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Addressing Cancer-Related Financial Toxicity in Rural Oncology Care Settings

Not Applicable
Recruiting
Conditions
Neoplasms
Carcinoma
Interventions
Behavioral: Financial Navigation
Registration Number
NCT04931251
Lead Sponsor
UNC Lineberger Comprehensive Cancer Center
Brief Summary

The financial burden, or financial toxicity (FT), of cancer is a consequential and growing problem, particularly for rural patients. It is important to improve our understanding of how financial navigation (FN) can reduce the material, psychological, and behavioral burden of costs associated with cancer care in both rural and non-rural community settings. The purpose of this study is to conduct a financial navigation program in 5 rural and 4 non-rural oncology practices in North Carolina and evaluate the effects of financial navigation on patient outcomes, including financial toxicity and health-related quality of life.

Detailed Description

This study is designed to evaluate the implementation and effectiveness of a financial navigation intervention within 5 rural and 4 non-rural oncology settings in North Carolina. Financial navigators from each of the 9 sites will recruit and enroll 255 patients total across all sites into a financial navigation program. The financial navigation intervention consists of screening patients using the COST measure for financial toxicity. If the patient scores 23 or lower, they are considered to have moderate to severe financial toxicity and will be enrolled in the study. Patients will then complete a series of baseline questionnaires to measure their health related quality of life and then they will meet with a financial navigator for a comprehensive intake process to determine potential financial assistance resources the patient may be eligible for and continued visits with the financial navigator until all financial assistance resources have been explored and patients have received benefits or referrals to financial assistance programs. At the end of the intervention, the patients will complete the COST measure again, and repeat baseline surveys to measure health-related quality of life and the patient's acceptability and responsiveness of the financial navigation intervention. Patient participation depends on the depth of patient need but ranges from 2 visits to 6 visits with the financial navigator over approximately 4 months but possibly longer depending on the complexity of the patient's financial need.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
255
Inclusion Criteria
  • Patients 18 years of age and older
  • Patients with any type of cancer diagnosed within 5 years and/or living with advanced disease
  • Patients who score 22 or lower on the COST measure indicating high FT
  • Patients must be able to read and speak English
Exclusion Criteria
  • Participants without a cancer diagnosis
  • Patients diagnosed more than 5 years ago without advanced disease
  • Patients or caregivers under the age of 18
  • Patients who do not sign the consent form
  • Patients who do not complete the baseline COST survey
  • Patients who cannot read and speak English

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Financial NavigationFinancial Navigationincludes a financial toxicity screening measure (COST), baseline and post-intervention surveys, and approximately 2-6 visits with a financial navigator to identify financial assistance resources
Primary Outcome Measures
NameTimeMethod
COST (Comprehensive Score for Financial Toxicity) measure4-6 months

To evaluate the change from baseline to follow-up in scores from the Comprehensive Score for Financial Toxicity (COST) measure after participation in the financial navigation program among 780 rural and non-rural NC cancer patients with high baseline financial distress.

Secondary Outcome Measures
NameTimeMethod
Health-Related Quality of Life (HrQoL) Measures4-6 months

To evaluate the change from baseline to follow-up in scores from HRQoL, care-altering behaviors and patient perspectives on the intervention itself

Trial Locations

Locations (9)

NC Basnight Cancer Hospital

🇺🇸

Chapel Hill, North Carolina, United States

Novant Health

🇺🇸

Charlotte, North Carolina, United States

Vidant Medical Center, Cancer Center

🇺🇸

Greenville, North Carolina, United States

Pardee UNC Health Care, Pardee Cancer Center

🇺🇸

Hendersonville, North Carolina, United States

UNC Lenoir Cancer Care Services

🇺🇸

Kinston, North Carolina, United States

Carteret Health Care Cancer Center

🇺🇸

Morehead City, North Carolina, United States

The Outer Banks Hospital

🇺🇸

Nags Head, North Carolina, United States

Nash UNC Health Care

🇺🇸

Rocky Mount, North Carolina, United States

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

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