Cancer Prevention and Screening for People Experiencing Homelessness: Co-Designing the Health Navigator Model

TL;DR

Researchers developed a model called Health Navigator to help homeless people access cancer prevention services through a collaborative approach involving health professionals and the homeless community.

Contribution

The Health Navigator Model is a co-designed, person-centered intervention aimed at improving cancer prevention for people experiencing homelessness.

Findings

The Health Navigator Model was co-developed with input from homeless individuals and healthcare professionals across four countries.

Thematic analysis revealed the need for health navigators to coordinate care and raise cancer awareness among homeless populations.

Training and supervision of health navigators were identified as essential for the model's success.

Abstract

People experiencing homelessness (PEH) face major barriers to accessing healthcare, including cancer preventive services, which results in increased cancer morbidity and mortality. However, tailored integrated care interventions addressing these disparities are scarce.

Using a qualitative, participatory approach, seven focus group discussions were conducted with 15 PEH and 41 health and social care professionals in Austria, Greece, Spain, and the UK. Data were thematically analysed using a framework based on ten core components of navigation interventions.

Collaborative discussions led to a consensus on the Health Navigator Model (HNM), designed to improve cancer prevention for PEH. This model introduces “health navigators” from health and social care backgrounds to identify health needs, raise cancer awareness, coordinate healthcare access, and provide practical support. Thematic analysis ensured consistency across countries, shaping a person-centred approach. Comprehensive training and supervision were identified as critical for the effectiveness of the HNM.

The co-design approach allowed PEH and professionals to actively shape the intervention, addressing gaps in cancer prevention. The HNM offers a structured, internationally consistent model that could bridge access gaps in cancer care for PEH. Further research using implementation science frameworks is needed to evaluate its effectiveness in real-world settings.