Addressing unmet social needs using a health navigator for cancer patients at a major metropolitan hospital: a mixed-methods feasibility and acceptability study

The Health Navigator (HN) intervention will take place in the Northern Cancer Centre at the Lyell McEwin Hospital (LMH). Participants will be screened for unmet health-related social needs (food and housing instability, financial insecurity, social isolation etc) in the Cancer Centre using a validated screening tool for unmet social needs developed in collaboration with LMH staff and patients: the Unmet Needs Screening Tool (UNST). Participants with unmet needs will be referred, with their consent, to a HN to help connect them community resources that may be able to help with their unmet needs. The HN is a community worker with experience in the community services sector and an understanding of hospital workflow and clinical trials, with experience working with highly vulnerable and disadvantaged populations. To perform the HN role, the HN will undergo 4 days of training in understanding cancer and cancer treatment, case management principles, familiarisation with community organisations and culturally safe methods of providing case management. Participants have the choice to meet with the HN in the Cancer Centre or from their home via a Zoom meeting, telephone call or other electronic communication platforms at a time that is convenient for them. During this initial meeting, the HN will develop a collaborative plan with the participant to prioritise their unmet needs, which should take approximately 60 minutes, and advocate for them in setting up appointments and referrals with appropriate community services. For example, if a participant is struggling with finances and budgeting, the HN will provide a warm handover to Anglicare financial planning services, offering them assistance by booking the appointment for them, filling out paperwork with them, ensuring they have all the necessary information, or attending the appointment with them if they require further support. The HN will then organise a follow-up time with the participant, either in-person or remotely, to discuss whether their referral was useful, if they need further help/clarification or want to try another service. This follow-up is scheduled to occur once per month at the participant's convenience, but they are also able to contact the HN on an ad hoc basis (during their work hours) whenever they require. This follow-up will occur once per month for a six month period. To monitor adherence, the study database contains multiple checkpoints which the HN must report to. The HN will also be supervised by a qualified Social Worker to ensure they are following case management guidelines.