Abstract 4016: Understanding clinician level barriers and facilitators to managing cancer survivors with chronic conditions at community health centers

Abstract Background: Primary care clinicians (PCCs) play a critical role in delivering comprehensive care to patients with chronic conditions, including cancer survivors. Community health centers (CHCs) serve as primary healthcare facilities, providing accessible and affordable care to underserved and vulnerable populations, including cancer survivors. Despite the essential role of CHCs, significant gaps remain in knowledge and research training regarding survivorship care within these settings. Given the rising population of cancer survivors in the United States, addressing these gaps is crucial to ensuring high-quality survivorship care. This study aimed to assess the barriers and facilitators PCCs encounter when providing survivorship care to cancer survivors with chronic conditions at CHCs. Methods: Qualitative in-depth interviews were conducted with PCCs from two healthcare systems, encompassing four urban CHCs in Texas during two phases. The research team developed semi-structured interview guides to explore barriers and facilitators in survivorship care. Interviews were conducted via phone or WebEX, a virtual platform, and were audio-recorded and transcribed verbatim by a certified transcription service. A team member reviewed the transcripts to ensure accuracy. Data were analyzed using an adapted immersion and crystallization approach, guided by the Chronic Care Model (CCM), to identify key themes related to survivorship care. Results: Ten PCCs participated in the study. Qualitative analysis identified five key barriers to delivering high-quality survivorship care: (1) role ambiguity between PCCs and specialists, (2) inaccessibility of survivorship clinical guidelines, (3) limited communication between PCCs and oncologists, (4) inconsistent documentation of medical history, and (5) patient socioeconomic challenges, including financial difficulties. Pragmatic solutions were proposed to mitigate these barriers, and a patient-centered approach emerged as a key facilitator in improving care delivery. Conclusions: These findings highlight valuable opportunities to enhance survivorship care within CHCs by addressing identified barriers and leveraging facilitators to foster patient-centered, high-quality care for underserved cancer survivors. The utilization of the CCM framework provided deeper insights into the specific gaps and challenges PCCs face in CHCs. Citation Format: Maram Museitif, Bijal Balasubramanian, Gretchen H. Walton, Laura Aubree Shay, Hilary Ma, Simon Lee. Understanding clinician level barriers and facilitators to managing cancer survivors with chronic conditions at community health centers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4016.