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The CANCERLESS project co-developed and implemented the Health Navigator Model (HNM) \u2013 a person-centred approach using trained health navigators to provide tailored support, promote cancer awareness, and facilitate access to preventive services \u2013 in Austria, Greece, Spain, and the UK. This study examined the HNM\u2019s impact on healthcare empowerment, health-related quality of life (HRQoL), and self-rated health among PEH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This non-randomised, single-arm study included 652 PEH from 16 pilot sites in four European countries between June 2022 and December 2023. Healthcare empowerment, HRQoL, and self-rated health were assessed using the healthcare empowerment questionnaire and the EQ-5D-5L (including the EQ Visual Analogue Scale) when participants entered and completed the intervention. A per-protocol analysis with repeated measures ANOVA revealed changes over time and between countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants were predominantly male (64.1%) and middle-aged (mean 47.4, SD 13.8), with secondary education (58.0%), and varied legal status and experiences of homelessness. Despite a drop-out rate of 57.5%, significant improvements in overall healthcare empowerment (F\u2009=\u200944.325,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;.001, \u03b7\u00b2=0.026), HRQoL (F\u2009=\u20094.421,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.036, \u03b7\u00b2=0.002), and self-rated health (F\u2009=\u200916.945,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;.001, \u03b7\u00b2=0.011) were observed, particularly in Austria and the UK.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HNM holds promise for improving healthcare empowerment and HRQoL among PEH, but context-specific factors and a considerable drop-out pose challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12955-026-02588-8","type":"journal-article","created":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:15:13Z","timestamp":1784420113000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Empowerment and quality of life through cancer prevention in people experiencing homelessness: evaluating the Health Navigator Model"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1373-5279","authenticated-orcid":false,"given":"Tobias","family":"Fragner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Alhambra-Borr\u00e1s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ascensi\u00f3n","family":"Do\u00f1ate-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicent","family":"Blanes-Selva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan M.","family":"Garc\u00eda-G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Gawronska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Moudatsou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Tabaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Belogianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pania","family":"Karnaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Rico","family":"Varad\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa G\u00f3mez","family":"Trenado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Barrio-Cortes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Gil-Salmeron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Grabovac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"2588_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. 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