To explore individual, community, and health system factors that influence access to HD care for all HD patients, including Latinos with HD.

Access to specialized HD care is crucial for HD patients' timely access to treatments, clinical research, and psychosocial support. Social and structural determinants of health are known to impact access to specialized neurologic care for minoritized groups, although less is known about their influence on access to HD care.

Through a 60-minute focus group, four HD providers at HDSA Centers of Excellence (COEs) in California, Florida, and Texas were asked to identify what they perceived as barriers and facilitators to HD care for 1) all HD families and 2) Latino families. Guided by the National Institute of Minority Health and Health Disparities (NIMHD) Research Framework, we used a deductive thematic analysis in which two independent coders analyzed the transcript, and codes with greater than 50% agreement were grouped into barriers or facilitators to HD care.

Availability of services and quality of care were the most frequently used codes. Common barriers for all patients include limited disease knowledge, restrictive health insurance plans, and geographic proximity to a COE. Facilitators included access to HD resources and caregiver support. For Latino patients, barriers included certain cultural norms and limited English proficiency. Facilitators included access to language-concordant HD providers and educational resources.

Health system, interpersonal, and individual level factors influence access to HD care for all patients, whereas language and culture are key factors for Latino families. Equitable care for Latino HD families requires both cultural humility and language-appropriate services.