Financial Stress, Oncology Patients
Conditions
Keywords
Financial toxicity, Hardship, Cost conversations
Brief summary
The overall objective of this study is to implement a sustainable oncology legal navigation program that will provide direct legal navigation services to help patients and caregivers overcome legal barriers to care in order to reduce cancer-related financial toxicity (FT) and improve health-related quality of life (QOL) among patients/caregivers.
Interventions
OTHERoncology legal navigation services
Participants receive direct legal assistance/navigation followed by consultation, and assistance with legal issues related to health/social benefits, housing, employment/education, planning ahead, and family law
Sponsors
Jean Edward
University of California, Davis
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
Yes
Inclusion criteria
* receiving or have received services at the Markey Cancer Center, University of Kentucky * patient with cancer diagnosis * caregiver of patient with cancer diagnosis * 18 years or older * facing legal barriers to care
Exclusion criteria
* Unable to provide consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants enrolled | 12 months | Feasibility was defined as 60% or higher enrolled participant retention and resolution of financial or legal issue (based on existing oncology financial navigation studies) |
| Acceptability assessed by 5-item survey | Post intervention at 12 months | Acceptability is measured using a 5 item post-intervention survey of relevance, helpfulness, convenience, recommendation to others, and value. Ratings on a scale from 0 to 10 where a higher score means greater acceptability |
| Change in Total Financial Toxicity | Baseline and post intervention,up to 12 months | Measured using the COmprehensive Score for financial Toxicity (COST) tool, a measure that describes the financial distress experienced by cancer patients. Scores range from 0-44 with a higher score representing better financial well-being. |
| Change in Participant Quality of Life (physical and mental) | Baseline and post intervention, up to 12 months | Measured using the 10-item PROMIS® (Patient-Reported Outcomes Measurement Information System) Parent Proxy Global Health scale. A 7-item summary assessment of a child's self-reported health with higher scores representing better quality of life. Values range from 7-35, with higher scores representing better health. |
| Change in Participant Quality of Life (Depression) | Baseline and post intervention, up to 12 months | Measured using the 6-item Patient-Reported Outcomes Measurement Information System PROMIS® Depression Short Form. Scores range from 6 to 30. Higher scores indicate more of the construct being measured. |
| Change in Participant Quality of Life (Anxiety) | Baseline and post intervention, up to 12 months | Measured using the 4-item Patient-Reported Outcomes Measurement Information System PROMIS® Anxiety short form. Scores range from 4 to 20. Higher scores indicate more of the construct being measured. |
| Resolution of legal Issue | 12 months | Number of participants that resolved a legal or financial case as a result of the intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Receiving Financial Benefit | 12 months | financial benefit defined as economic hardship avoided or decreased public/government income |
| Single Item Literacy Screener (SILS) | Baseline and post-intervention at 12 months | Single Item Literacy Screener (SILS); SILS asks "How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?" with answer options: "Never, Rarely, Sometimes, Often Always". Higher scores indicate lower health literacy. |
| Health Insurance Literacy (HIL) | Baseline and post-intervention at 12 months | Single Item Health Insurance Literacy Scale; "Did you ever have a problem understanding health insurance or medical bills related to your cancer, its treatment, or the lasting effects of that treatment?" Those who answered "Yes" were coded as having inadequate health insurance literacy and those who responded "No" were coded as having adequate HIL. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORJean Edward, PhD, RN
University of Kentucky
Outcome results
None listed