Evidence map›Paper›PMID 39138428›Full record

ArticleBMC health services research2024

Financial hardship screening among Native American patients with cancer: a qualitative analysis.

Amber S Anderson-Buettner, Amanda E Janitz, Mark P Doescher, Stefanie D Madison, Michaela A Khoussine, Keri L Harjo, Marvin B Bear, Stephnie Dartez, Sheryl K Buckner, Dorothy A Rhoades

Abstract read
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In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Amber S Anderson-BuettnerDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences, Oklahoma City, OK, USA. Amber-S-Anderson@ouhsc.edu.
Amanda E JanitzDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
Mark P DoescherDepartment of Family Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
Stefanie D MadisonOklahoma City Veterans Affairs Health Care System, Oklahoma City, OK, USA.
Michaela A KhoussineCentral States Research, Tulsa, OK, USA.
Keri L HarjoOklahoma City Indian Clinic, Oklahoma City, OK, USA.
Marvin B BearLittle Axe Health Center, Absentee Shawnee Tribe, Norman, OK, USA.
Stephnie DartezStephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
Sheryl K BucknerFran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
Dorothy A RhoadesDepartment of Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.

Funding

Tissue Pathology Shared ResourceP30CA225520 · NCI · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI Wade Williams · 2018 to 2026
$27.1M
NCI NIH HHS P30 CA225520
6 · The paper itself

Abstract

backgroundCancer-related financial hardship is an increasingly recognized concern for patients, families, and caregivers. Many Native American (NA) patients are at increased risk for cancer-related financial hardship due to high prevalence of low income, medical comorbidity, and lack of private health insurance. However, financial hardship screening (FHS) implementation for NA patients with cancer has not been reported. The objective of this study is to explore facilitators and barriers to FHS implementation for NA patients.

methodsWe conducted key informant interviews with NA patients with cancer and with clinical staff at an academic cancer center. Included patients had a confirmed diagnosis of cancer and were referred to the cancer center through the Indian Health Service, Tribal health program, or Urban Indian health program. Interviews included questions regarding current financial hardship, experiences in discussing financial hardship with the cancer care and primary care teams, and acceptability of completing a financial hardship screening tool at the cancer center. Clinical staff included physicians, advanced practice providers, and social workers. Interviews focused on confidence, comfort, and experience in discussing financial hardship with patients. Recorded interviews were transcribed and thematically analyzed using MAXQDA® software.

resultsWe interviewed seven patients and four clinical staff. Themes from the interviews included: 1) existing resources and support services; 2) challenges, gaps in services, and barriers to care; 3) nuances of NA cancer care; and 4) opportunities for improved care and resources. Patients identified financial challenges to receiving cancer care including transportation, lodging, food insecurity, and utility expenses. Patients were willing to complete a FHS tool, but indicated this tool should be short and not intrusive of the patient's financial information. Clinical staff described discomfort in discussing financial hardship with patients, primarily due to a lack of training and knowledge about resources to support patients. Having designated staff familiar with I/T/U systems was helpful, but perspectives differed regarding who should administer FHS.

conclusionsWe identified facilitators and barriers to implementing FHS for NA patients with cancer at both the patient and clinician levels. Findings suggest clear organizational structures and processes are needed for financial hardship to be addressed effectively.

Indexed as

Financial StressIndians, North AmericanNeoplasmsQualitative ResearchAdultAgedFemaleHumansInterviews as TopicMaleMiddle AgedCancerFinancial hardshipNative American

Identifiers

PMID39138428
PMCPMC11323667

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.