A Navigator-Delivered Model to Enhance Early Palliative Care Access for Women of Color with Advanced Breast Cancer (RP314)

Outcomes 1. Identify key barriers to palliative care access for women of color with advanced breast cancer.2. Discuss the importance of community linkage and trust in overcoming barriers to early palliatve care. Key Message This study highlights the development of a community-engaged, innovative care model to address and mitigate disparities in palliative care access and outcomes for women of color with advanced breast cancer. Importance Innovative model that addresses the impact of historical racism and marginalization on PC disparities are needed. ACCESS is an adapated model that embeds community-clinical linkage, patient-centricity, and socio-cultural sensitivity to improve PC access and cancer related distress among Black and Latina women with advanced breast cancer. Objective(s) Black and Latina women with advanced breast cancer (ABC) face significant challenges, including heightened distress, unaddressed symptoms, poor communication with healthcare providers, and barriers to palliative care (PC) access compared to non-Latina White women. To address these disparities, the objective of this study was to utilize community engagement and inter-disciplinary qualitative feedback to adapt ACCESS - a navigator led, early PC intervention to improve PC access and cancer-related distress among women of color with ABC. Scientific Methods Utilized We conducted one-on-one interviews with Black and Latina women with ABC (N=30), their care partners (N=10), and interdisciplinary providers (N=20). Participants were recruited from various urban healthcare settings. Using inductive coding and thematic analysis, transcripts were reviewed by an interdisciplinary team of investigators. Community scientists and advisory board members conducted member checking. Results We identified barriers to and facilitators of PC access. Barriers included inadequate communication among healthcare teams, PC stigma, health literacy challenges, and structural racism. Facilitators included time to develop trust, patient-patient referrals, support groups, trusted provider referrals, and community organizations addressing social determinants of health. These findings, along with participant input, informed the development of ACCESS, a culturally and linguistically concordant navigator-led intervention. ACCESS provides tailored psycho-educational discussions on PC and connects patients to community and clinical resources. Conclusion(s) These formative evaluations led to the development of ACCESS – a socio-culturally sensitive, community-based, early palliative care intervention, which will be evaluated for preliminary impact on PC utilization and cancer-related distress through an upcoming pilot randomized controlled trial. Impact This study contributes to the growing expansion of navigation to address disparities in early palliative care for historically minoritized patients with cancer. Keywords Qualitative and mixed methods research/Cultural diversity