“It was just right:” Patient experience, acceptability, and perceived utility of a novel financial navigation program in oncology.

Abstract

279 Background: Cancer-related financial hardship is prevalent and associated with poor health outcomes. CAFÉ is a multi-site randomized control trial (RCT) testing a financial navigation intervention to reduce financial hardship for people newly diagnosed with cancer. Methods: The CAFÉ trial randomized participants (n=371) to usual care or one of two intervention arms. Participants randomized to the intervention arms received either brief (one proactive outreach) or extended (three proactive outreaches) contact from a navigator along with access to navigation services for 6 months. At the final outreach call, we asked participants to answer open-ended questions about the perceived acceptability and helpfulness of the program. Navigators recorded verbatim notes, and a trained qualitative methodologist conducted content analysis. Results: Among 69 participants (35 extended; 34 brief) who completed final outreach calls, to date, 65% were female, average age was 63 years, and 3 were Spanish-language speakers. Cancer diagnoses included: breast (35%), prostate (16%), colorectal (7%), lung (4%), and other (38%). Almost all (99%; 68) expressed high satisfaction with the navigation program. Most (83%; 57) reported easy rapport-building (e.g., sharing needs; feeling listened to). Most (81%; 56) found the frequency of outreach appropriate to their needs and reported navigators were accessible when needed (72%: 50). Most participants (84%; 58) found their experience helpful, including the proactive outreach and advocacy provided by the navigators. Useful program components included answering patients cost-related questions and identifying financial resources (74%; 41); satisfaction about the navigator’s expertise (72%; 50); and ongoing reminders about patient actions (e.g. applying for medical financial assistance) (48%; 33). Areas for improvement included offering more personalized financial resources; more support applying for such resources; extending the service beyond 6 months; and starting outreach closer to cancer diagnosis date. Brief arm participants less often endorsed appropriate frequency (74% vs 86%) and ease of contact (68% vs 77%) than those in the extended arm. Conclusions: Components of the CAFÉ financial navigation program found to be highly acceptable included proactive outreach, ongoing support and navigator knowledge; ease of rapport-building; and accessibility. Future analyses will determine the effectiveness of the CAFÉ program on financial, health and healthcare outcomes. Clinical trial information: NCT05018000 .