Exploring cancer care needs for Latinx adults: a qualitative evaluation

Abstract

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.

Racial and Ethnic Disparities in Intensity of Care at the End of Life for Patients With Lung Cancer: A 13-Year Population-Based Study

“…44,45 In previous work, we identified multilevel barriers that preclude the delivery of high-quality EOL care. Structural deficiencies including clinician time limitations, 46 workforce shortages, 47,48 health literacy, language barriers, 49 and provider reluctance to discuss ACP because of patients' religious or cultural beliefs 50 exacerbate and contribute to these ongoing EOL care disparities. Increasingly, interventions are being deployed to improve equity in high-quality EOL care including education and community-based support to improve patient engagement in ACP and palliative care and hospice use.…”