Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Partnering with community: adaptation of a fear of cancer recurrence clinical pathway for Chinese-speaking people with cancer (126245)

Verena S Wu 1 , Carolyn Ee 2 3 , Ben Smith 1 , Eric Yeung 4 , Sim Yee (Cindy) Tan 5 , Ash Malalasekera 3 5 6 , Jing Liu 1 , Chad Han 7 , Heather Shepherd 8 9 , Joanne Shaw 10 , Laura Kirsten 11 , Jia (Jenny) Liu 12 13 , Suzanne Grant 2 3
  1. The Daffodil Centre, Faculty of Medicine and Health, The University of Sydney and Cancer Council NSW, Sydney, NSW, Australia
  2. NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
  3. Chris O’Brien Lifehouse Cancer Centre, Camperdown, NSW, Australia
  4. CanRevive Inc., Haymarket, NSW, Australia
  5. Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
  6. Bankstown Cancer Centre, Bankstown Hospital, Sydney, NSW, Australia
  7. Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
  8. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  9. Implementation Science Academy, Sydney Health Partners, Sydney, NSW, Australia
  10. Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia
  11. Nepean Cancer Services, Nepean Blue Mountains Local Health District, Kingswood, NSW, Australia
  12. The Kinghorn Cancer Centre, St Vincent’s Hospital, Sydney, NSW, Australia
  13. St Vincent’s Clinical School, UNSW Sydney, Darlinghurst, NSW, Australia

Background

Fear of cancer recurrence (FCR) is one of the most common unmet needs reported, affecting up to 67% of people from culturally and linguistically diverse backgrounds. In response to this need, a clinical pathway was developed to assist with FCR identification and management. Community engagement is vital to ensuring that patient perspectives are integrated in pathway adaptations. In partnership with CanRevive (Australia’s largest support organisation for Chinese-speaking families affected by cancer), the aim of this research was to identify culturally specific barriers and enablers to equitable implementation of the clinical pathway, and guide culturally appropriate adaptations.

Methods

CanRevive provided input on the translated study materials, cultural considerations surrounding FCR, and appropriate recruitment strategies. Further qualitative interviews and focus groups informed by the Health Equity Implementation Framework (HEIF) will be used to identify implementation determinants and factors contributing to health disparities, undertaken by a bilingual Chinese-background researcher. Multiple perspectives will be sought from Chinese-speaking survivors (n=10), caregivers (n=5), healthcare professionals (n=10), and community stakeholders (n=5). Sample size was guided by a previous qualitative study applying the HEIF. Directed content analysis will be performed on transcripts, coded independently by two researchers.

Impact on practice

Through community engagement, we will identify implementation determinants including: 1) culturally relevant factors of recipients (e.g., health literacy); 2) patient-provider interactions (e.g., communication of treatment options); 3) societal context (e.g., local availability of language resources). Identification of these determinants will inform adaptations required to aid equitable implementation in practice.

Discussion

Findings will contribute to improved supportive and survivorship care in a multicultural context that serves a high proportion of people from Chinese-speaking backgrounds. By integrating community engagement in the adaptation process, we will optimise implementation of a clinical pathway to identify and manage FCR in this priority population, and contribute to health service delivery improvements.