Periodic Reporting for period 1 - CO-CAPTAIN (CANCER PREVENTION AMONG INDIVIDUALS WITH MENTAL ILL-HEALTH: CO-ADAPTING AND IMPLEMENTING PATIENT NAVIGATION FOR PRIMARY CANCER PREVENTION)
Période du rapport: 2023-06-01 au 2024-11-30
More than 80 million people in Europe live with mental ill-health, constituting a leading public health in Europe. Additionally, 4 million new cases of cancer are diagnosed every year, with cancer being the second most common cause of death. There is an overlap between these two burning public health issues, as people with mental-ill health report both higher incidence of cancer and experience higher levels of cancer mortality. This excess burden is linked to increased engaging in risky health behaviors, as well as experiencing significant barriers when accessing often highly fragmented health care systems. These barriers include discrimination and stigmatization of people living with mental-ill health as well as biases from healthcare professionals that is often operationalized as “diagnostic overshadowing” – a form of bias that leads healthcare professionals to ascribe somatic symptoms and complaints as mental health issues.
Timely and evidence-based preventive strategies, including optimizing healthcare pathways, service integration provide solutions to reduce the high cancer morbidity and mortality in disadvantageous populations, such as people with mental-ill health. The aim of the CO-CAPTAIN project is to co-create, define and implement an innovative solution based on the Patient Navigation Model, which is an evidence-based, patient-centred intervention supporting patient empowerment via removal of systemic barriers, provision of social support, improving health literacy and promoting timely access to primary cancer prevention. The CO-CAPTAIN project is based on implementation science frameworks and framed as a feasibility pilot intervention in four different European countries; Austria, Greece, Poland and Spain. Results of the intervention should be used to create a transformative new integrated care pathway for primary cancer prevention in an underserved population.
Timely and evidence-based preventive strategies, including optimizing healthcare pathways, service integration provide solutions to reduce the high cancer morbidity and mortality in disadvantageous populations, such as people with mental-ill health. The aim of the CO-CAPTAIN project is to co-create, define and implement an innovative solution based on the Patient Navigation Model, which is an evidence-based, patient-centred intervention supporting patient empowerment via removal of systemic barriers, provision of social support, improving health literacy and promoting timely access to primary cancer prevention. The CO-CAPTAIN project is based on implementation science frameworks and framed as a feasibility pilot intervention in four different European countries; Austria, Greece, Poland and Spain. Results of the intervention should be used to create a transformative new integrated care pathway for primary cancer prevention in an underserved population.
For the first reporting period the consortium focused on an analysis of barriers and facilitators to cancer prevention and general access to somatic health services of people experiencing mental-ill health, as well as the role of diagnostic overshadowing. As part of activities in workpackage 2, a total of 81 participants were interviewed covering, people with mental-ill health, health and social care providers, representatives of patient organizations as well as managers of health care institutions. Following a thematic analysis five categories arose from the analysis. After the mapping of facilitators and barriers, we conducted iterative workshops with same groups of stakeholders in order to define the CO-CAPTAIN model and to define services and activities that should be covered in each pilot site. These workshops included 50 participants across 4 piloting countries. Following a deductive thematic analysis based on the DeGroff Model of patient navigation, the overarching definition of the CO-CAPTAIN model was defined.
As of July 2024 the pilot implementation started and is currently ongoing. There were differences in the beginning of the pilot implementation across different pilot countries, with some experiencing considerable delays. Until the end of RP1 we have informed 570 people with mental ill-health about the project and its aims and the benfits of participation and provided information on cancer prevention activities regardless of their participation in the study. However, only 134 people so far agreed to participate in the formal analysis and consented to participate in the study. The recruitment and implementation of the intervention continues, with monitoring of the process by work package 3 and constant reflection on potential strategies to improve the outreach and increase the recruitment. These tasks will continue in the second reporting period and are scheduled to end in October 2025.
As of July 2024 the pilot implementation started and is currently ongoing. There were differences in the beginning of the pilot implementation across different pilot countries, with some experiencing considerable delays. Until the end of RP1 we have informed 570 people with mental ill-health about the project and its aims and the benfits of participation and provided information on cancer prevention activities regardless of their participation in the study. However, only 134 people so far agreed to participate in the formal analysis and consented to participate in the study. The recruitment and implementation of the intervention continues, with monitoring of the process by work package 3 and constant reflection on potential strategies to improve the outreach and increase the recruitment. These tasks will continue in the second reporting period and are scheduled to end in October 2025.
As mentioned above a total of 570 people have been informed of the study and on the importance of cancer prevention with 134 being included as of November 2024. As part of the project activities the previously developed and tested CIDMA platform (previously recognized as a key innovation https://innovation-radar.ec.europa.eu/innovation/58991(s’ouvre dans une nouvelle fenêtre)) was specifically adjusted for CO-CAPTAIN project and intervention. Further steps have been made to improve CIDMA`s usability. The Consortium continues with implementation of the intervention, active recruitment and further development of innovative solutions towards RP2.