ASPO Abstracts
Understanding Access to Cancer Care amongst African Americans in East Winston: A Qualitative Approach Exploring Financial Barriers
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Study Purpose: To support the unique needs of African Americans (AAs) in our catchment area, we
collaborated with an independent research firm to conduct a needs assessment in the high-risk community
of East Winston known for its high poverty rates, low levels of education and health literacy, and a wide
chasm of social determinants compared to neighboring communities.
Methods: A protocol exploring knowledge, attitudes and beliefs around access to and perceptions of
cancer care was implemented by racially concordant staff. Focus groups (N=4) and key informant
interviews (N=14) were conducted with patients (N=24), caregivers (N=8), stakeholders (N=13), and
medical providers (N=4) who live in or serve residents of zip codes 27101, 27105, and 27107 (N=49
overall). Data were analyzed using NVivo 12 Plus and coded thematically. A second coder compared
transcripts. Double coding was repeated until agreement amongst coders reached > 90%.
Results: All patients, caregivers, and stakeholders were AA. Patients represented various points on the
cancer continuum, with 42% of patients reporting they were currently undergoing cancer treatment. Over
50% of patients and caregivers held less than a bachelor’s degree while over 50% of stakeholders held a
minimum of a bachelor’s degree. Over 75% of patients made less than $50k per year; 25% of caregivers
made a minimum of $50k per year, and 50% of stakeholders made a minimum of $50k per year. Findings
identified serval overarching themes related to financial barriers. Transportation, parking fees, insurance
status, and cost of cancer care are critical barriers to address in order to improve access to and ensure
timely, quality cancer care.
Conclusions: A community forum comprised of residents, stakeholders and providers was held to share
results and discuss potential solutions. As a result, the Wake Forest Baptist Comprehensive Cancer
Center recently added a population-specific patient navigator to assist AAs in removing barriers during
their cancer care. Alleviating fees associated with parking could reduce burden during the cancer
experience. Currently, clinical trial participants and radiation patients receive free parking for study visits
and treatment visits. Potential revisions to the parking policy are being explored.
Keywords: health disparities, financial barriers