ASPO Abstracts
Financial Hardship Screening among Native American Patients with Cancer: A Qualitative Analysis
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose of the study: We sought to characterize cancer-related financial hardship faced by Native American patients and identify facilitators and barriers at both patient and clinician levels to inform implementation of financial hardship screening. Methods: In 2022 we conducted key informant interviews with eleven Native American patients with cancer and clinical staff at a single cancer center in Oklahoma. Patient interviews included questions about current financial hardship, experiences in discussing financial hardship with the cancer care and primary care team, and acceptability of completing a financial hardship screening tool at the cancer center. Clinician interviews focused on confidence, comfort, and experience in discussing financial hardship with patients. Recorded interviews were transcribed and thematically analyzed using MAXQDA® software. Results: Patients expressed many financial challenges to receiving cancer care. The most frequently stated challenges included transportation, lodging during treatment, food insecurity, and utility expenses. Patients were willing to complete a financial hardship screening tool, but indicated this tool should be short and not overly intrusive of the patient's finances. Clinical staff described discomfort in discussing financial hardship with patients, primarily due to a lack of training and knowledge about resources to support patients. There were also differing perspectives on who should be responsible for addressing financial hardship and timing of such screening. Conclusions: We identified facilitators and barriers at both the patient and clinician levels to complete a financial hardship screening tool. These preliminary findings suggest that cancer centers need to develop clear organizational structures and processes for financial hardship to be addressed effectively. We are currently implementing a screening tool in a pilot study and conducting additional interviews among patients and clinical staff to identify methods to address financial hardship among Native American cancer patients. Findings from the pilot intervention will also be presented.
Keywords: Native American Health Disparities, Financial Hardship, Patient Navigation