Abstract C153: Findings from the breast and cervical navigation in communities for equity (BC-NiCE) study: A community health worker/patient navigator model to decrease screening disparities

Abstract Background: Black women in Alabama have higher breast and cervical cancer mortality rates than white women despite having higher screening rates than their counterparts. Among the potential systemic factors underlying these disparities is the dwindling health system infrastructure. Since 2010, at least 14 hospitals across Alabama have closed, leading to limitations in access to timely medical care. However, the UAB O’Neal Comprehensive Cancer Center’s (OCCC) Office of Community Outreach & Engagement at the University of Alabama at Birmingham (UAB) has utilized its community health workers (CHWs) and patient navigators to fill this gap by linking women to timely cancer screening and treatment. To strengthen breast and cervical cancer screening (BCCS) uptake in Alabama, O’Neal partnered with the UAB Division of General Internal Medicine & Population Science investigators, the Black Women’s Health Imperative (BWHI), and local providers in Federally Qualified Health Centers (FQHCs) to form a community-academic partnership model as the “Breast and Cervical Navigation in Communities for Equity” (BC-NiCE) study. Methods: At community events, OCCC CHWs identified Black women not current on BCCS according to American Cancer Society guidelines and offered BCCS navigation. Additionally, patients were asked to participate in the BC-NiCE study to share experiences about their navigation. Those who provided consent were followed by a patient navigator. The navigator linked participants to FQHCs and UAB cancer services while identifying barriers/facilitators, mitigating barriers, and monitoring screening progress. Patients completed a pre-navigation survey and 3- and 6-months post-navigation interviews. Descriptive statistics were used to assess quantitative data on sociodemographic variables and navigation outcomes (e.g., screening) using SAS and SPSS. Thematic analysis was used to analyze qualitative data using NVivo 15. Results: 121 women (mean age = 55; 67% annual income <$50,000) participated; 118 were navigated to BCCS. BCCS referrals (N = 127) were provided to 110 patients ultimately seeking screening across 41 different providers. Surveys indicate above average stress from discrimination (mean=44.63). The most important barriers to screening at time of navigation included: Finances (28.8%), Lack of a Primary Care Provider (15.3%), and Copayment/Treatment cost (14.4%). 108 3-month and 44 6-month interviews (still awaiting screening) were completed. 38 patients reported completing cervical cancer screening and 55 reported completing breast cancer screening. In interviews, key themes related to barriers included accessibility, motivation for screening, healthcare communication, culture (such as historical mistrust of medicine), and negative personal health experiences. Implications/Future Directions: Partnerships where CHWs and patient navigators link patients to BCCS services to mitigate identified barriers to BCCS can increase access to care. Partnerships expansion may lend to timelier BCCS and reduction of cancer mortality for Black women. Citation Format: Lori Bateman, Catanya Stager, Samantha Whitfield, Maya T. Zeigler, Silvia Gisiger. Camata, Kimberly Braden, Carla Harrell, Ada G. Webb, Melissa Ryan, Elabrar Ebrahim, Erika Harris, Raegan W. Durant, DeBran Tarver, Ifeoma Udoh, Timiya S. Nolan. Findings from the breast and cervical navigation in communities for equity (BC-NiCE) study: A community health worker/patient navigator model to decrease screening disparities [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C153.