Financial-Legal navigation reduces financial toxicity of pediatric and AYA cancers.

BACKGROUND:Pediatric and Adolescent and Young Adult (AYA) cancer patients and caregivers are at high risk for financial toxicity and few evidence-based oncology financial and legal navigation programs exist to address it. We tested the feasibility, acceptability, and preliminary effectiveness of FINassist (Financial and Insurance Navigation Assistance), a novel interdisciplinary financial and legal navigation intervention for pediatric oncology patients and caregivers. METHODS:We used a single-arm feasibility and acceptability trial design in the Division of Pediatric Oncology and Hematology and collected pre- and post- intervention surveys to assess changes in financial toxicity (three domains: psychological response/Comprehensive Score for Financial Toxicity [COST], material conditions and coping behaviors), health related quality of life (PROMIS Physical and Mental Health, Anxiety, Depression and Parent Proxy scales), and perceived feasibility, acceptability, and appropriateness. RESULTS:45 participants received financial navigation, 6 received legal navigation and 10 received both. Among 15 adult patients, there were significant improvements in COST (p=.041), and physical health (.036). Among 46 caregivers, significant improvements were noted for COST (<.001), the total financial toxicity score (.001), and the parent proxy global health score (.0037). We were able to secure roughly $335,323 (USD) in financial benefits for 48 participants. The intervention was rated highly for feasibility, acceptability, and appropriateness. CONCLUSIONS:Integrating financial and legal navigation via FINassist was feasible, acceptable, and underscores the benefit to a multidisciplinary approach to addressing financial toxicity.