Feasibility of screening for and matching adolescents and young adults with cancer to a community-partnered financial and health-related social needs navigation intervention.

Abstract

281 Background: Adolescents and young adult (AYAs, defined by the NCI as aged 15-39) cancer survivors experience high rates of financial toxicity, and the risk for and severity of financial toxicity are associated with unmet health-related social needs (HRSN: e.g., difficulty affording housing, food, transportation, insurance). Financial navigation may be an effective intervention to reduce financial toxicity and improve health outcomes. We have adapted an AYA- and caregiver-informed intervention to reduce financial burden among English- and Spanish-speaking AYAs on active cancer treatment. We report on the preliminary feasibility of a baseline financial and HRSN assessment among AYAs and navigating AYAs with unmet needs to the Patient Advocate Foundation (PAF), our community-partner, at a large, urban comprehensive cancer center. Methods: AYAs aged 15-39 years who speak English or Spanish and are receiving curative-intent treatment for cancer completed a baseline needs assessment that assessed financial and HRSN. The following indicates a positive screen for financial or HRSN: Comprehensive Score for Financial Toxicity (COST, AYA) score < 22 or Personal Financial Wellness Scale (PFWS, caregiver) ≤ 4; Any food, housing, transportation, utility insecurity or uninsurance. Participants are also distinctly offered connection to our community partner regardless of screening response. Participants with a positive screen will receive a needs navigation intervention in partnership with PAF for 6 months. We report the initial uptake, rates of baseline assessment completion, and reasons for screening positive in preparation for the next wave of recruitment. Results: Of 12 AYAs approached, eleven participated in the baseline assessment: one was completed by a parent proxy, and seven caregivers concurrently completed a dyadic assessment. In total, of the 11 AYAs, six screened positive for one or more unmet needs, thus meeting criteria to receive the financial and HRSN navigation intervention. Additionally, one AYA and caregiver dyad requested connection to the intervention in the absence of a positive screen. Unmet needs included housing insecurity (n=3), transportation (n=2), utilities (n=1); all six AYAs who screened positive met criteria for financial toxicity. Among dyadic responses, 5 of 6 were concordant. Conclusions: Preliminary data support the feasibility of screening AYAs for and matching them to a financial and HRSN navigation intervention. Next steps will include recruitment and expansion to demonstrate feasibility of the intervention and explore impact on financial and HRSN as well as health outcomes.