Developing an Educational Intervention to Address Financial Hardship in Cancer Patients

Nandita Khera; Ashok Kumbamu; Shelby L Langer; Aminah Jatoi; Celia C Kamath; Elizabeth Mathew; Yousuf S Zafar; Joan M Griffin

doi:10.1016/j.mayocpiqo.2020.04.004

Developing an Educational Intervention to Address Financial Hardship in Cancer Patients

Mayo Clin Proc Innov Qual Outcomes. 2020 Jul 15;4(4):424-433. doi: 10.1016/j.mayocpiqo.2020.04.004. eCollection 2020 Aug.

Authors

Nandita Khera¹, Ashok Kumbamu², Shelby L Langer³, Aminah Jatoi⁴, Celia C Kamath⁵, Elizabeth Mathew¹, Yousuf S Zafar⁶, Joan M Griffin⁷

Affiliations

¹ Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ.
² Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN.
³ Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ.
⁴ Division of Medical Oncology, Mayo Clinic, Rochester, MN.
⁵ Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
⁶ Duke Cancer Institute, Durham, NC.
⁷ Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN.

Abstract

Objective: To develop an educational intervention to empower patients to manage their financial health better.

Participants and methods: This study was conducted from September 1, 2017, to January 31, 2019. Focus groups were held with social workers, case managers, and patient financial service staff and interviews were conducted with patients and caregivers to inform the content, delivery format, and timing of an intervention for mitigating financial hardship from treatment (phase 1). Based on qualitative data, theories of adult learning, and a review of the literature, we created an educational presentation to be delivered in a classroom setting. Two patient focus groups were then held for feedback on the presentation (phase 2).

Results: In phase 1, both patients and allied health care staff providers believed that an educational intervention about financial aspects of care early during treatment would help them cope and plan better. Participants' suggestions for the intervention's content included billing information, insurance, authorization processes, employment policies related to health care and disability benefits, and alternative financial resources. Based on these suggestions, a preliminary educational presentation was developed with 3 main themes: insurance issues, employment issues, and financial health. Phase 2 focus group participants suggested refinement of the presentation, including targeting specific groups, adding graphics, and more information about resources.

Conclusion: Our study provides the basis for a patient-centered education module for emotional, instrumental, and informational support for financial distress for use in a clinical setting.

Keywords: FG, focus group.