Interventions to address cancer-related financial toxicity: Recommendations from the field

Jean Edward, Victoria M. Petermann, Jan M. Eberth, Whitney E. Zahnd, Robin C. Vanderpool, Natoshia Askelson, Catherine L. Rohweder, Sarah Koopman Gonzalez, Lindsay R. Stradtman, Linda K. Ko, Paige E. Farris

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: Addressing financial toxicity among cancer patients is a complex process that requires a multifaceted approach, particularly for rural patients who may face additional cost-related barriers to care. In this study, we examined interventions being implemented by financial navigation staff at various cancer centers that help address financial toxicity experienced by oncology patients. Methods: We conducted semistructured interviews with a convenience sample of financial navigation staff across 29 cancer centers in both rural and urban areas in 7 states. Interviews were audio-recorded and transcribed. Descriptive coding and thematic analysis techniques were used to analyze the data. Findings: Thirty-five participants were interviewed, the majority of whom worked in cancer centers located in rural counties. Participants identified the use of screening tools, patient education, and access to tailored financial assistance resources as best practices. Immediate resource needs included additional financial navigation staff, including lay navigators and community health workers, to promote linkages to local resources. Suggested clinical areas for intervention included proactive and early implementation of financial assessments and discussions between providers and patients, along with training and access to regularly updated resources for those in financial navigator/counselor roles. Participants also discussed the need for policy-level interventions to reform health systems (including employment protections) and health insurance programs. Conclusions: Implementing proactive methods to screen for and address financial needs of patients is essential to improving cancer-related outcomes. Additional programs and research are needed to help establish systematic and standardized methods to enhance financial navigation services, especially for underserved rural communities.

Original languageEnglish
Pages (from-to)817-826
Number of pages10
JournalJournal of Rural Health
Volume38
Issue number4
DOIs
StatePublished - Sep 1 2022

Bibliographical note

Funding Information:
This study was conducted by the Cancer Prevention and Control Research Network (CPCRN), a research network of 8 universities across the United States, funded by the Centers for Disease Control and Prevention (CDC). The CPCRN's mission is to adopt and implement evidence‐based cancer prevention and control strategies, particularly for underserved populations, including rural communities. Members of the CPCRN rural cancer workgroup designed and conducted semistructured interviews across 7 CPCRN states (IA, KY, NC, OH, OR, SC, and WA). This study was reviewed and determined to be exempt by Institutional Review Boards at all participating CPCRN sites. 13

Funding Information:
This study was funded by the Health Promotion and Disease Prevention Research Center supported by Cooperative Agreements (U48-DP005017, U48-DP005053, U48-DP005014, U48-DP005030, U48-DP005013, U48-DP005006, and U48-DP005021) from the Centers for Disease Control and Prevention. CHAI Core is funded by the UNC Gillings School of Global Public Health Nutrition Obesity Research Center through NIH (DK056350) and the UNC Lineberger Comprehensive Cancer Center through NCI (P30-CA16086). Victoria Peterman is supported by the Rita and Alex Hillman Foundation and the UNC Lineberger Cancer Control Education Program T32 (T32CA057726-27). The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the Hillman Foundation, or the National Institutes of Health. The authors thank Mr. Randall Teal and Dr. Maihan Vu from CHAI core.

Funding Information:
This study was funded by the Health Promotion and Disease Prevention Research Center supported by Cooperative Agreements (U48‐DP005017, U48‐DP005053, U48‐DP005014, U48‐DP005030, U48‐DP005013, U48‐DP005006, and U48‐DP005021) from the Centers for Disease Control and Prevention. CHAI Core is funded by the UNC Gillings School of Global Public Health Nutrition Obesity Research Center through NIH (DK056350) and the UNC Lineberger Comprehensive Cancer Center through NCI (P30‐CA16086). Victoria Peterman is supported by the Rita and Alex Hillman Foundation and the UNC Lineberger Cancer Control Education Program T32 (T32CA057726‐27). The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the Hillman Foundation, or the National Institutes of Health.

Publisher Copyright:
© 2021 National Rural Health Association.

Keywords

  • financial hardship
  • financial navigation
  • financial toxicity
  • oncology
  • rural

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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