{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T02:02:52Z","timestamp":1789351372416,"version":"build-2803163510"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon 2020 Research","award":["965351"],"award-info":[{"award-number":["965351"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cancer-related mortality among People Experiencing Homelessness (PEH) is twice as high as in the housed population, with one-third of deaths in this community linked to conditions preventable through timely healthcare. The Health Navigator Model (HNM) is a person-centred approach to improve healthcare access for PEH. This study assessed the feasibility of implementing the HNM across four European countries. A non-randomised, single-arm pilot study was conducted from June 2022 to December 2023 in Austria, Spain, Greece,\u00a0and the UK. Trained Health Navigators supported adult PEH\u2014excluding those with cancer diagnoses or cognitive impairments\u2014through tailored guidance, education,\u00a0and referrals. Feasibility indicators (demographics, recruitment, retention, engagement) were collected at baseline and follow-up points. Health Navigators\u2019 experiences were explored via qualitative interviews. Out of 1981 individuals approached, 652 PEH participated. The average age was 47.4\u2009years; 64.1% were male, 41.6% relied on state benefits and 62.4% had experienced homelessness for over a year. Nineteen Health Navigators (mean age 34.95\u2009years) were involved. Engagement included cancer education (N\u2009=\u2009494), health consultations (N\u2009=\u2009286), specialist referrals (N\u2009=\u2009212), and screening tests (N\u2009=\u2009169). Follow-up rates were 69% at the first time point and 42.5% at the second. Low cancer awareness, prioritisation of subsistence needs over health,\u00a0and system-level barriers were identified as challenges, while building trust with individuals and stakeholders emerged as facilitators. Health Navigators reported increased empathy, awareness of PEH\u2019s needs,\u00a0and confidence in empowering them as key benefits of their role. Training skilled Health Navigators, building trust and fostering strong inter-organisational collaborations are key to successfully implementing the HNM among PEH.<\/jats:p>","DOI":"10.1093\/eurpub\/ckag119","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:55:55Z","timestamp":1783598155000},"source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and implementation insights from implementing the health navigator model for cancer prevention among people experiencing homelessness across Europe"],"prefix":"10.1093","volume":"36","author":[{"given":"Katerina","family":"Belogianni","sequence":"first","affiliation":[{"name":"Institute of Preventive Medicine, Environmental and Occupational Health Prolepsis , Athens,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-8486","authenticated-orcid":false,"given":"Alejandro","family":"Gil-Salmer\u00f3n","sequence":"additional","affiliation":[{"name":"International Foundation for Integrated Care (IFIC) , Oxford,","place":["United Kingdom"]},{"name":"PhD Programme in Social Work, Faculty of Social Work, Complutense University of Madrid , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Fragner","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna , Vienna,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Gawronska","sequence":"additional","affiliation":[{"name":"Centre for Health, Performance and Wellbeing, Anglia Ruskin University , Cambridge,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Trenado Gomez","sequence":"additional","affiliation":[{"name":"Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP) , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Tabaki","sequence":"additional","affiliation":[{"name":"PRAKSIS\u2014Programs of Development, Social Support and Medical Cooperation , Athens,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Moudatsou","sequence":"additional","affiliation":[{"name":"PRAKSIS\u2014Programs of Development, Social Support and Medical Cooperation , Athens,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-9833","authenticated-orcid":false,"given":"Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre for Health, Performance and Wellbeing, Anglia Ruskin University , Cambridge,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Alhambra-Borras","sequence":"additional","affiliation":[{"name":"Polibienestar Research Institute, University of Valencia , Valencia,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicent Blanes","family":"Selva","sequence":"additional","affiliation":[{"name":"Biomedical Data Science Lab, Instituto Universitario de Tecnolog\u00edas de la Informaci\u00f3n y Comunicaciones, Universitat Polit\u00e8cnica de Val\u00e8ncia , Valencia,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archontoula","family":"Dalma","sequence":"additional","affiliation":[{"name":"Institute of Preventive Medicine, Environmental and Occupational Health Prolepsis , Athens,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matina","family":"Kouvari","sequence":"additional","affiliation":[{"name":"Institute of Preventive Medicine, Environmental and Occupational Health Prolepsis , Athens,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9605-1467","authenticated-orcid":false,"given":"Igor","family":"Grabovac","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna , Vienna,","place":["Austria"]},{"name":"Comprehensive Cancer Centre, Medical University of Vienna and Vienna General Hospital , Vienna,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"2026091321120552400_ckag119-B1","volume-title":"What is Cancer","author":"National Cancer Institute","year":"2021"},{"key":"2026091321120552400_ckag119-B2","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay","year":"2024"},{"key":"2026091321120552400_ckag119-B3","doi-asserted-by":"publisher","first-page":"S92","DOI":"10.1038\/bjc.2015.48","article-title":"Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review","volume":"112","author":"Neal","year":"2015","journal-title":"Br J Cancer"},{"key":"2026091321120552400_ckag119-B4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1071\/PY04043","article-title":"Access to primary health care: three challenges to equity","volume":"10","author":"Harris","year":"2004","journal-title":"Aust J Public Health"},{"key":"2026091321120552400_ckag119-B5","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/1472-6947-13-94","article-title":"Analyzing the impact of social factors on homelessness: a fuzzy cognitive map approach","volume":"13","author":"Mago","year":"2013","journal-title":"BMC Med Inform Decis Mak"},{"key":"2026091321120552400_ckag119-B6","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/s0140-6736(14)61132-6","article-title":"The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations","volume":"384","author":"Fazel","year":"2014","journal-title":"Lancet"},{"key":"2026091321120552400_ckag119-B7","author":"FEANTSA (European Federation of National Organisations Working with the Homeless)"},{"key":"2026091321120552400_ckag119-B8","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/s0140-6736(14)61132-6","article-title":"Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England","volume":"4","author":"Aldridge","year":"2019","journal-title":"Wellcome Open Res"},{"key":"2026091321120552400_ckag119-B9","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1111\/acem.13358","article-title":"Homelessness and emergency medicine: a review of the literature","volume":"25","author":"Salhi","year":"2018","journal-title":"Acad Emerg 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