Study protocol: Feasibility of medically tailored meals for pediatric populations at risk for disparities in serious illness outcomes due to inequities in food-related social drivers of health (MTM-Kids).

Background: Food and nutrition insecurity are actionable, clinically relevant social determinants of health that disproportionately affect pediatric populations, particularly those with serious illnesses, including cancer. Lack of consistent access to nutritious food contributes to poorer treatment tolerance, increased infection risk, lower quality of life, and worsened long-term health outcomes. Medically-tailored meals (MTM) have shown promise in improving health outcomes in adults with diet-sensitive conditions, but their feasibility and acceptability in pediatric populations remain unexplored.

Patient Perspectives on Prior Authorization for Cancer Care.

Importance: Health insurance companies may require prior authorization at any stage in the cancer care continuum, leading to the potential for denials and/or delays of diagnosis, treatment, or survivorship care. Patient experiences with prior authorization are largely unexplored, with most surveys focused on clinicians.

Objective: To characterize prior authorization for cancer care from the perspective of patients with cancer, using their own words.

Screening for Financial Toxicity and Health-Related Social Risks in Patients With GI Cancer: Results From a Large Cancer Center.

Purpose: Patients with GI cancers often face significant financial toxicity (FT) and health-related social risks (HRSRs), yet best practices for screening remain unclear. This study aimed to evaluate the prevalence of FT and HRSR and identify associated factors.

Methods: From June 2022 to August 2023, patients were screened using the Comprehensive Score for Financial Toxicity (COST), patient-reported HRSR (eg, housing, food insecurity), and quality of life (QOL).

A Community-Led Approach to Addressing Health Disparities among Adolescent and Young Adult Cancer Survivors.

Adolescent and young adult (AYA) cancer survivors (i.e., those diagnosed between the ages of 15 and 39 years) experience significant health and health care disparities.

Cancer Care Affordability and the Healthcare Team: Expanding an Assessment of Clinical Perceptions and Attitudes in Nursing.

Objectives: To investigate nursing staff perceptions of financial toxicity (FT), its causes, and their role in mitigating it, as well as their prior training in addressing financial concerns.

Sample & Setting: 535 RNs, advanced practice providers, and ancillary staff at an urban comprehensive cancer center.

Methods & Variables: Respondents completed an online survey, adapted from prior work with physicians, as part of a quality improvement effort.

Enduring Economic Effects of a Cancer Diagnosis in Adolescence and Young Adulthood.

In the article that accompanies this editorial, “Long-Term Dynamic Financial Impacts Among Adolescents and Young Adults with Cancer: A Longitudinal Matched-Cohort Study,” the authors demonstrate that adolescents and young adults with cancer experience persistent loss of income, even in a universal health care system, with differential losses noted across cancer subtypes. These data highlight the need for the design and implementation of tailored interventions to decrease financial hardship along the cancer continuum in diverse health care settings.

Decisions of young women with breast cancer regarding fertility preservation before cancer treatment and family building after treatment.

Purpose: Approximately 19% of breast cancer cases in 2020 were diagnosed in women under age 50. These premenopausal women with early-stage breast cancer face unique challenges related to family building. This study examines the decision-making and outcomes of patients who pursue fertility preservation before treatment and family building afterwards.

Development and Validation of a Simplified Financial Toxicity Screening Tool for Use in Clinical Practice.

Purpose: Cancer-related financial toxicity occurs frequently and is a key driver of inequities in access to care and disparities in treatment outcomes. Current practices to screen for financial toxicity are inconsistent because of the lack of a validated and clinically integrated screening tool. This analysis aimed to create and assess an abbreviated version of the validated Comprehensive Score for Financial Toxicity (COST) tool, a measure of financial toxicity used for research purposes, which could easily be added into often-lengthy clinical screening workflows.

Interventions to Address Cancer-Related Financial Hardship: A Scoping Review and Call to Action.

Purpose: As oncology practices implement routine screening for financial hardship (FH) and health-related social needs, interventions that address these needs must be implemented. A growing body of literature has reported on FH interventions.

Methods: We conducted a scoping review of the literature using PubMed, EMBASE, PsychInfo, and CINAHL to identify key studies (2000-2024) reporting on interventions to address cancer-related FH.

