Abstract C073: Enhancing cancer care: Insights from the CAFÉ Trial on Financial Navigation and program improvements
Authors: Schneider Jennifer L. , Locher Blake , Rivelli Jennifer S. , King Deborah A. , Shulman Lisa , Petrik Amanda F. , Henrikson Nora B. , Banegas Matthew P. 
Published: September 2024

Abstract
Purpose: Cancer-related financial hardship is prevalent and associated with poor health outcomes. CAFÉ is a multi-site randomized control trial (RCT) testing a financial navigation intervention to reduce financial hardship for people newly diagnosed with cancer. Methods: The CAFÉ trial randomized participants to usual care or one of two intervention arms. Participants randomized to the intervention arms received either brief (one proactive outreach) or extended (three proactive outreaches) contact from a navigator to assess for financial concerns. Navigation services lasted for 6 months. At the final outreach call, we asked participants to provide feedback on areas of program improvement. We also conducted two rounds of interviews (early and later intervention) with the CAFÉ financial navigators to explore lessons learned regarding implementing the program. Data was summarized using a content analysis approach. Results: Among 201 participants (102 extended; 99 brief) that offered feedback at the final outreach call, 64% (129) were satisfied with the navigation program and did not feel changes were warranted. Suggested improvements included: improving the timeliness and usefulness of resources offered (18%; 37); offering earlier and more frequent/ongoing outreach from the navigators (14%; 28); receiving more active support from the navigators in accessing or processing information and resources (13%; 27); and increasing the scope of the navigator role to aid in complicated billing or insurance questions (9%; 19). Improving timeliness/usefulness of resources offered and frequency of outreach was noted slightly more often by participants in the brief arm (36%) than those in the extended arm (29%). Financial navigators (n=4) reported parallel themes for improvement including: expanding the navigator’s scope to help with billing, insurance, and cost questions; tailoring resources offered to the participant’s specific needs; and reaching out to participants closer to their cancer diagnosis. Navigators identified additional improvements including: having sufficient staffing and time to fulfill navigator functions; creating a simple and integrated documentation/tracking tool within the organization’s electronic health record; and translating important resources and instructions, like financial assistance applications, into Spanish. Conclusion: The overall satisfaction with the CAFÉ program underscores its potential to positively impact the well-being of individuals newly diagnosed with cancer. However, patients and navigators alike underscored important areas of improvement that health care systems may want to consider for future implementation: timeliness and length of the outreach, personalization of offered resources, and expansion of navigator role. Navigators also noted opportunities for improving data tracking and staffing. Future analyses will determine the effectiveness of the CAFÉ program on financial, health and healthcare outcomes.
Citation Format: Jennifer L. Schneider, Blake Locher, Jennifer S. Rivelli, Deborah A. King, Lisa Shulman, Amanda F. Petrik, Nora B. Henrikson, Matthew P. Banegas. Enhancing cancer care: Insights from the CAFÉ Trial on Financial Navigation and program improvements [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C073.