Abstract
Fragmentation of healthcare in Latin America (including Ecuador) causes delays in cancer diagnosis, especially among vulnerable populations. The context of this study was the EU-funded EquityCancer-LA project, and we aimed to describe the co-design process and adaptation of an integrated care intervention to reduce cancer diagnosis delays in Quito. These study's results target the population of Quito, Ecuador, aiming to reduce cancer diagnosis delays. It involves healthcare professionals improving skills, care coordination, and patient information. This project is of interest to public health researchers, stakeholders, health managers, integrated care experts, patients, and physicians, particularly for scaling up integrated care in Latin America. This cancer diagnosis -integarted care- intervention in Quito involved an inter-level professionals’ group of healthcare workers, including family physicians, specialists, social workers, and health managers, as well as researchers. They conducted eight participatory sessions to co-design an integarted care intervantion based, mainly, in professional capacities, care coordination, and patient information. Continuous engagement with Ministry of Health authorities ensured support and regular updates throughout the project. The initiative, nested in the EquityCancer-LA project, adapted an integrated care intervention to reduce cancer diagnosis delays in Quito. An inter-level professionals' group of healthcare workers and researchers conducted eight participatory sessions focusing on professional capacities, care coordination, and patient information. The intervention, supported by the Ministry of Public Health, will be implemented over 7 months. The process identified and addressed obstacles in cancer diagnosis in Quito, leading to adapted interventions. Thirty-two healthcare professionals collaboratively co-designed the intervention, focusing on improving care coordination, patient information, and professional skills. Implementation and continuous evaluation over 7 months aim to reduce diagnosis delays and improve outcomes. It will be evaluated (processes, outputs, and outcomes) posteriorly. We are convinced that international audiences can learn that using Participatory-Action Research (PAR), in co-design process, effectively adapts health interventions to local contexts. Engaging diverse healthcare workers and stakeholders ensures relevant and feasible solutions. This approach can be replicated to improve care coordination and patient outcomes globally, emphasizing the support from health authorities. The next steps in the development of this integrated care intervention, which has been adapted and co-designed by healthcare professionals, decision-makers, and stakeholders, will be its deployment in one of the two networks in the city of Quito. This evaluation, conducted from both quantitative and qualitative perspectives, will provide authorities with a comprehensive proposal on how to adapt, implement, and evaluate the intervention, as well as its expected outcomes in terms of contextual efficacy, effectiveness, and satisfaction among patients and professionals involved. This will enable authorities to make informed decisions regarding the scaling up of this public health strategy in other urban contexts within Ecuador and LA region.