Impact of Financial Toxicity on Treatment Adherence and Quality of Life in Pancreatic Cancer.

Purpose: Financial toxicity (FT) is increasingly recognized as a major issue in cancer care. We evaluated the prevalence and risk factors for FT in patients with pancreatic ductal adenocarcinoma (PDAC) and FT associations with treatment adherence and quality of life (QOL).

Methods: A screening questionnaire based on the Comprehensive Score for Financial Toxicity (COST) was implemented at our National Cancer Institute-designated comprehensive cancer center.

Prioritizing Patient-Centered Care in a World of Increasingly Advanced Technologies and Disconnected Care.

With more treatment options in oncology lead to better outcomes and more favorable side effect profiles, patients are living longer-with higher quality of life-than ever, with a growing survivor population. As the needs of patients and providers evolve, and technology advances, cancer care is subject to change. This review explores the myriad of changes in the current oncology landscape with a focus on the patient perspective and patient-centered care.

Exploring research engagement among nurses in a Magnet®-recognized cancer center: An analysis of knowledge, attitudes, practices, and influencing factors.

Objective: Despite the significance of research in nursing practice and its role in enhancing the quality of life for cancer patients, nurses report limited opportunities to engage with research. Known barriers include limited organizational support, a lack of time, resources, and knowledgeable colleagues/mentors. The study aims to determine research knowledge, attitudes, and practices among cancer nurses and understand factors influencing nurses' involvement in research.

Financial Toxicity Among Women with Breast Cancer Varies by Age and Race.

Introduction: Financial toxicity negatively affects clinical outcomes in breast cancer. Underrepresented demographics may be at higher risk for financial toxicity. We characterized disparities on the basis of age and other factors.

Screening for Health-Related Social Needs and Financial Toxicity Among Patients With Cancer Treated With Radiation Therapy: Findings From a Quality Improvement Project.

Introduction: Financial toxicity is common among patients with cancer, as are co-occurring health-related social risks (HRSRs). There is limited evidence to support best practices in screening for HRSRs and financial toxicity in the cancer context. This analysis sought to understand variations of identified needs based on treatment course using data from a large screening program.

Using Real-World Data to Explore the Impact of One-Time Financial Grants Among Young Adult Cancer Survivors.

Young adult (YA) cancer survivors experience worse financial outcomes than older survivors. This analysis used data from Expect Miracles Foundation to explore the impact of one-time financial grants on financial well-being and access to health care. Among 300 respondents, the average grant was $1526 (standard deviation = $587; range $300-$3000).

The Patient Experience of Prior Authorization for Cancer Care.

Importance: Prior authorization (PA) requires clinicians and patients to navigate a complex approval pathway. Resultant delays and denials can be particularly problematic for patients with cancer, who often need urgent treatment or symptom management.

Objective: To investigate the patient perspective of PA for cancer-related care, including perceptions about the process, outcomes (including delays and denials), and patient administrative burden.

Administrative Burden Associated with Cost-Related Delays in Care in U.S. Cancer Patients.

Background: U.S. cancer patients engage in administrative tasks to pay for their healthcare.

Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors?

Purpose: This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15-39 years old) cancer survivors.

Methods: Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients' levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis.

Financial Toxicity Order Set: Implementing a Simple Intervention to Better Connect Patients With Resources.

Purpose: Financial toxicity of cancer treatment is well described in the literature, including characterizations of its risk factors, manifestations, and consequences. There is, however, limited research on interventions, particularly those at the hospital level, to address the issue.

Methods: From March 1, 2019, to February 28, 2022, a multidisciplinary team conducted a three-cycle Plan-Do-Study-Act (PDSA) process to develop, test, and implement an electronic medical record (EMR) order set to directly refer patients to a hospital-based financial assistance program.

The long-term financial experiences of adolescent and young adult cancer survivors.

Background: Cancer-related financial hardship can negatively impact financial well-being and may prevent adolescent and young adult (AYA) cancer survivors (ages 15-39) from gaining financial independence. This analysis explored the financial experiences following diagnosis with cancer among AYA survivors.

Methods: We conducted a cross-sectional, anonymous survey of a national sample of AYAs recruited online.