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

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.