A Community-Engaged, Mixed-Methods Approach to Prioritizing Needs in a Statewide Assessment of Community Cancer Needs.

Introduction: Kentucky has the highest all-site cancer incidence and death rate in the US. In 2021, the University of Kentucky Markey Cancer Center convened a steering committee to conduct a statewide community cancer needs assessment (CNA). The goal of the final CNA phase was to gather community input on prioritizing Kentucky's cancer-related needs and ways to address them. Methods: In 2021, we recruited 162 people to participate in online concept mapping, a participatory mixed method, to explore connections and identify priority areas. Fifty-one community members and 111 organizational partners participated in survey-based activities to prioritize 80 items representing key CNA findings and discussion groups to explore key focus areas and strategies for Kentucky communities. Results: Concept maps display perceived similarity of the 80 items and a 6-cluster solution. High-priority focus areas included lung cancer screening, smoking, human papillomavirus (HPV) vaccination, and disparities driven by social determinants among rural, Appalachian, Black, and Hispanic residents. High-priority strategies to address needs included expanding health communication on risks, screening guidelines, and insurance benefits; patient navigation; accessible, culturally appropriate treatment information and self-efficacy in treatment decisions; access to care through financial assistance, mobile clinics, and at-home screening; and patient-provider trust and communication. Conclusion: Our findings indicate the utility of the concept mapping process to facilitate the prioritization of wide-ranging catchment area needs and ways to address them. Moving forward, the prioritized focus areas and strategies can inform Kentucky's new state cancer plan and future research to reduce the state's cancer burden and disparities.