A pilot study of the Pediatric RISE (Resource Intervention to Support Equity) program indicates that providing direct financial assistance to low-income families can significantly alleviate the burdens associated with childhood cancer treatment. The study, conducted by researchers at Dana-Farber Cancer Institute, assessed the feasibility and value of RISE, revealing promising results presented at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition.
Addressing Financial Hardship in Pediatric Cancer Care
Kira Bona, MD, MPH, a pediatric oncologist at Dana-Farber/Boston Children’s Cancer and Blood Disorder Center, emphasized the critical need for such interventions. "One in three children diagnosed with cancer lives in a low-income household in a family that is concerned about meeting basic needs while the child is receiving cancer treatment," she stated. Previous research by Bona highlighted that children from low-income households face higher relapse rates and lower survival rates, despite receiving standardized treatment at top academic centers. These disparities are often linked to social determinants of health, including food insecurity, housing instability, and transportation challenges.
Program Design and Implementation
Pediatric RISE addresses these challenges by providing eligible families with twice-monthly cash transfers over three months. The amount is based on the Child Tax Credit and the number of household dependents. In the pilot study, twenty families with children being treated at Dana-Farber participated, with 65% of the children being treated for blood cancer. The families were predominantly non-white or Hispanic, publicly insured, and more than half lived in single-parent households. The median household income was $27,250.
The study successfully distributed cash transfers via direct deposit, pre-paid debit card, or online payment app. Families reported high satisfaction with RISE, using the funds for essential needs such as rent/mortgage payments, groceries, utilities, and transportation. Notably, family-reported hardships related to food, housing, utilities, and transportation decreased from 90% to 74% during the three-month program.
Impact on Family Well-being
Colleen A. Kelly, MD, a pediatric hematology/oncology fellow, highlighted the program's positive impact on families' peace of mind. "Families thought the program was very helpful and reduced stress because it helped them meet housing, food, and other needs," Kelly noted. Parents also reported an increased ability to spend more time at their child's bedside.
Program Refinements and Future Directions
Feedback from parents led to rapid refinements of the intervention, including increased payment amounts and duration. The program is designed to mitigate concerns about cash payments by treating them as non-taxable gifts and offering an optional session with a certified benefits counselor to review potential impacts on government benefits. The payments are made through a nonprofit to ensure no connection between funding and medical care, and families can use the support for any needs during treatment.
Bona envisions integrating interventions like RISE into standard supportive care. "The vision we have is to investigate interventions like RISE the same way we develop novel drugs," Bona stated. A larger, randomized, phase 2 pilot study at Dana-Farber and Columbia University Irving Medical Center will further evaluate a revised implementation of RISE.
