Jean Edward1, Victoria M Petermann2, Jan M Eberth3, Whitney E Zahnd4, Robin C Vanderpool5, Natoshia Askelson6, Catherine L Rohweder7, Sarah Koopman Gonzalez8, Lindsay R Stradtman9, Linda K Ko10, Paige E Farris11. 1. College of Nursing, University of Kentucky, Lexington, Kentucky, USA. 2. School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 3. Epidemiology and Biostatistics, Arnold School of Public Health & Rural and Minority Health Research Center, University of South Carolina, Columbia, South Carolina, USA. 4. Holden Comprehensive Cancer Center, College of Public Health, University of Iowa, Iowa City, Iowa, USA. 5. College of Public Health, University of Kentucky, Lexington, Kentucky, USA. 6. Community and Behavioral Health, University of Iowa, Iowa City, Iowa, USA. 7. Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 8. Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio, USA. 9. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 10. Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, USA. 11. Knight Cancer Institute's Community Outreach and Engagement Program, Oregon Health & Science University, Portland, Oregon, USA.
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.
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.
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