Abstract

Background: Pediatric, adolescent, and young adult patients with cancer and their caregivers are at high risk of financial toxicity, and few evidence-based oncology financial and legal navigation programs exist to address it. We tested the feasibility, acceptability, and preliminary effectiveness of Financial and Insurance Navigation Assistance, a novel interdisciplinary financial and legal naviga- tion intervention for pediatric, adolescent and young adult patients and their caregivers.

Methods: We used a single-arm feasibility and acceptability trial design in a pediatric hematology and oncology clinic and collected preintervention and postintervention surveys to assess changes in financial toxicity (3 domains: psychological response/ Comprehensive Score for Financial Toxicity [COST], material conditions, and coping behaviors); health-related quality of life (Patient-Reported Outcomes Measurement Information System Physical and Mental Health, Anxiety, Depression, and Parent Proxy scales); and perceived feasibility, acceptability, and appropriateness.

Results: In total, 45 participants received financial navigation, 6 received legal navigation, and 10 received both. Among 15 adult patients, significant improvements in FACIT-COST (P ¼ .041) and physical health (P ¼ .036) were noted. Among 46 caregivers, signifi- cant improvements were noted for FACIT-COST (P < .001), the total financial toxicity score (P ¼ .001), and the parent proxy global health score (P ¼ .0037). We were able to secure roughly $335 323 in financial benefits for 48 participants. The intervention was rated highly for feasibility, acceptability, and appropriateness.

Conclusions: Integrating financial and legal navigation through Financial and Insurance Navigation Assistance was feasible and acceptable and underscores the benefit of a multidisciplinary approach to addressing financial toxicity.

ClinicalTrials.gov registration: NCT05876325

Document Type

Article

Publication Date

3-2024

Notes/Citation Information

© The Author(s) 2024. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Digital Object Identifier (DOI)

https://doi.org/10.1093/jncics/pkae025

Funding Information

This study was funded by The Robert Wood Johnson Foundation (No. 77293); the Patient Oriented and Population Science Shared Resource Facilities and Research Communications Office, Markey Cancer Center University of Kentucky (P30CA177558); the National Institutes of Health National Center for Advancing Translational Sciences through grant No. UL1TR001998; and UK HealthCare’s Patient Financial Services. H. F. was supported by American Cancer Society grant No. IRG-22-152-34-IRG and American Cancer Society Center for Diversity in Cancer Research grant No. POST-BACC-22-1042000-01-DPBACC.

Download

Share

COinS