Optimising cancer support for rural residents from a refugee background: changing models of access and care

BACKGROUND: Former refugee populations settling in regional Australia often experience low cancer literacy, delayed health-seeking and reduced engagement with cancer services. This study reports on the first phase of a community-led service improvement initiative designed to improve cancer literacy and access to culturally responsive cancer care for Karen and Afghan former refugees in Bendigo, Victoria. METHODS: A participatory, action-oriented service improvement approach was used, combining literature review, community consultation and health service engagement. Phase 1 involved a structured needs analysis including nine focus groups with Karen and Afghan community members (n = 128), alongside consultations with cancer service staff and health professionals. Findings informed the co-design of culturally responsive interventions and system-level improvements. A theory of change framework was developed to guide implementation and evaluation. RESULTS: The needs analysis identified limited cancer knowledge, fatalistic beliefs, mistrust of Western health systems and significant language and navigation barriers. System-level challenges included interpreter limitations, complex service pathways and limited culturally appropriate resources. In response, a cross-sectoral partnership implemented bicultural workforce development, in-language education programs, co-designed resources, navigation support and service system improvements. Early outcomes from 39 community education sessions (n = 412 participants) showed high reported uptake of knowledge (99%) and intention to use knowledge (92%). CONCLUSION: Early findings suggest that integrating community-led needs analysis with system-level service redesign shows promise for improving culturally responsive cancer care in regional settings. With former refugees increasingly settling in regional Australia, this place-based model provides a potential framework for strengthening equitable access to cancer prevention, screening and care for refugee populations.