Associate Professor, Vice Chair for Diversity, Equity and Inclusion, Department of Population Health Sciences, Duke University School of Medicine, Associate Research Professor, Duke Global
BIOGRAPHY
We Don't Care What You Know Until You Show Us That You Care': Characterizing Access to Healthcare among Black, Hispanic and White Cancer Survivors
Speaker
Abstract
Background: Healthcare access (HCA) encompasses five important dimensions: Affordability, Availability, Accessibility, Accommodation and Acceptability. Published studies of cancer typically focus on affordability, availability and accessibility, however accessibility and accommodation are typically less studied
Objectives: The goal of the current study is to conduct a qualitative study characterizing cancer survivor’s perceptions of HCA dimensions and to identify key facilitators or barriers to equitable healthcare among Black, Hispanic and White cancer survivors
Methods: We recruited a total of 32 cancer survivors into a qualitative study to understand their cancer treatment journey and experiences accessing healthcare. Over 60% of participants were Black, and 18% were Hispanic. Focus groups were moderated by an experienced facilitator, and data were coded and analyzed using NVivo 12 to identify key themes. Peer debriefing was done to evaluate the credibility and completeness of analysis
Results: Across the five HCA dimensions evaluated, acceptability emerged as the most important among cancer survivors. Acceptability was discussed in a variety of positive ways, such as the importance of bedside manner, patient-provider communication, and empathy. Accommodation—relating to ability to see provider when convenient, limited language barriers—were also identified as important. Faith and access to support groups were noted as facilitators of healthcare access, while role conflict was noted as a barrier
Conclusion: Access to healthcare is a top priority for cancer survivors, and impacts quality of initial treatment, supportive care and survival. Even when there were underlying concerns about affordability and accessibility, issues related to acceptability were key to survivor’s feeling a sense of psychological safety with their providers might be a specific, quantifiable and impactful measure of patient-centered, high-quality care
Learning Objectives:
1. Understand the 5 dimensions of healthcare access
2. Identify the salient healthcare access dimension for cancer survivors