Facing a growing number of foreign population and Swiss residents with migrant background, pediatric oncology providers have to adapt to these changes and have to work towards cultural equity in pediatric oncology care. Barriers to healthcare access for migrant children have been described for the Swiss context. Reasons for this health inequity, amongst others, are the structuring of the healthcare system (e.g. insufficient migrant orientation) or formal access barriers (e.g. travel distances and geographical location). Furthermore, for Switzerland it is known that pediatric oncology providers face difficulties in shared decision-making due to cultural aspects of families from different origins (e.g. religiously determined illness understandings) as well as the challenge to provide individually tailored and culturally appropriate care to all children and families. However, it is imperative that the migrant population has reasonable access to pediatric oncology care and that they receive culturally competent pediatric oncology care. Moreover, the imperative to study barriers to culturallyequitable pediatric oncology care in Switzerland is both an ethical and a medical one, because access to healthcare is a fundamental human right and, ultimately, good health of migrant children leads to better overall population health.

Thus, the proposed research project aims to better understand the existing cultural barriers in pediatric oncology in Switzerland by (a) identifying the key cross-cultural competences for pediatric oncology providers, (b) examining pediatric oncology providers’ cross-cultural competences, and (c) analyzing cultural minorities’ access of specialized pediatric oncology care. The study is composed of three empirical modules which enable us to address our guiding research questions. Thus, we will obtain different but complementary data. This study design allows us to identify important variables related to culturally equitable pediatric oncology care in Switzerland. First, we will review the existing literature on cross-cultural competences in pediatric oncology. For this purpose, we will conduct a systematic review of published literature, which is normative in the sense of providing standards regarding culturally competent decision-making in pediatric oncology. Second, we will survey pediatric oncology providers’ cross-cultural competences. For this purpose, we will employ a validated tool measuring cross-cultural competence of healthcare professionals, namely the Cross-Cultural Competence of Healthcare Professionals. Third, we will
analyze the accessibility of SPOG centers for both migrant and native children. For this purpose, we will employ spatial accessibility analysis which will analyze Swiss children’s (e.g. migrant vs. native) access to pediatric oncology centers with the variable of interest being the travel time from residence to the respective center for
each 100x100meters raster-cell in Switzerland.