To date, there have been no prospective studies evaluating the impact of the interventions aimed at reducing financial hardship among people with cancer.
Up to half of people with cancer experience financial hardship. Cancer-related financial hardship is associated with several adverse intermediate and health outcomes, including poor quality of life, treatment non-adherence, and lower survival.
An increasing body of observational evidence suggests that communication about financial concerns and out-of-pocket (OOP) costs early in the treatment trajectory and in partnership with the care team could help to prevent or lessen financial hardship. This type of communication could be delivered through patient navigation programs and is consistent with both patient and care team preferences.
However, to date there is no evidence from randomized trials suggesting that navigation during the active treatment period reduces financial hardship. Further, no intervention-based studies have provided evidence on the most effective ways to mitigate cancer-related financial hardship. CAFÉ (Cancer Financial Experience) is a randomized controlled trial to test the effectiveness of the financial navigation program in reducing financial hardship.
CAFÉ participants randomized to the intervention group will receive a written list of financial assistance resources plus 6 months of personalized outreach and assistance with financial concerns. Participants randomized to the control group (enhanced usual care) will receive the same written list of financial assistance resources that the intervention group participants receive.
The intervention is based on the research team’s prior studies and is informed by a conceptual framework of how patient-centered communication can improve health.
We have designed the intervention in close partnership with KPWA and KPNW members, clinic teams, administrative staff, and health plan leaders. The CAFÉ study has the full support and partnership of clinical and operational teams at KPWA and KPNW.