Optimising cancer support for rural residents from a refugee background: changing models of access and care
Abbie Lockwood, Iain Butterworth, April Gerolemou, Eh Ta Mue Lue, Boe Htoo, Zahir Azimi, Lisa Carson, Kaye Graves, Cheryl Martin, Simon BakerBackground
Former refugee populations settling in regional Australia often experience low cancer literacy, delayed health-seeking and reduced engagement with cancer services. This study reports on the first phase of a community-led service improvement initiative designed to improve cancer literacy and access to culturally responsive cancer care for Karen and Afghan former refugees in Bendigo, Victoria.
Methods
A participatory, action-oriented service improvement approach was used, combining literature review, community consultation and health service engagement. Phase 1 involved a structured needs analysis including nine focus groups with Karen and Afghan community members (n = 128), alongside consultations with cancer service staff and health professionals. Findings informed the co-design of culturally responsive interventions and system-level improvements. A theory of change framework was developed to guide implementation and evaluation.
Results
The needs analysis identified limited cancer knowledge, fatalistic beliefs, mistrust of Western health systems and significant language and navigation barriers. System-level challenges included interpreter limitations, complex service pathways and limited culturally appropriate resources. In response, a cross-sectoral partnership implemented bicultural workforce development, in-language education programs, co-designed resources, navigation support and service system improvements. Early outcomes from 39 community education sessions (n = 412 participants) showed high reported uptake of knowledge (99%) and intention to use knowledge (92%).
Conclusion
Early findings suggest that integrating community-led needs analysis with system-level service redesign shows promise for improving culturally responsive cancer care in regional settings. With former refugees increasingly settling in regional Australia, this place-based model provides a potential framework for strengthening equitable access to cancer prevention, screening and care for refugee populations.