Strengthening preventive cancer screening in Northern Ontario, Canada: Structural supports and systemic barriers with the all nations health partners Ontario health team.

Objective: Northern Ontario populations experience significant health disparities, particularly in rural and remote areas. This study examined the supports and barriers to preventive health care services, specifically cancer screening, in the Kenora, Ontario, Canada, All Nations Health Partners Ontario Health Team (ANHP OHT). Methods: Participants included project team members, administrators, program leads, and clinicians from organizations involved in the planning, delivery, and reporting of cancer screening, recruited through purposive and snowball sampling. Data were collected in Kenora, ON, Canada, between July & August 2023. Interviews were transcribed and thematically coded. Results: Four key themes emerged: (1) healthcare data integration, emphasizing governance, trust, and improved Electronic Medical Record (EMR) interoperability; (2) enhanced care coordination to streamline preventive services and optimize resource use; (3) infrastructure, funding, and incentive challenges across multiple regulatory bodies affecting screening delivery; and (4) the need for contextualized, culturally safe cancer screening incorporating trauma-informed approaches. Conclusions: We developed contextualized recommendations to strengthen the evidence base for high-quality primary care preventive service delivery. This work identifies systemic barriers to cancer screening, offers practical recommendations for improvement, and advances understanding of preventive service delivery in a geographically distinct region.