The Immigrant Cancer Portal Project is a program funded by the New York Community Trust to provide assistance to largely low-income, immigrant, and minority patients in 11 New York City hospital cancer clinics where treatment appointment keeping had been noted to be problematic. Most patients at these sites prefer to communicate in languages other than English, most often in Chinese and Spanish. This study is a nested cohort of all Chinese patients participating in the Portal Project between 2008 and 2009, their areas of needed assistance, and appointment keeping for cancer treatment.
Central to the Portal intervention is the trained, bilingual access facilitator who assesses needs and coordinates an individualized set of transdisciplinary services for each patient. Access facilitators operate in a breadth of areas, ranging from assessing and prioritizing needs; providing assistance with intake procedures to patients with low literacy and limited English proficiency; providing financial support, i.e., assisting with obtaining reimbursements and funding that may go towards doctor’s visits, radiation therapy, chemotherapy, radiological scans, pain medications, medical supplies, and home care; addressing food insecurity; assisting with transportation; assisting with rent support and housing conditions; assisting with accessing programs that provide free medications; assisting with insurance and obtaining mandated hospital fee reductions; accessing free or low-cost legal resources for immigration, eviction, wills, and work discrimination concerns; assisting with referrals to social services, counseling, and cancer support groups; assisting with accessing child care for appointments; accessing and working with interpreters; and helping patients improve patient–provider communication.
Eligible patients in the nested cohort included all English, Mandarin, Cantonese, and Fukianese-speaking immigrant adults with Chinese ancestry with a diagnosis of cancer who were undergoing treatment. Facilitators approached all patients in the waiting area prior to their medical visits. As part of the patients’ care, access facilitators conducted a needs assessment survey in the patient’s preferred language. The needs assessment included sociodemographic indicators; need for socioeconomic assistance (financial support, food, transportation, rent, medications, insurance issues, legal issues, social and psychosocial services, and child care); reports of missed oncology, radiation therapy, and/or chemotherapy appointments and the reason(s) why. Once patient needs were identified, facilitators provided immediate and ongoing assistance in those areas.
We performed descriptive statistics to examine sociodemographic characteristics, areas of needed assistance, and missed appointments.