Evaluating the Implementation and Impact of Standard-of-care Delivered Oncology Financial Navigation
Summary
The purpose of this study is to understand the implementation and impact of a pragmatically-delivered oncology financial navigation program. The main questions it aims to answer are: 1. How did oncology financial navigation implementation strategies affect implementation outcomes? 2. What is the impact of financial navigation on patient financial hardship, quality of life, and psychological distress? 3. How were implementation strategies utilized to overcome barriers to oncology financial navigation? Researchers will examine secondary, standard-of-care collected, patient-reported data, electronic medical record data, and qualitative interview data to answer these questions.
Detailed description
Guided by the RE-AIM Extension for Equitable Sustainability framework, the investigators will use a series of implementation and effectiveness aims to evaluate equitable implementation of oncology financial navigation into routine cancer care delivery. The investigators hypothesize the proposed assessment will identify potential areas to improve implementation of oncology financial navigation, which will result in better financial and clinical outcomes for patients with cancer. The investigators propose a pragmatic, hybrid effectiveness-implementation study to assess outcomes of oncology financial navigation delivered as routine cancer care and collect information on strategies to address implementation barriers. Outcomes will be assessed overall and for inequities by race, residence, and insurance status using the following specific aims: Aim 1. Track oncology financial navigation implementation strategies and their effect on implementation outcomes Aim 2. Evaluate oncology financial navigation effectiveness Aim 3. Assess how implementation strategies were utilized to overcome barriers to oncology financial navigation
Arms & interventions
- BehavioralFinancial navigation
Oncology financial navigation is an evidence-based intervention which helps patients prepare for out-of-pocket treatment costs, optimize health insurance, and access financial resources to reduce cancer-related financial hardship.
Outcome measures
Primary
Change in financial hardship
Change in patient-reported financial distress (COmprehensive Score for financial Toxicity)
Time frame: 6 months post-initiation of systemic therapy
Change in financial difficulties
Change in patient-reported financial difficulties (trouble paying for basic needs, utilities, transportation or lodging for treatment, medications, medical supplies, upfront medical payments, insurance or medical bills, child or eldercare, and employment or disability issues)
Time frame: 6 months post-initiation of systemic therapy
Change in quality of life
Change in patient-reported quality of life (PROMIS v1.1 Global Health)
Time frame: 6 months post-initiation of systemic therapy
Change in psychological distress
Change in patient-reported psychological distress (National Comprehensive Cancer Network Distress Thermometer)
Time frame: 6 months post-initiation of systemic therapy
Utilization of implementation strategies
Track oncology financial navigation implementation strategies using the Expert Recommendations for Implementing Change (ERIC) implementation strategy taxonomy and their effect on implementation outcomes of Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)
Time frame: Quarterly tracking of strategies with monthly assessment of implementation outcomes, through study completion, an average of 4 years
Patient, provider, and health system perspectives of oncology financial navigation implementation barriers addressed via implementation strategies
Using qualitative interviews, we will assess patient, provider, and health system perspectives of oncology financial navigation implementation barriers addressed via implementation strategies
Time frame: Annually through study completion, an average of 4 years
Eligibility criteria
Study locations (1)
University of Alabama at Birmingham
Birmingham, Alabama, 35233