Evaluating the impact of virtual oncology financial and legal navigation on cancer-related financial toxicity.
In a single-arm pediatric and adolescent/young-adult oncology study, virtual financial and legal navigation was feasible and acceptable, was associated with significantly reduced caregiver financial toxicity, and was accompanied by patient-reported reductions in stress and anxiety.
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In a single-arm pediatric and adolescent/young-adult oncology study, virtual financial and legal navigation was feasible and acceptable, was associated with significantly reduced caregiver financial toxicity, and was accompanied by patient-reported reductions in stress and anxiety.
Research significance
The record provides preliminary evidence that virtual oncology financial and legal navigation can reduce caregiver financial toxicity and is implementable in a largely rural population; it is reasonable—but not established—to hypothesize that relieving financial and legal burdens could improve psychosocial well-being, care access, or treatment adherence.
Source abstract
PURPOSE: To evaluate the impact of a virtual oncology financial and legal navigation (OFLN) intervention on cancer-related financial toxicity (FT) and health-related quality of life (QOL) in pediatric and adolescent and young adult (PAYA) cancer patients and caregivers, as well as assess the intervention's acceptability and feasibility. METHODS: A single-arm trial was conducted in a PAYA oncology clinic between March 2024 and May 2025. Pre- and post-intervention surveys included the Comprehensive Score for Financial Toxicity (COST), Patient-Reported Outcomes Measurement Information System global health, anxiety and depression scales, National Comprehensive Cancer Network's Distress Thermometer, and intervention acceptability, appropriateness and feasibility of Measures. RESULTS: The majority (36 patients and 88 caregivers) identified as female (73%), non-Hispanic White (85%), rural residents (61%), with incomes above the federal poverty level (71%). Participants reported moderate levels of FT at baseline with mean COST of 20.9 (SD = 11.14) for patients and 19.3 (SD = 10.12) for caregivers and high levels of anxiety, depression, and distress. Among caregivers, there was a significant (p = 0.01) post-intervention increase in COST (indicating decreased FT). Almost all patients reported decreases in subjective stress and anxiety (94%) and feeling better prepared to navigate financial/legal issues. Participants rated the intervention highly across implementation outcomes of acceptability (76%), appropriateness (76%), and feasibility (75%), which was also supported by 89% enrollment and 95% retention rates. CONCLUSION: Findings demonstrate that virtual OFLN has the potential to increase access to supportive care services especially in rural communities. Additional research supporting scalability and uptake for widespread implementation is needed.