Integrating care of Latino cancer survivors into primary care – a community health center model

Cancer survivors have unique health care needs in addition to age-appropriate prevention and screening requirements and on-going care of non-cancer illnesses. As the number of cancer survivors increases, there is a need for appropriate models of care. An ideal model would re-integrate the cancer survivor into a primary care setting that has resident expertise in cancer survivorship, specialized services to address the medical and mental health needs associated with this transition, and effective communication with the cancer treatment institution. Disparities in cancer-related outcomes exist in all phases of cancer care, including screening, treatment, and survivor care. To the extent that survivor services exist, they are designed with the well-insured, well-educated, affluent patient in mind. Minority cancer survivors face particular challenges due to language, literacy, cultural and geographic barriers. Safety net providers rarely offer specialized care of any sort. Brookside Community Health Center serves first generation, Spanish speaking immigrants from Central and South America and the Caribbean. With funding provided by the Lance Armstrong Foundation, we have developed a model of care for Latino cancer survivors. The model was developed with the strong participation of cancer survivors among our patient population, and includes a nurse practitioner-run survivor clinic within the primary care unit, specialized mental health services, and electronic medical record enhancements to foster communication between primary care providers and oncologists and to generate electronic reminders for time-sensitive care. We will present qualitative data from key informant interviews and indicators of cancer survivor care from our first 9 months of operation.