Multilevel Determinants of Socioeconomic Disparities in Geographic Late-Stage Hepatocellular Carcinoma Hotspots

Primary outcomes

1. Social determinants of health

   Time frame: Up to 4 years

   Patient social determinants of health-related needs will be measured through a health questionnaire created for the study. The patient can respond yes or no to having a lack of transportation to and from appointments. The patient is given a scale of never true, sometimes true and often true for questions regarding food insecurity. The patient can indicate that they do or do not have housing today (or choose not to answer), and they can indicate how many times they moved in the last year as 0, 1, or 2+. For the remaining questions regarding housing, paying for utilities, paying for medications, unemployment, education and child or family care, the patient can respond yes, no or choose not to answer. Responses of yes indicate the patient has a need, and no indicates that they do not have a need.

2. Barriers to completion of the early detection pathway for liver cancer

   Time frame: Up to 4 years

   For assessment we will conduct semi-structured interviews with key stakeholders, including low-income patients with liver cancer, providers in an interconnected safety net system, and community leaders of hotspot neighborhoods.