Evaluating Childcare Support in NCI Designated Cancer Centers for Patients with Young Children Undergoing Treatment

The daily nature of radiotherapy treatment can be challenging for parents diagnosed with cancer who have young children. Access to affordable and convenient childcare can be a considerable hurdle to treatment adherence. We aim to determine the breadth of childcare services and support provided by NCI-designated cancer centers to decrease the burden and stress of receiving radiotherapy treatment of patients with children.We conducted a cross-sectional survey of the 70 NCI-designated cancer centers. Centers were originally contacted by phone call utilizing their publicly available website, and the researcher asked to speak with the radiation oncology department social worker. Calls were conducted from June 2022 through February 2023. As a result of low response rate, a second methodological design was developed through a collaboration with Association for Directors of Radiation Oncology Programs (ADROP) whereby their listserv was utilized to connect with social workers. For both query designs, social workers were asked what childcare services are offered by the center, if such services are internal, if patients are referred to external organizations, as well as if such organizations operate charitably or require payment for their services. Centers were stratified by type of childcare support offered and compared across private versus public institutions.Sixty-three of the 70 NCI-designated cancer centers were contacted for data collection, excluding 6 identified as basic laboratories and 1 center serving only pediatric patients. Contact was established with the social work department of 39 cancer centers (62%), of which only 19 (49%) had a radiation oncology departmental social worker. Response data were gathered from 11 (58%) total centers regarding their childcare services. Of the centers surveyed, 10 (91%) indicated the primary form of support offered was via referral to external organizations. Four centers (36%) described offering financial support for childcare, three of which are privately-funded institutions. When queried about the need for childcare support provided by cancer centers, 4 of the 5 surveyed public institutions expressed a need for expansion of these services; the 6 private institutions denied a need for these services among their patient population.Lack of access to childcare presents a significant burden to adherence to radiotherapy among parents undergoing radiotherapy with young children. Our study showed that external community organizations currently play a crucial role in providing childcare support to parents with cancer and demonstrates an inequity between private and public institutions in the perceived need of childcare support for their patients as well as ability to offer direct financial support.