{"doi":"10.1093/jncics/pkae025","title":"Financial-legal navigation reduces financial toxicity of pediatric, adolescent, and young adult cancers","abstract":"BACKGROUND: Pediatric, adolescent, and young adult patients with cancer and their caregivers are at high risk of 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 Financial and Insurance Navigation Assistance, a novel interdisciplinary financial and legal navigation intervention for pediatric, adolescent and young adult patients and their caregivers. METHODS: We used a single-arm feasibility and acceptability trial design in a pediatric hematology and oncology clinic and collected preintervention and postintervention surveys to assess changes in financial toxicity (3 domains: psychological response/Comprehensive Score for Financial Toxicity [COST], material conditions, and coping behaviors); health-related quality of life (Patient-Reported Outcomes Measurement Information System Physical and Mental Health, Anxiety, Depression, and Parent Proxy scales); and perceived feasibility, acceptability, and appropriateness. RESULTS: In total, 45 participants received financial navigation, 6 received legal navigation, and 10 received both. Among 15 adult patients, significant improvements in FACIT-COST (P = .041) and physical health (P = .036) were noted. Among 46 caregivers, significant improvements were noted for FACIT-COST (P < .001), the total financial toxicity score (P = .001), and the parent proxy global health score (P = .0037). We were able to secure roughly $335 323 in financial benefits for 48 participants. The intervention was rated highly for feasibility, acceptability, and appropriateness. CONCLUSIONS: Integrating financial and legal navigation through Financial and Insurance Navigation Assistance was feasible and acceptable and underscores the benefit of a multidisciplinary approach to addressing financial toxicity. CLINICALTRIALS.GOV REGISTRATION: NCT05876325.","journal":"JNCI Cancer Spectrum","year":2024,"id":426863,"datarank":0.6345593037086747,"base_score":2.833213344056216,"endowment":2.833213344056216,"self_citation_contribution":0.42498200160843247,"citation_network_contribution":0.20957730210024222,"self_endowment_contribution":0.42498200160843247,"citer_contribution":0.20957730210024222,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":12,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9621,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT05876325"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1226903,"name":"Kimberly D. Northrip","orcid":null,"position":1,"is_corresponding":false},{"id":598377,"name":"Mary Kay Rayens","orcid":"0000-0001-8465-8763","position":2,"is_corresponding":false},{"id":1226394,"name":"Andrea Welker","orcid":"0000-0001-5305-1715","position":3,"is_corresponding":false},{"id":1226904,"name":"Rachel O’Farrell","orcid":null,"position":4,"is_corresponding":false},{"id":1226905,"name":"Jennifer Knuf","orcid":null,"position":5,"is_corresponding":false},{"id":1226906,"name":"Haafsah Fariduddin","orcid":null,"position":6,"is_corresponding":false},{"id":1226395,"name":"Julia F. Costich","orcid":"0000-0001-8687-4478","position":7,"is_corresponding":false},{"id":744700,"name":"John A. D’Orazio","orcid":"0000-0003-1008-6234","position":8,"is_corresponding":false},{"id":317123,"name":"Jean Edward","orcid":"0000-0001-9184-1048","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T01:58:42.796720Z","pmid":"38552323","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}