CLEAR-ACCESS: Barriers and facilitators to accessing symptom support among culturally and linguistically diverse cancer patients receiving treatment.

Abstract

e13520 Background: Patients from culturally and linguistically diverse (CALD) backgrounds experience inequities in cancer outcomes, partly due to barriers in accessing timely care for treatment-related side effects. Symptom support such as Symptom and Urgent Review Clinics and access to Clinical Nurse Consultant-led care provide early intervention and can reduce unplanned emergency department presentations and admissions, yet CALD patients are under-represented amongst service users. This study examined the barriers and facilitators influencing access to symptom support for CALD patients receiving systemic anti-cancer therapy. Methods: A qualitative study was conducted across two Australian cancer centres. Focus groups and semi-structured interviews were undertaken with CALD patients, caregivers and community representatives from Vietnamese, Mandarin and Greek-speaking backgrounds as well as healthcare professionals (HCPs). Data were collected in participants’ preferred language. Transcripts were analysed using inductive reflexive thematic analysis. Themes were mapped to Levesque et al.’s framework for patient-centred access to healthcare. Results: Thirty-five participants took part: patients (n = 20), caregivers (n = 4) and community representatives (n = 7) and HCPs (n = 4). Among patient, caregiver and community representatives, 26% (10/35) identified as Chinese, 14% (5/35) as Greek and 46% (16/35) as Vietnamese. The median age of patients, caregivers, community representatives and HCPs were 61 years (51-79), 58 years (51-65), 54 years (37-69) and 47 years (38-62) respectively. Four interrelated themes influenced access to and engagement with symptom support: (1) Availability of family facilitate access : relatives were central in contacting services but reliance on them created delays when they were unavailable or patients wished to avoid burdening them; (2) Limited awareness of available services and supports reflected the challenges of language-discordant, information-dense encounters with inconsistent interpreter access (3) Limited availability of accessible, in-language information impairs healthcare navigation and (4) Patient confidence in communication with HCPs shape engagement: trust and shared language with general practitioners supported symptom discussion, often positioning primary care as a preferred access point. Conclusions: Access to symptom support among CALD patients was shaped by the knowledge of the services and how understandable and reachable those services were as well as how confidently participants could engage with them. These insights directly inform ADVANCE-ACCESS, a co-design study across four Australian health services focused on developing interventions to improve access to symptom support services for CALD cancer patients.