The Cancer Community Health Resources and Needs Assessment (Cancer CHRNA) aimed to identify multilevel determinants for cancer prevention and disparities, and examine the role of racial discrimination on healthcare access and prevention behaviors in racial/ethnic and immigrant populations. This study evaluates the process of implementing the Cancer CHRNA.

Methods

Cancer CHRNA was implemented in community-settings in 9 languages-English, Arabic, Bangla, Chinese-Simplified/Traditional, Haitian-Creole, Korean, Spanish, Russian, Urdu. This study was a qualitative process evaluation, including 1)in-depth interviews among community health workers (CHWs) implementing with Chinese, Haitian-Creole, Korean, Russian communities (n=4); 2)group discussion among research team members (n=3); 3)analysis of field notes. Questions focused on survey development, community partnerships, recruitment, best practices/challenges at the clinical, community, and institutional level. Data was analyzed using deductive thematic analysis.

Results

Consistent findings at community and institutional levels included importance of building strong partnerships with community-based organizations to maintain trust among communities. Overall, recruitment was least effective in clinic settings. Recruitment at community events and third-places (e.g.,churches, local restaurants) was an effective and highly utilized approach. Future adaptations include increased stakeholder engagement in survey development, multi-step process to ensure translations are responsive to cultural meaning and intent of items, and use of culturally appropriate incentives.

Conclusions

Cancer CHRNA is the only needs assessment to our knowledge that assesses cancer related social and behavioral priorities in nine languages. The novel implications of best practices, lessons learned and future adaptations from this process evaluation provide a model for future large-scale needs assessments across immigrant and underrepresented populations.