PO.CL04.02 · 临床研究
太平洋地区夏威夷原住民/太平洋岛民退伍军人的资源限制与癌症照护可及性
Resource limitations and cancer care access for Native Hawaiian/Pacific Islander veterans in the Pacific region
该海报暂无可下载的资料
AACR 官方页面
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
夏威夷原住民/太平洋岛民(NHPI)人群可能经历较差的癌症相关结局，这受到诸如贫困率较高和在全国数据中代表性不足等社会决定因素的影响。NHPI退伍军人因与军事相关的暴露以及需要在不同的退伍军人健康管理局(VHA)照护途径中进行导航而面临更高的脆弱性，这增加了平民所不会经历的复杂性。夏威夷和美国附属太平洋岛屿(USAPI)各地肿瘤服务有限，加之地理隔离和劳动力短缺，增加了诊断和治疗延迟的风险。本项来自PaCiPIC退伍军人研究的定性分析，考察了改善居住在USAPI的NHPI退伍军人癌症照护可及性的关键挑战和机遇。我们对居住在退伍军人事务部Sierra Pacific Network 21范围内的NHPI退伍军人进行了半结构式访谈(截至目前n = 8，目标为15-20)。访谈被录音、转录、去标识化，并在ATLAS.ti中进行主题分析。编码由一个具备临床、心理和定性研究专业知识的多学科团队通过团队共识迭代形成，以Fortney的照护可及性框架为指导。退伍军人描述了在社区照护转诊方面的挑战，包括延迟和对后续随访的不确定性。许多人认为岛上的资源仍然有限，指出尽管进行了倡导，但服务或可及性随时间推移几乎没有明显改善。为诊断和治疗进行长途旅行，因机票、住宿和照护者支持而造成经济和后勤压力，除非退伍军人符合特定的服务相关标准。远程肿瘤学被视为一种可能可接受的替代方案，可减轻随访照护的旅行负担，尽管退伍军人强调核心方面——实验室检查、影像学和操作——需要面对面就诊。家庭和社区网络成为必不可少的支持系统，提供交通、协调和情感关怀，弥合缺口。初步研究结果凸显资源限制是太平洋地区NHPI退伍军人癌症照护的关键岛屿性障碍，这与我们此前发表著作中的临床医生观点一致。基于这些见解，我们将识别可行的策略来应对系统层面的制约，并为该地区服务的实施提供依据。
查看英文原文 English abstract
Native Hawaiian/Pacific Islander (NHPI) populations may experience poorer cancer-related outcomes, shaped by social determinants such as higher poverty rates and underrepresentation in national data. NHPI Veterans face heightened vulnerability due to military-related exposures and the need to navigate distinct Veterans Health Administration (VHA) pathways for care, adding complexity not experienced by civilians. Limited oncology services across Hawai‘i and the U.S.-Affiliated Pacific Islands (USAPI), compounded by geographic isolation and workforce shortages, increase risk for delayed diagnosis and treatment. This qualitative analysis from the PaCiPIC Veterans Study examines key challenges and opportunities to improve access to cancer care among NHPI Veterans residing in the USAPI. Semi-structured interviews were conducted with NHPI Veterans residing within the VA Sierra Pacific Network 21 (n = 8 to date, target = 15-20). Interviews were recorded, transcribed, de-identified, and analyzed thematically in ATLAS.ti. Codes were iteratively developed through team consensus by a multidisciplinary team with clinical, psychological, and qualitative research expertise, guided by Fortney's Access to Care Framework. Veterans described challenges with community care referrals, including delays and uncertainty over follow-up. Many felt resources on the islands remain limited, noting few, if any, noticeable improvements in services or access over time despite advocacy. Long-distance travel for diagnostics and treatment created financial and logistical strain from airfare, lodging, and caregiver support unless Veterans met specified service-related criteria. Teleoncology was viewed as a potential acceptable alternative to reduce travel burden for follow-up care, though Veterans emphasized core aspects-laboratory testing, imaging, and procedures-required in-person encounters. Family and community networks emerged as essential support systems, providing transportation, coordination, and emotional care bridging gaps. Preliminary findings highlight resource limitations as key insular barriers to cancer care for NHPI Veterans in the Pacific, consistent with clinician perspectives from our previously published works. Building on these insights, we will identify feasible strategies to address system-level constraints and inform implementation of services in the region.
利益披露 Disclosure
T. Helenihi, None..
A. Jain, None..
C. Phibbs, None..
R. Trivedi, None..
N. Singh, None.