UW PhD student’s study highlights the power of racial, cultural, and language concordance
When University of Washington Health Services PhD student Ashlyn Tom began studying how patients experience cancer care, she noticed a pattern that extended far beyond clinical treatment. “I began to see that the barriers patients faced weren’t simply about resources or logistics — they reflected deeper issues tied to racism, culture, and language,” she said. “These factors shape how patients are treated, how they experience care, and ultimately, their outcomes.”
That observation became the foundation for a new study published in the Journal of Health Equity, where Tom and her team tested an innovative model of racially, ethnically, and linguistically concordant (RELC) patient navigation at Fred Hutchinson Cancer Center. The research offers early but compelling evidence that when patients and navigators share the same race, cultural, or linguistic connections, cancer care becomes more equitable.
Rethinking what “equity” means in cancer care
For decades, cancer researchers have worked to close the survival gap across racial and ethnic groups. Advances in screening, therapy, and early detection have helped — but the benefits haven’t reached everyone equally. Patients from historically marginalized and minoritized communities still encounter the effects of structural racism — including language and cultural discordance with healthcare professionals, transportation and insurance barriers, and financial strain — which, together with experiences of bias and discrimination, foster mistrust in the healthcare system and contribute to delayed and lower-quality care.
“Achieving equity in cancer care requires more than new therapies,” said Tom. “It means tackling the everyday barriers related to race, culture, and language that too many patients still encounter.”
Her research moves beyond documenting these disparities to testing equity-oriented solutions — practical, system-level strategies designed to make cancer care more accessible and humane for every patient.
“Equity isn’t only about access, it’s about belonging. When care reflects you – your culture, language, and lived experience, the care experience changes completely.”
-Ashlyn Tom, Health Services PhD
What is a concordant navigation model?
Patient navigation is a well-established approach that provides individuals with a guide — someone who helps them coordinate appointments, understand medical information, and access supportive resources. The RELC model expands upon that idea by matching patients with navigators who share their racial, ethnic, or linguistic background.
The underlying theory is simple but profound: shared identity fosters trust. When patients feel seen, understood, and respected, they’re more likely to engage actively in their care, ask questions, and pursue recommended treatments.
“Language and culture are not just communication tools — they’re sources of comfort and credibility,” Tom explained. “When patients can speak to someone who looks like them, speaks the same language, and understands their lived experience, it changes the entire care dynamic – representation matters.”
Inside the pilot study at Fred Hutch
Tom’s study used a mixed methods design, combining quantitative data on patient experience with qualitative interviews to capture deeper insights. Conducted as a pilot project, the research examined early outcomes of the RELC model in a major cancer center setting.
Key findings emerged from both data streams:
- Patients paired with racially, ethnically, or linguistically concordant navigators reported higher satisfaction with their care.
- They experienced less perceived discrimination within the healthcare system.
- They showed greater engagement in clinical trial discussions — a critical area where participation from underrepresented populations remains low.
In interviews, patients described feeling “heard,” “understood,” and “valued” in ways that differed from past medical experiences. Navigators noted that cultural and linguistic alignment allowed for more candid conversations, fewer misunderstandings, and faster resolution of logistical challenges.
One participant summarized their experience: “She did well because we were communicating in our language, Spanish, so that meant we understood each other better… and she would explain things correctly. And thanks to that help, we were able to solve our issues.”
Trust as a therapeutic ingredient
The study’s qualitative data highlight something difficult to measure but vital to patient outcomes: trust. When patients trusted their navigator and the care team, they were more likely to follow through with treatment plans and to voice questions or concerns. This sense of psychological safety, Tom says, may be as important as any clinical protocol.
“These results reinforce what many patients and communities have been saying for years,” said Tom. “Equity isn’t only about access, it’s about belonging. When care reflects you – your culture, language, and lived experience, the care experience changes completely.”
From pilot to practice
While the pilot was small by design, its implications are significant. The RELC model could be adapted to other health systems, expanding the reach of patient navigation to meet communities where they are — racially, culturally, and linguistically.
The next phase of Tom’s work will explore whether concordant navigation helps patients begin treatment sooner and apply implementation frameworks to understand how such models can support navigators in culturally responsive care without overburdening limited resources.
“I hope my research will advance equity in cancer care by developing and promoting patient navigation and system-level strategies that reduce care barriers,” Tom said. “Every patient, regardless of race, culture, or language, deserves an equal chance at recovery and survival.”
Personal motivation, professional mission
For Tom, this work is deeply personal. “Seeing friends and family navigate cancer care barriers showed me how issues related to race, culture, and language shape outcomes,” she said. “It’s why I pursue research to advance equity and create care systems that reflect and better serve the communities most impacted.”
Her approach exemplifies the University of Washington’s Department of Health Services’ focus on community-centered research that drives practical change in health systems. By combining rigorous methods with lived experience and cultural humility, Tom’s study points to what equitable cancer care can — and should — look like.
Looking ahead
As the U.S. healthcare system continues to reckon with disparities in cancer outcomes, Tom’s research underscores a hopeful message: small, human-centered changes can make a measurable difference. The RELC patient navigation model doesn’t require expensive new infrastructure or cutting-edge drugs — it requires listening, representation, and relationships.
“Equity is achievable,” Tom said. “It starts with care that reflects people’s identities, values, and communities — not just their diagnosis.”