Enhancing Health Cost Literacy and Financial Capability among Young Adult Cancer Survivors

提高年轻癌症幸存者的健康成本知识和财务能力

• 批准号: 10459715
• 负责人: Bridgette H Thom
• 金额: $ 24.43万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-11 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10459715
• 关键词: Achievement; Address; Adolescence; Adolescent and Young Adult; Age; Age Reporting; Age-Years; Anxiety; Bankruptcy; Behavior; Cancer Survivor; Cancer Survivorship; Career Mobility; Caring; Clinical; Consultations; Data; Development; Diagnosis; Disease; Distress; Economics; Education; Face; Feedback; Financial Hardship; Focus Groups; Health; Health Care Costs; Health Services Accessibility; Healthcare; Hospitals; Individual; Intervention; Knowledge; Literature; Malignant Neoplasms; Measurement; Medical; Methodology; Modeling; National Cancer Institute; Nonprofit Organizations; Patients; Personal Satisfaction; Pharmaceutical Preparations; Play; Population; Productivity; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Resources; Risk; Risk Factors; Role; Sampling; Schools; Stress; Survivors; Testing; Work; aged; base; cancer therapy; coping; efficacy testing; experience; financial decision making; financial toxicity; follow-up; health service use; human centered design; improved; literacy; neoplasm registry; novel; peer; pilot test; pilot trial; population based; prevent; primary outcome; programs; recruit; satisfaction; simulation; skills; social media; survivorship; therapy development; usability; virtual; web-based intervention; young adult

Project Summary/Abstract Financial toxicity, the economic distress related to cancer treatment, has been reported at higher rates among young adult (YA) cancer survivors than older survivors. Financial toxicity can negatively impact long-term financial well-being, including risk for bankruptcy, asset depletion, and medical debt; increase levels of anxiety, worry, and stress; and decrease engagement with necessary survivorship care and other healthcare. Young adult survivors of adolescent and young adult (AYA) cancer [survivors aged 18-39 years who were diagnosed with cancer after age 14] are particularly susceptible to financial toxicity, and they have higher out-of-pocket medical expenses, are less likely to be able to afford medication, and experience more difficulty maintaining work/school productivity than their healthy peers. There is limited research on the context and implications of financial toxicity in this population and, to our knowledge, no tailored interventions to address financial toxicity among YA cancer survivors specifically. The proposed study aims to address financial toxicity and subsequent financial barriers to survivorship care by developing and pilot-testing a health cost literacy and financial capability intervention with a national sample of YA survivors. Using mixed methodology, the intervention will be guided by the Developmental Model of Financial Capability and developed in consultation with survivors of AYA cancer, clinical experts, and a non-profit organization dedicated to reducing financial toxicity in YA survivors. The planned web-based intervention will use virtual role-play simulations that allow survivors to practice skills associated with health cost literacy and financial capability in scenarios tailored to their cancer survivorship experience, and we will pilot test the intervention in a randomized controlled trial of 50 YA survivors recruited via social media and through hospital-based programming. The intervention content will be based upon our previous work developing a toolkit to help YA survivors manage their finances after cancer. The primary aims are to 1) Assess the usability, acceptability, and user satisfaction of an iteratively developed online skills-based health cost literacy and financial capability intervention for survivors of AYA cancer; 2a) Use a randomized controlled trial to pilot-test the efficacy of the developed intervention to improve health cost literacy and financial capability in a sample of 50 survivors of AYA cancer; 2b) Examine the relationship between survivors’ reported financial toxicity and their health cost literacy and financial capability. Measurement for Aims 2a and 2b will occur at baseline and 1- and 3-month follow-up. The proposed study will create a new intervention to address factors associated with financial toxicity in YA cancer survivors. Contextually, it is important to understand the health cost literacy and financial capability of YA cancer survivors to determine their impact on health-related financial decision-making and health services utilization, particularly cancer survivorship care

项目总结/摘要 财务毒性，与癌症治疗有关的经济困境，在以下人群中报告的发生率较高： 年轻的成年人（YA）癌症幸存者比年长的幸存者。财务毒性可能会对长期 财务状况，包括破产风险，资产耗尽和医疗债务;增加焦虑水平， 担心和压力;减少与必要的生存护理和其他医疗保健的接触。年轻 青少年和青年（AYA）癌症的成年幸存者[被诊断为癌症的18-39岁的幸存者] 14岁以后患癌症的人]特别容易受到金融毒性的影响，他们的自付费用更高， 医疗费用，不太可能负担得起药物，并且更难维持 工作/学习效率高于健康同龄人。关于这一问题的背景和影响的研究有限， 据我们所知，这一人群的金融毒性，没有针对性的干预措施来解决金融毒性 尤其是癌症幸存者。拟议的研究旨在解决金融毒性和随后的 通过制定和试点健康成本扫盲和财政 对全国YA幸存者样本进行能力干预。使用混合方法，干预措施将 以财务能力发展模型为指导，并与幸存者协商制定 AYA癌症，临床专家和一个致力于减少YA财务毒性的非营利组织 幸存者计划中的网络干预将使用虚拟角色扮演模拟，让幸存者 在针对癌症的情景中，练习与健康成本知识和财务能力相关的技能 生存经验，我们将在一项随机对照试验中对50名YA进行干预试验。 通过社交媒体和医院方案招募幸存者。干预内容将是 基于我们以前的工作，开发了一个工具包，帮助YA幸存者在癌症后管理他们的财务。 主要目的是1）评估迭代开发的 针对AYA癌症幸存者的基于在线技能的健康成本扫盲和财务能力干预; 2a）使用 一项随机对照试验，以初步测试所开发的干预措施在改善医疗费用方面的有效性 识字和财务能力的样本50名幸存者的AYA癌症; 2b）检查的关系 幸存者报告的财务毒性与他们的健康成本识字率和财务能力之间的关系。 将在基线以及1个月和3个月随访时测量目标2a和2b。拟定的研究将 创建一个新的干预措施，以解决与YA癌症幸存者的经济毒性相关的因素。 在上下文中，重要的是要了解YA癌症的健康成本知识和财务能力 幸存者，以确定其对与健康有关的财务决策和保健服务利用的影响， 特别是癌症生存护理