Feasibility of a combined surgery-focused lay navigation and enhanced recovery program (ERP) for gastrointestinal (GI) cancer.

259 Background: Lay navigation in cancer care improves patient outcomes and quality of life. Similarly, ERP interventions have shown to improve perioperative outcomes and reduce disparities. The combination of surgery-focused lay navigation and ERP intervention is yet to be explored, thus we aim to assess its feasibility in a GI cancer cohort. Methods: The ASCENDS study implemented a combined surgery-focused lay navigation and ERP intervention for colorectal, esophageal, and pancreatic services. Patients were ≥18 years, Black (rural or urban areas) or white (rural areas), with newly diagnosed cancer, and first-time surgical candidates. The surgical navigator followed patients from pre- to post-operative visits, and conducted knowledge assessments of ERP components at 7 critical time periods. Knowledge gaps were identified and addressed. A 35-question survey was administered after the postoperative visit to assess the intervention. Fisher Exact test was performed to compare Black vs. white patients’ knowledge and experience. Results: Of 27 patients, 96.3% completed all navigation touch points, and 80.8% completed survey evaluation. Mean age was 59.3 ± 13.57 years, 28.6% were female, 23.8% Black, 35% from rural areas, and 81% with colorectal cancer. On ERP knowledge assessments, most Black and white patients reported discussing ERP components with providers (p>0.05, Table 1) except for preoperative blood clot prevention medications. After navigation, most patients reported being “very confident” about: 1) feeling prepared for surgery (76.2%), 2) feeling ready to go home when discharged (57.1%), 3) understanding discharge instructions (81.0%), and 4) caring for themselves after surgery (57.1%) (p>0.05 for Black vs. white). More than half (52.3%) were “fairly/very confident” in understanding ERP, and 76.2% “strongly agreed” that interacting with the surgical navigator was worthy. Conclusions: Implementation of surgery-focused lay navigation and ERP was feasible, well received by Black and white GI cancer patients, and ensured ERP components were discussed. Future work will assess efficacy of the combined intervention. ERP components patients reported to the surgical navigator. ERP components Total (n=21), % Black (n=5), % White (n=16), % p-value Preoperative Completing bowel preparation 95.2 100.0 93.8 1.000 Receiving antibiotics 24 hours prior to surgery 90.5 100.0 87.5 1.000 Injection for pain control before surgery 61.9 40.0 68.8 0.263 Multimodal pain medications on surgery day 85.7 80.0 87.5 0.579 VTE chemoprophylaxis before surgery 38.1 0.0 50.0 0.036 Postoperative Early ambulation within 24 hours of surgery 95.2 80.0 100.0 0.238 Early drinking of fluids and food within 24 hours of surgery 95.2 100.0 93.8 1.000 Removing drains within 24 hours of surgery 95.2 80.0 100.0 0.238 Nausea and vomiting prevention medications after surgery 85.7 80.0 87.5 0.278