# Developing and Testing an Online Portal for Virtual Navigation for Asian American Patients With Cancer: Pilot Feasibility Study

## TL;DR

A multilingual online portal for virtual patient navigation was developed and tested for Asian American cancer patients, showing cultural appropriateness and improved emotional well-being.

## Contribution

A pilot feasibility study of a culturally tailored, multilingual virtual patient navigation portal for Asian American cancer patients.

## Key findings

- The program was deemed culturally appropriate by 94% of participants.
- Participants showed improved emotional well-being at 6 months compared to baseline.
- Most participants (74%) found navigator calls helpful and would recommend the program.

## Abstract

Asian American patients have reported unique needs and barriers related to cancer care. While patient navigation can facilitate care coordination and help address barriers to care, in-person navigation is time and resource intensive. Virtual patient navigation can extend the benefits of patient navigation to more patients, especially those with non-English language needs.

This study aimed to develop, implement, and test an online portal providing virtual navigation, including access to resources in English, Chinese, and Vietnamese, for Asian American patients with newly diagnosed colorectal, lung, or liver cancer.

The online portal was built on a secure, cloud-based platform. We recruited adults aged 21 years or older with a recent diagnosis of stage I-IV colorectal, lung, or liver cancer; who identified as Asian American; spoke English, Cantonese, Mandarin, or Vietnamese; and resided in the Greater San Francisco Bay Area, California. Participants were assigned a language-concordant navigator who assessed their needs and provided tailored resources and support over 6 months through the online portal. Participants completed baseline, 3-month, 6-month, and user experience surveys. We report descriptive statistics on sociodemographic characteristics, quality of life (Functional Assessment of Cancer Therapy–General [FACT-G]), and user experiences. We used generalized estimating equations (GEE) to analyze repeated measures of quality of life.

The online portal included (1) a public-facing landing page, (2) a navigator interface, and (3) a participant interface, which were all available in English, Chinese, and Vietnamese. Among 51 participants, 47 (92%) and 49 (96%) completed the 3- and 6-month surveys, respectively. The mean age was 58 (SD 13) years, with 37 (73%) men, 33 (65%) speaking English, and 20 (39%) having less than a college education. Twenty-six participants (51%) had colorectal cancer, 21 (41%) had lung cancer, and 4 (8%) had liver cancer. The average total FACT-G score was 73.0 (SD 17) at baseline, 73.2 (SD 17) at 3 months, and 75.1 (SD 19) at 6 months. In GEE models, participants reported an increase in emotional well-being at 6 months compared to baseline (coefficient 0.99, 95% CI 0.01‐1.97). Among the 47 participants who completed the user experience survey, some reported issues with registering and logging into the portal, but 44 (94%) reported that the program was culturally appropriate, 35 (74%) found calls from the navigators helpful, and 35 (74%) would recommend the program to others.

This multilingual virtual patient navigation program for Asian American patients with cancer was deemed culturally appropriate and helpful in our pilot study. Emotional well-being improved among users of the portal. Some participants reported technical challenges, but most were satisfied with the program. Language-concordant virtual patient navigation and online supportive care tools can extend the reach and benefits of patient navigation.