Validation of navigator-assisted hypofractionation (NAVAH) program surveys in African-American prostate cancer patients.

Abstract

313 Background: Prostate cancer is a leading cause of malignancy and death in men. African-Americans have the highest overall cancer death rate and shortest survival time of any racial or ethnic group in the United States, with African-American prostate cancer patients having a morality rate 80% higher than White patients. The disparities in access to radiation therapy (RT), mortality rates, and treatment outcomes among African-American prostate cancer patients compared to other populations highlight the urgent need for targeted interventions. The Navigator-Assisted Hypofractionation (NAVAH) program, with its innovative patient navigation approach and culturally sensitive survey, aims to better identify the specific barriers faced by African-American patients with prostate cancer. This study is a report of the NAVAH program experience piloting a culturally sensitive survey in African -American prostate cancer patients. Methods: African-American patients with established prostate cancer having seen a Radiation Oncologist and consented to receive RT were recruited to participate in our ongoing Phase I trial (clinicaltrials.gov, NCT05978232); those enrolling on trial were administered surveys prior to receipt of RT. Survey information was assessed by topic category and survey responses were combined into a representative score for each category (outstanding, excellent, good, average, below average). Survey categories include availability (access to a medical center, coordinating care, and overall quality of care), accessibility (transportation, distance to care, and healthcare literacy), affordability (financial considerations, employment, and level of education), accommodation (access to internet, navigating transportation), acceptability (comfort and prejudice among interactions with the system), and cancer screening/cancer treatment. Results: Mean scores noted good availability (32 responses), excellent accessibility (20 responses), excellent affordability (22 responses), excellent accommodation (18 responses), average acceptability (44 responses), and average cancer screening/cancer treatment (40 responses). Patients noted neutral to positive interactions with doctors and nurses, but distrust of following the advice given to them at hospitals, and that the time interval from their first abnormal test to being informed of a cancer diagnosis was too long. Conclusions: Our findings indicate that this novel survey design is feasible in the African-American prostate cancer population. As more patients enroll in our ongoing Phase I trial, implementation of this survey will provide more definitive and comprehensive answers regarding additional topics, including financial challenges during treatment, access to accommodations, and perception of treatment during cancer care.