culturally tailored, evidence-based CRC education and screening resources within their respective catchment communities. Under the San Diego State University/UC San Diego Moores Cancer Center Partnership, the Juntos Contra el Cáncer team and the CHE identified specific Latino communities in San Diego County, California to which the S2S initiative was delivered. Objectives: The aims were to assess the feasibility of implementing the S2S program and to evaluate the preliminary impact of the S2S program on knowledge of CRC screening. It was hypothesized that CRC knowledge would increase significantly after implementation of the intervention. Methods: The S2S educational materials were culturally tailored for Latinos and offered in both English and Spanish. The sample included 42 Latinos (men=9 and women=33) ages 50-75 who participated in a 15-minute one-on-one or group educational intervention. Participants were recruited from community settings such as libraries, senior centers, and health fairs. The educational intervention strategies included a presentation using either a flipchart or a PowerPoint slideshow, both of which delivered information on CRC, risk factors, and screening methods. All enrolled participants were administered a consent form and a pretest before the intervention. Following the educational components, participants completed a post-test assessing knowledge and a qualitative survey evaluating the program, and received a $15 gift card as well as educational materials on colorectal cancer from the American Cancer Society. Analysis: A paired-samples t-test was conducted to evaluate the preliminary influence of the intervention on participants' scores on CRC knowledge measured by 14-item questionnaire in a pretest/post-test intervention study. Results: The results showed a statistically significant increase in CRC knowledge from the pretest [M=11.74 (3.04)] to the post-test [M=14.10 (3.40), t (41) = -6.29, p < .0005 (two-tailed)]. The results of the qualitative survey indicated that most participants expressed satisfaction with the S2S program and found the visuals and recommendations to be helpful. Overall, participants reported having learned about CRC, polyps, and screening methods. Some participants provided recommendations to improve the program, such as: (1) increasing awareness of CRC through other communication channels, (2) allocating more time to provide the health education, and (3) simplifying medical terminology. One participant reported that providing this information in a public setting was inconvenient due to the nature of the topic. Discussion: The present study's results suggest that the S2S program showed preliminary efficacy in increasing CRC knowledge among participants. Also, our findings suggest that the S2S program was feasible to implement in a community setting. Based on participants' feedback, it is recommended that the terminology used in the S2S program be simplified. Research suggests that increasing CRC knowledge and awareness is a crucial component to increasing CRC screening rates among racially and ethnically diverse communities. Future research should examine the impact of the S2S program on the screening practices of participants who receive program using a rigorous study design. Citation Format: Carolina López De la Torre, Sumayah Nuhaily, Jesse Dubin, Jessica Haughton, Elva M. Arredondo. Feasibility and preliminary impact of the Screen to Save Initiative on colorectal cancer screening knowledge [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C65.