Austin R Waters, Bridgette Thom, Allison M Deal, Camille R Murray, Kevin Pignone, Michelle L Manning, Mindy Gellin, Neda R Padilla, Lisa P Spees, Arrianna Marie Planey, Katherine E Reeder-Hayes, Donald L Rosenstein, Stephanie B Wheeler
Our findings demonstrate that receipt of FN decreased anxiety and depression and improved global mental health. Findings highlight the crucial role of FN in cancer care.
BACKGROUND: Financial toxicity is associated with worse health outcomes among cancer survivors. It is unknown if financial navigation (FN) can meaningfully improve the health of survivors experiencing financial toxicity.
AIMS: This analysis assesses changes in health-related quality of life (HRQoL) among cancer survivors receiving an FN intervention.
METHODS: A single-arm Type II Hybrid Implementation-Effectiveness clinical trial was conducted at eight clinical oncology sites in North Carolina. Cancer survivors within five years of diagnosis or living with advanced disease with a COmprehensive Score for financial Toxicity (COST-FACIT) score of < 23, and the ability to read and understand English were recruited to receive the Lessening the Impact of Financial Toxicity (LIFT) intervention, which included a comprehensive intake and at least one check-in with a trained navigator. Participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical and Mental Health, Anxiety, Depression, and Psychosocial Illness Impact-Positive measures.
RESULTS: A total of N = 86 cancer survivors received the LIFT FN intervention and completed baseline and follow-up surveys. Receipt of LIFT FN was associated with statistically significant improvements in measures of global mental health (change: 1.72, 95% CI: 0.07, 3.38), depression (change: -2.07, 95% CI: -3.90, -0.25), and anxiety (change: -3.33, 95% CI: -5.42, -1.24). From baseline to follow-up, mean depression scores clinically improved from "mild" to "within normal limits," and mean anxiety scores clinically improved from "moderate" to "mild."
CONCLUSIONS: Our findings demonstrate that receipt of FN decreased anxiety and depression and improved global mental health. Findings highlight the crucial role of FN in cancer care.
TRIAL REGISTRATION: NCT04931251.