A Health Navigator intervention to identify and respond to the health-related social needs of an Australian population living with cancer: a mixed-methods feasibility study

BACKGROUND: People living with cancer often require intensive support throughout their cancer journey. While cancer coordination services provide support accessing cancer care and understanding treatment options, many patients experience considerable health-related social needs (e.g. unemployment, financial insecurity) that impact their health and wellbeing. Health Navigator interventions address patients' health-related social needs through ongoing support to access relevant support organisations in the community. This study assessed the feasibility and acceptability of a Health Navigator intervention to address the health-related social needs of a population living with cancer attending an outpatient oncology clinic in Australia. METHODS: A mixed-methods study design was employed to explore the feasibility and acceptability of a Health Navigator intervention in an outpatient oncology treatment clinic. Participants were patients attending the outpatient clinic and ≥ 18 years old. Eligible participants were screened for health-related social needs using the Unmet Needs Screening Tool. Participants with health-related social needs who requested assistance with their needs were referred to a Health Navigator who co-designed referral plans and provided follow-up in the community for six months. Participants without needs were the comparison group. Primary outcomes were intervention feasibility and acceptability, measured using process measures: (1) recruitment rate, (2) intervention uptake and (3) intervention completion. Focus groups with participants, participants' carers and clinicians working in the oncology clinic, were used to explore intervention acceptability. Secondary outcomes included reported changes in participants' health-related social needs and other patient-reported outcome measures. RESULTS: The rate of recruitment did not meet the pre-defined 80% threshold, although intervention uptake (100%, n = 55/55) and completion (77%, n = 36/47) suggest that the intervention may be feasible for participants who reported health-related social needs. Participants, their carers and clinicians reported the intervention was acceptable. Lack of support was the most commonly reported health-related social need (85%, n = 47/55) and the prevalence of all health-related social needs decreased post-intervention. Health Navigators experienced a greater than expected caseload complexity, which limited availability to support some participants. CONCLUSIONS: The Health Navigator intervention may be feasible and acceptable to participants who reported health-related social needs, and reduced participants' health-related social needs. Further research is required to refine intervention procedures, including exploring optimum caseload numbers for Health Navigators and strategies to maintain Health Navigator wellbeing. TRIAL REGISTRATION: This trial was prospectively registered in the Australian New Zealand Clinical Trials Registry on 8th June 2022 (clinical trial number: ACTRN12622000802707p) (URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384126&isReview=true).