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Addressing Cancer-Related Financial Hardship through Delivery of a Proactive Financial Navigation Intervention

Award Number: R01CA248656
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/16/2020
PERIOD OF PERFORMANCE END DATE: 03/31/2026

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Addressing Cancer-Related Financial Hardship through Delivery of a Proactive Financial Navigation Intervention - Project Summary/Abstract ‘Financial toxicity’ is a well-documented side effect of cancer diagnosis that encompasses a range of material, psychological, and behavioral hardships such as debt, bankruptcy, financial worry, and treatment non- adherence. Studies suggest that all patients, regardless of insurance type or socioeconomic status, are vulnerable to adverse financial consequences following cancer diagnosis. Financial hardship can impact entire families, most severely affecting spouse caregivers, whose assets, income, and expenses are often inextricably linked with patients’. A number of studies have shown that, collectively, these financial hardships contribute to disparities in patients’ quality of life and survival as well as caregivers’ well-being and ability to perform caregiving duties. Accordingly, interventions to mitigate financial toxicity should address the shared financial concerns of cancer patients and their spouses. Given the pressing need for such interventions in the context of rising healthcare costs, we developed a financial navigation intervention in collaboration with: 1) Consumer Education and Training Services (CENTS), a Seattle-based financial education and counseling organization; and 2) Patient Advocate Foundation (PAF), a national patient navigation organization. Based on our preliminary work demonstrating feasibility of delivering this intervention in the oncology clinic setting, we propose a prospective, randomized pragmatic trial in which 536 cancer patient - spouse caregiver dyads will receive proactive financial navigation or usual care. The intervention will consist of a one-time financial literacy education video, monthly contact for six months with CENTS counselors and PAF case managers who will help the couple with the financial aspects of cancer care, including budget management, insurance enrollment and optimization, access to copay assistance and other resources to manage medical and non-medical out-of-pocket costs. Usual care will also receive the one-time financial literacy video in order to standardize their experience. Our goals are to: 1) Determine the impact of a remotely-administered financial navigation program on development of material household financial hardship, 2) Investigate whether proactive financial navigation improves patient and caregiver psychosocial and healthcare utilization outcomes, and 3) Describe the use of financial navigation services by financially fragile, lower income, younger, and minority race households and evaluate the intervention’s effect in these subgroups. We will assess outcomes using survey, credit report, and medical record data obtained at baseline, six months, and twelve months post-enrollment. The primary endpoint of this study is incidence of household financial hardship within one year of enrollment. We expect that the results of this study will show that proactive financial navigation improves financial, psychosocial, and clinical outcomes in cancer patients and their spouse caregivers and should therefore be an essential component of high-quality cancer care in the United States.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $407,338 )
2025	2025	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	001	6	5/22/2025	NON-COMPETING CONTINUATION	$40,734
2025	2025	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	000	6	3/18/2025	NON-COMPETING CONTINUATION	$366,604
														Subtotal = $407,338

Issue Date FY: 2024 ( Subtotal = $452,824 )
2024	2024	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	001	5	4/26/2024	NON-COMPETING CONTINUATION	$23,834
2024	2024	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	000	5	3/19/2024	NON-COMPETING CONTINUATION	$428,990
														Subtotal = $452,824

Issue Date FY: 2023 ( Subtotal = $254,311 )
2023	2023	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	000	4	3/27/2023	NON-COMPETING CONTINUATION	$254,311
2023	2023	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	001	4	3/29/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $254,311

Issue Date FY: 2022 ( Subtotal = $619,802 )
2022	2022	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	001	3	5/27/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$619,802
2022	2022	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	003	3	8/9/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$223,778
2022	2021	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	000	2	5/27/2022	NON-COMPETING CONTINUATION	$0
2022	2021	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	002	2	8/9/2022	NON-COMPETING CONTINUATION	-$223,778
														Subtotal = $619,802

Issue Date FY: 2021 ( Subtotal = $626,428 )
2021	2021	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	001	2	3/3/2021	NON-COMPETING CONTINUATION	$626,428
2021	2020	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	000	1	2/16/2021	NEW	$0
														Subtotal = $626,428

Issue Date FY: 2020 ( Subtotal = $669,251 )
2020	2020	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Cause and Prevention Research	000	1	4/16/2020	NEW	$669,251
														Subtotal = $669,251

Grand Total All Awards = $3,029,954

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Addressing Cancer-Related Financial Hardship through Delivery of a Proactive Financial Navigation Intervention

Award Number: R01CA248656

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/16/2020

PERIOD OF PERFORMANCE END DATE: 03/31/2026

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