ASPO Abstracts
Community-partnered, multi-method assessment of determinants of cancer screening in immigrant communities in Brooklyn, New York
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose. We engaged community representatives from two neighborhoods in New York City (NYC) to understand structural determinants of cancer screening access and to inform neighborhood-specific multilevel strategies to increase cancer screening uptake among immigrant communities in NYC. Methods. Guided by our Neighborhood Action Councils (NACs), made up of local community organizations, we conducted multi-methods formative assessments to identify structural determinants of cancer screening. Our quantitative community survey assessed cancer risk and social determinants of health with an optional structural racism module, translated into 9 languages to reach understudied populations; we conducted descriptive statistics. Our qualitative assessment consisted of in-language semi-structured interviews with key informants and focus groups with community members (English, Spanish, Haitian Creole, Mandarin, Cantonese); we used inductive content analysis. Results. We administered the survey in place-based settings with 2,581 respondents (61.9% female; 42.9% Asian; mean age of 44.9 years [SD 17.9]) and completed interviews with 12 key informants and 8 focus groups with 47 community members. Survey findings indicate cancer screening adherence was lower than Healthy People 2030 goals and NYC screening rates (57.4% for colorectal cancer, 51.1% for breast cancer, 57.2% for cervical cancer). Recurrent qualitative themes included poor access to healthcare due to lack of insurance, shortage of culturally competent care, and difficulty navigating the health system. Participants also reported high stress levels due to financial instability, food insecurity, documentation status, and an increased cost of living. Conclusion. Taken together, our quantitative and qualitative findings clarified health priorities in each neighborhood; cancer risk was linked contextual factors restricting optimal health. We have shared findings with the NACs for co-interpretation of the data and will hold consensus-building activities to co-develop and implement responsive, neighborhood-specific multilevel strategies.
Keywords: Community engagement, cancer screening, cancer disparities, structural determinants