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

项目概要/摘要 财务毒性（与癌症治疗相关的经济困境）在人群中的报告率较高 年轻成人 (YA) 癌症幸存者高于年长幸存者。财务毒性会对长期产生负面影响 财务状况，包括破产风险、资产耗竭和医疗债务；增加焦虑程度， 担心和压力；并减少对必要的生存护理和其他医疗保健的参与。年轻 青少年和青年 (AYA) 癌症的成年幸存者 [被诊断为 18-39 岁的幸存者 14 岁后患有癌症] 特别容易受到经济毒性的影响，而且他们的自付费用较高 医疗费用，不太可能负担得起药物，并且维持更困难 工作/学校生产力高于健康同龄人。关于其背景和影响的研究有限 据我们所知，没有针对该人群的财务毒性，没有针对性的干预措施来解决财务毒性 特别是在青少年癌症幸存者中。拟议的研究旨在解决财务毒性和后续问题 通过开发和试点测试健康成本知识和财务障碍来消除幸存者护理的财务障碍 对全国青少年青少年幸存者样本进行能力干预。使用混合方法，干预将 以财务能力发展模型为指导，并与幸存者协商制定 AYA 癌症、临床专家和致力于减少 YA 经济毒性的非营利组织 幸存者。计划中的基于网络的干预措施将使用虚拟角色扮演模拟，使幸存者能够 在针对癌症的场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 50 年的随机对照试验中试点测试干预措施 通过社交媒体和医院项目招募幸存者。干预内容将是 基于我们之前的工作，开发了一个工具包来帮助青少年幸存者在癌症后管理他们的财务。 主要目标是 1) 评估迭代开发的可用性、可接受性和用户满意度 针对 AYA 癌症幸存者的基于在线技能的健康成本知识和财务能力干预； 2a) 使用 一项随机对照试验，旨在测试所开发的干预措施在改善医疗成本方面的功效 50 名 AYA 癌症幸存者样本的识字率和经济能力； 2b) 检查关系 幸存者报告的财务毒性与他们的健康成本素养和财务能力之间的关系。 目标 2a 和 2b 的测量将在基线以及 1 个月和 3 个月的随访中进行。拟议的研究将 制定新的干预措施来解决与 YA 癌症幸存者经济毒性相关的因素。 根据具体情况，了解 YA 癌症的健康成本知识和财务能力非常重要 幸存者以确定其对与健康相关的财务决策和卫生服务利用的影响， 特别是癌症幸存者护理

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