Evaluating the impact of virtual oncology financial and legal navigation on cancer-related financial toxicity.

Authors

Jean S Edward, Lynn J Andreae, Haafsah Fariduddin, Elizabeth Ruschman, Lori Eisele, Mackenzie Caldwell, Joanna Doran, Monica Bryant, Jordan Heflin, Brent Shelton, John D'Orazio, Kimberly D Northrip

Published in

JNCI cancer spectrum. Aug 24, 2026. Epub Aug 24, 2026.

Abstract

To evaluate the impact of a virtual oncology financial and legal navigation (OFLN) intervention on cancer-related financial toxicity (FT) and health-related quality of life (QOL) in pediatric and adolescent and young adult (PAYA) cancer patients and caregivers, as well as assess the intervention's acceptability and feasibility.
A single-arm trial was conducted in a PAYA oncology clinic between March 2024 and May 2025. Pre- and post-intervention surveys included the Comprehensive Score for Financial Toxicity (COST), Patient-Reported Outcomes Measurement Information System global health, anxiety and depression scales, National Comprehensive Cancer Network's Distress Thermometer, and intervention acceptability, appropriateness and feasibility of Measures.
The majority (36 patients and 88 caregivers) identified as female (73%), non-Hispanic White (85%), rural residents (61%), with incomes above the federal poverty level (71%). Participants reported moderate levels of FT at baseline with mean COST of 20.9 (SD = 11.14) for patients and 19.3 (SD = 10.12) for caregivers and high levels of anxiety, depression, and distress. Among caregivers, there was a significant (p = 0.01) post-intervention increase in COST (indicating decreased FT). Almost all patients reported decreases in subjective stress and anxiety (94%) and feeling better prepared to navigate financial/legal issues. Participants rated the intervention highly across implementation outcomes of acceptability (76%), appropriateness (76%), and feasibility (75%), which was also supported by 89% enrollment and 95% retention rates.
Findings demonstrate that virtual OFLN has the potential to increase access to supportive care services especially in rural communities. Additional research supporting scalability and uptake for widespread implementation is needed.

PMID:
42636254
Bibliographic data and abstract were imported from PubMed on 25 Aug 2026.

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