HIAYA CHAT study protocol: a randomized controlled trial of a health insurance education intervention for newly diagnosed adolescent and young adult cancer patients

Abstract

Background For adolescent and young adult (AYA) cancer patients aged 18 to 39 years, health insurance literacy is crucial for an effective use of the health care system. AYAs often face high out-of-pocket costs or have unmet health care needs due to costs. Improving health insurance literacy could help AYAs obtain appropriate and affordable health care. This protocol illustrates a randomized controlled trial testing a virtual health insurance education intervention among AYA patients. Methods This is a two-arm multisite randomized controlled trial. A total of 80 AYAs diagnosed with cancer in the Mountain West region will be allocated to either usual navigation care or tailored health insurance education intervention with a patient navigator that includes usual care. All participants will complete a baseline and follow-up survey 5 months apart. The primary outcomes are feasibility (number enrolled and number of sessions completed) and acceptability (5-point scale on survey measuring satisfaction of the intervention). The secondary outcomes are preliminary efficacy measured by the Health Insurance Literacy Measure and the COmprehensive Score for financial Toxicity. Discussion This trial makes a timely contribution to test the feasibility and acceptability of a virtual AYA-centered health insurance education program. Trial registration ClinicalTrials.gov NCT04448678. Registered on June 26, 2020

Financial burden and recommended multilevel solutions among caregivers of pediatric hematopoietic stem cell transplant recipients

“…However, unlike most cancer patients and their caregivers, caregivers in our sample were required to meet with social work at least once to discuss the financial impact of cancer—however, financial assistance resources are sometimes simply not available 47 . This finding suggests that caregivers’ recommendations, which parallel the growing literature surrounding the development and testing of financial navigation, employment, and health insurance literacy interventions may not mitigate long‐term financial toxicity among caregivers of HSCT recipients after treatment 48–52 . However, most interventions are tailored to adult patients on treatment and often do not explicitly include caregivers in the intervention design.…”

“…47 This finding suggests that caregivers' recommendations, which parallel the growing literature surrounding the development and testing of financial navigation, employment, and health insurance literacy interventions may not mitigate long-term financial toxicity among caregivers of HSCT recipients after treatment. [48][49][50][51][52] However, most interventions are tailored to adult patients on treatment and often do not explicitly include caregivers in the intervention design. At the same time, it is crucial that clinical providers not be completely removed from the financial burden concerns of patients as cost-conversations with providers have the potential to result in lower costs (e.g., prescription of generic medication).…”

“…Currently, there are ongoing interventions focused on reducing financial burden and improving resources through financial navigation and health insurance literacy only among adult and adolescent and young adult cancer patients. [48][49][50][51][52] These interventions may provide evidence and direction for the types of interventions that should be conducted among pediatric HSCT recipients and their caregivers. At the same time, however, these interventions will need to be adapted and integrated into existing social work workflows already embedded in HSCT programs.…”

Cost of Cancer in Adolescents and Young Adults in the United States: Results of the 2021 Report by Deloitte Access Economics, Commissioned by Teen Cancer America

“…One of most striking gaps is our understanding of the economic consequences of cancer diagnosis and treatment both during and beyond the AYA years. A greater understanding of the economic consequences of cancer is critical given the developmental timing of the cancer diagnosis, prevalence of uninsured and underinsured, and low health literacy in this population, 9,10 coupled with the growing costs of cancer treatment in the United States.…”

Recent advances in hydrogels-based osteosarcoma therapy

“…Osteosarcoma (OS), as a well-known primary bone tumor, involves the invasion of tumors into bone tissue and often occurs in children and adolescents ( Mann et al, 2022 ). Reports suggested that OS has become the second leading cause of death among young cancer patients, especially to the stage of tumor lung metastasis ( Siclari and Qin, 2010 ; Roessner et al, 2021 ).…”