Community-engaged adaptation of ACCESS: A navigator-led early palliative care intervention for Black and Latina women with advanced breast cancer Journal Article


Authors: Mazor, M.; Lin, J. J.; Smith, C.; Rosa, W. E.; Moorehead, D.; Boorstin, R. M.; Karpin, J.; Nelson, A.; Bakitas, M. A.; Miller, S.; Odom, J. N.
Article Title: Community-engaged adaptation of ACCESS: A navigator-led early palliative care intervention for Black and Latina women with advanced breast cancer
Abstract: Introduction: Disparities in early palliative care (PC) access for Black and Latina women with advanced breast cancer (ABC) persist. This study elicited qualitative feedback from patients with ABC and health professionals to adapt a community navigator-led early PC program called ACCESS to improve PC access and supportive care outcomes for Black and Latina women with ABC. Methods: This was a formative evaluation study using a community-engaged approach. Guided by a community advisory board, qualitative interviews were conducted with Black and Latina women with ABC (N = 20) and interdisciplinary health professionals and patient navigators (N = 20) to elicit feedback on the content, delivery, and format of ACCESS, a navigator-delivered early PC intervention to improve PC access and outcomes. Thematic analysis was conducted using inductive coding followed by deductive analysis using the Consolidated Framework for Implementation Research framework to guide intervention adaptation. Results: Findings indicate that ACCESS addresses the early PC needs of Black and Latina women with ABC, yet needs to embed flexibility per patient preferences. Additionally, PC should be introduced as supportive care to enhance acceptability. Navigators emphasized fostering awareness and access to resources, which are crucial for patients' well-being. Strong interdisciplinary relationships and care coordination are essential for embedding ACCESS. Recognizing patient individuality, addressing historical and cultural factors, and ensuring navigators are empathetic, well-trained, and culturally aligned with patients were highlighted as pivotal for the intervention's success. Conclusions: These findings will inform the adaptation of ACCESS for feasibility and preliminary efficacy testing. © 2025 American Cancer Society.
Keywords: adult; clinical article; aged; middle aged; major clinical study; chemotherapy; organization and management; palliative care; palliative therapy; psychology; breast neoplasms; patient care; health practitioner; breast tumor; physician; outpatient; communication skill; crystallization; qualitative research; therapy; african american; health care access; cultural factor; caucasian; geography; hispanic; supportive care; health care disparity; ethnology; thematic analysis; health services accessibility; social worker; patient navigation; healthcare disparities; white; procedures; urban area; adaptation; advanced breast cancer; humans; human; female; article; evaluation study; early palliative care; health equity; hispanic or latino; black or african american; community engaged intervention development; community navigation; community engaged adaptation
Journal Title: Cancer
Volume: 131
Issue: 4
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2025-02-15
Start Page: e35745
Language: English
DOI: 10.1002/cncr.35745
PUBMED: 39916311
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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  1. William   Rosa
    199 Rosa