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

项目摘要/摘要 经济毒性，即与癌症治疗有关的经济困难，在 年轻成人(YA)癌症幸存者多于老年幸存者。金融毒害会对长期经济产生负面影响 财务健康，包括破产、资产枯竭和医疗债务的风险；焦虑程度增加， 焦虑和压力；减少对必要的生存护理和其他医疗保健的投入。年青的 青春期和青壮年(Aya)癌症的成年幸存者[确诊的18至39岁的幸存者 14岁以后患癌症的人]特别容易受到经济风险的影响，而且他们的自付费用更高 医疗费用，更不可能负担得起药物，并经历更多的困难维持 工作/学校工作效率高于健康的同龄人。关于这一问题的背景和影响的研究有限。 这一人群中的金融毒害，据我们所知，没有针对金融毒害的量身定做的干预措施 尤其是在YA癌症幸存者中。拟议的研究旨在解决金融毒性和随后的 通过制定和试行健康成本、扫盲和财政政策，为生存护理设置财务障碍 以全国青年会幸存者为样本进行能力干预。使用混合方法，干预将 以财务能力发展模式为指导，并在与幸存者协商中制定 Aya癌症、临床专家和致力于降低YA财务毒性的非营利组织 幸存者。计划中的基于网络的干预将使用虚拟角色扮演模拟，允许幸存者 在为癌症量身定做的方案中，与健康成本、识字能力和财务能力相关的实践技能 生存经验，我们将在为期50年的随机对照试验中对干预措施进行试点测试 幸存者通过社交媒体和以医院为基础的规划招募。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YA幸存者管理他们癌症后的财务状况。 主要目标是1)评估迭代开发的 为Aya癌症幸存者提供基于在线技能的保健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改善医疗成本的有效性 对50名Aya癌症幸存者的识字能力和经济能力进行抽样调查；2b)检查两者之间的关系 幸存者报告的经济毒性与他们的健康费用、识字能力和经济能力之间的关系。 对目标2a和2b的测量将在基线以及1个月和3个月的后续行动中进行。拟议的研究将 创建一种新的干预措施，以解决与YA癌症幸存者的经济毒性相关的因素。 就背景而言，了解YA癌症的健康成本素养和财务能力是很重要的 幸存者以确定其对与卫生相关的财务决策和卫生服务利用的影响， 尤其是癌症的生存护理

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