Leads: Jagbir Kaur, Scott Beck

As part of a larger program of research being conducted by the Cancer Health Equity Collaborative, the purpose of this study is to (1) understand how oncology HCPs identify people affected by cancer who have lived/living experience of health and social inequities, and (2) understand what oncology HCPs do with that information. The findings will inform the design and implementation of equity-oriented service delivery at BC Cancer, the province's comprehensive cancer control program. 

Study Background & Rationale:

Half of all Canadians will be diagnosed with cancer in their lifetime, and one in four will die from their disease. However, cancer's impact varies across Canada, with disparities linked to social determinants of health, including socioeconomic, demographic, geographic, and structural factors —otherwise known as the Social Determinants of Health (SDoH). 

In cancer care, health and social inequities are unjust, avoidable differences in outcomes among groups 2-3. Those facing inequities are more likely to be diagnosed with preventable cancers, receive inadequate treatment, and suffer from insufficient pain management, often dying from curable cancers 4-5.

Research shows healthcare providers (HCPs) are aware of the impact of social determinants of health (SDoH) and support socioeconomic risk-screening tools. 6-10 One study found that understanding patients' social needs influences clinical decisions. One study even found that knowledge of patients' social needs influences clinical decision making. 11 However, outside of HCPs perspectives, little is known about how oncology HCPs identify patients facing health and social inequities. 

 

Methods:

 
This qualitative study uses interpretive description (ID) to generate experiential evidence on challenges faced by HCPs. 12-14. Semi-structured interviews will be conducted with HCPs from various professional backgrounds and cancer care settings across BC.   This study will include HCPs from various professions across six regional BC Cancer sites and the Community Oncology Network, including physicians (oncologists, general practitioners in oncology), nurses (RNs, NPs, RPNs, LPNs), allied health professionals (e.g., radiation therapists, pharmacists, counsellors, social workers, dietitians), and other clinical staff (e.g., unit clerks, health care assistants). 
 

Data Collection and Analysis:

  1. Data will be collected through 30-60 minute semi-structured interviews, in-person or via Zoom, with sociodemographic information gathered via a brief survey before the interview. Interviews will be recorded, transcribed, de-identified, and analyzed using NVivo™.
  2. Data collection and analysis will occur concurrently with input from all team members. Initially, open coding will identify patterns and diversities, followed by constant comparison to examine similarities and differences. Analytic codes will be grouped into broader categories, guiding sampling and topics for subsequent interviews.
  3. Building on equity-focused research by the Cancer Health Equity Collaborative at BC Cancer, this study will offer insights into practitioners' approaches to supportive cancer care for those facing inequities, with potential for future research to improve equity-oriented care across the cancer continuum. 

Knowledge Mobilization:

Following data analysis, an internal report will summarize key findings for the research team. The report will be shared with BC Cancer and CON staff via email, posted on the project webpage, and distributed through BC Cancer communications. The study may also be presented as part of the Nursing and Allied Health Research and Knowledge Translation department's equity program.

Findings will also be written as a manuscript for peer-reviewed publication. 

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