Converting curiosity into engagement: early experiences of Patient Navigation for cancer prevention in persons with mental health problems

Background: Persons with mental health problems (PwMHP) face inequalities in timely access and utilization of health care services. Addressing these inequities requires integrated, person-centred approaches that connect mental and physical health, strengthen continuity of care, and promote self-management and prevention. Within the EU-funded CO-CAPTAIN project (GA 101104784), an intervention based on the Patient Navigation (PN) Model was co-adapted for primary cancer prevention and is being implemented to help patients ‘navigate’ health services, overcome barriers and adopt healthier lifestyles. Evidence on PN for primary cancer prevention among PwMHP remains scarce, especially across multiple countries, leaving uncertainty about acceptability, mechanisms, and early perceived impact. This study explores PwMHP’s perceptions, expectations and early experiences of engagement with the PN-based intervention.

 

Approach: We conducted 28 semi-structured interviews with participants from the 288 PwMHP (9.72% of the sample) enrolled in a single-arm multi-centre interventional study across Austria, Greece, Poland and Spain. Interviews were performed 6-8 weeks after enrolment in the PN-based intervention targeting primary cancer prevention. Data were analysed thematically using an iterative and a combined inductive and deductive approach. All participants provided informed consent, and ethics approvals were obtained before study participation.

 

Results:Participants were predominantly female (67.86%), aged between 20 and 67 years (mean 44.53 years). They joined the CO-CAPTAIN intervention mainly to improve health and lifestyles and to prevent illness, yet curiosity emerged as a dominant initial motivator. Additional motivations included contributing to research, improving quality of life, and accessing practical and trustworthy health information.

Desired goals centred on modifiable risk factors (weight loss, smoking cessation, physical activity, diet) and self-care practices. Participants also aimed to establish new routines, gain knowledge about health and cancer, and engage in self-reflection on their behaviours. The PN was perceived as a trusted, culturally attuned, supportive guide, fostering a sense of continuity. Simple and regular communication via phone calls and text messages was considered optimal to maintain meaningful engagement. Early experiences often exceeded expectations particularly in terms of usefulness and empathy. Findings were consistent across countries, with only minor contextual variations in how trust was established.

 

Implications: Curiosity can serve as a key entry point to engage PwMHP in preventive care. Participants’ goals clustered around modifiable risk factors (smoking, physical activity, diet, etc.) and self-care, indicating the importance of brief, behaviour-specific goal-setting, tailored health information, and motivational support as central components of PN for this population. PN interventions should prioritise low-burden onboarding, brief, focused behaviour-change interactions, and continuous, relational communication to sustain engagement over time.

 

Given that early experiences of PwMHP within the PN-based intervention often exceeded expectations indicating potentially beneficial effects of the intervention at an early stage, health systems could embed PN within primary care and community mental health workflows, supported by standardised referral pathways and digital or remote communication. This could enhance accessibility and continuity of care. Future evaluations should assess changes in risk-factors, quality of life and assess cost-utility to inform scale-up and integration into health system practice.