A5065969968- Economic and Financial Impacts of Cancer
- Cervical Cancer and HPV Research
- Health Systems, Economic Evaluations, Quality of Life
- Global Cancer Incidence and Screening
- Vaccine Coverage and Hesitancy
- Evaluation and Performance Assessment
- Community Health and Development
- Multiple and Secondary Primary Cancers
- Palliative Care and End-of-Life Issues
- Healthcare Policy and Management
- Complex Systems and Decision Making
- Disaster Management and Resilience
- Colorectal Cancer Screening and Detection
- SARS-CoV-2 and COVID-19 Research
- Health Policy Implementation Science
- COVID-19 epidemiological studies
- Healthcare cost, quality, practices
- Adolescent and Pediatric Healthcare
- Primary Care and Health Outcomes
- Public Health Policies and Education
- Childhood Cancer Survivors' Quality of Life
- Patient Satisfaction in Healthcare
- Acute Lymphoblastic Leukemia research
- Medication Adherence and Compliance
- Vector-Borne Animal Diseases
University of North Carolina at Chapel Hill
2017-2025
UNC Lineberger Comprehensive Cancer Center
2021-2023
Public Health Department
2022-2023
Communities In Schools of Orange County
2022
Abstract Background Almost half of the patients with cancer report cancer-related financial hardship, termed “financial toxicity” (FT), which affects health-related quality life, care retention, and, in extreme cases, mortality. This increasingly prevalent hardship warrants urgent intervention. Financial navigation (FN) targets FT by systematically identifying at high risk, assessing eligibility for existing resources, clarifying treatment cost expectations, and working caregivers to develop...
Background: Despite screening's effectiveness in reducing cervical cancer incidence and mortality, disparities screening uptake remain, with lower rates documented among uninsured low-income individuals. We examined perceived financial barriers to, the cost burden of, screening. Materials Methods: surveyed 702 low-income, or publicly insured women ages 25–64 years North Carolina, U.S., who were not up to date on according national guidelines. Participants asked about how much they would...
Patients with cancer are at heightened risk of experiencing financial hardship. Financial navigation (FN) is an evidence-based approach for identifying and addressing patient caregiver needs. In preparation the implementation a multisite FN intervention, we describe existing
Cancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss changes in health insurance may not be uniformly experienced. We examined racial/ethnic differences the consequences of disruption.We surveyed a national sample cancer patients employed at diagnosis who had received assistance from nonprofit about impact treatment on employment. used logistic regression models examine coverage.Of 619 included, 63% identified as...
Background Cancer-related financial hardship is associated with negative clinical outcomes, which may be partially explained by cost-related delayed or forgone care in response to barriers. We sought understand patient experiences facing barriers medical following a cancer diagnosis. Methods conducted virtual, semi-structured interviews Fall 2022 20 adults history of who had experienced cancer-related the prior year. used template analysis within pragmatic paradigm, combining constructivist...
HPV vaccination coverage remains far below the national target of 80% among US adolescents, particularly in rural areas, which have vaccine uptake rates that are 10% points lower than non-rural areas on average. Primary care professionals (PCPs) can increase by using presumptive recommendations to introduce a way assumes parents want vaccinate. Through semi-structured interviews, we explored PCPs' experiences and perceptions rural- non-rural-serving primary clinics North Carolina. Thematic...
We retrospectively evaluated the clinical and economic impact of a program providing nonmedical financial assistance on missed treatment appointments among patients receiving cancer at large, Southeastern public hospital system.
Despite the use of interventions (e.g., monetary incentives, educational campaigns, on-site workplace vaccination) to increase COVID-19 vaccination, differences in uptake persist by poverty level, insurance status, geography, race, and ethnicity, suggesting that these may not be adequately addressing barriers faced populations. Among a sample resource-limited individuals with chronic illnesses, we (1) described prevalence different types vaccination (2) identified associations between...
Background Lessening the Impact of Financial Toxicity (LIFT) is an intervention designed to address financial toxicity (FT) and improve cancer care access outcomes through navigation (FN). FN identifies patients at risk for FT, assesses eligibility support, develops strategies cope with those costs. LIFT successfully reduced FT improved in a preliminary study among high levels single large academic center. Adapting requires distinguishing between core functions (components that are key its...
Background: Although the need to reduce impact of financial toxicity among patients with cancer is widely acknowledged, few interventions have been developed address this issue. We tested a novel, multiphase, patient-centered navigation (FN) intervention at large academic medical center. Methods: screening tool consisting Comprehensive Score for Financial Toxicity (COST) measure plus several additional items based on patient feedback. After systematizing process, 50 from North Carolina...
Abstract Purpose By requiring specific measures, cancer endorsements (e.g., accreditations, designations, certifications) promote high-quality care. While 'quality' is the defining feature, less known about how these consider equity. Given inequities in access to care, we assessed extent which equity structures, processes, and outcomes were required for center endorsements. Methods We performed a content analysis of medical oncology, radiation surgical research hospital from American Society...
Persons diagnosed with serious chronic illnesses and their caretakers experience multiple types of financial costs that strain income generate distress. Many turn to medical crowdfunding (MCF) mitigate the harms these on health quality life.
The COVID-19 pandemic response has demonstrated the interconnectedness of individuals, organizations, and other entities jointly contributing to production community health. This involved stakeholders from numerous sectors who have been faced with new decisions, objectives, constraints. We examined cross-sector organizational decision landscape that formed in North Carolina. conducted virtual semi-structured interviews 44 decision-makers representing nine Carolina between October 2020...
Purpose Healthcare discrimination has been associated with health disparities including lower cancer screenings, higher medical mistrust, and strained patient-provider relationships. Our study sought to understand patient-reported among survivors limited resources living in the United States.Design methods We used cross-sectional survey data distributed by Patient Advocate Foundation (PAF) 12/2020 07/2021. Respondents reported source reason of healthcare discrimination. Age, sex, race...
Abstract Background The healthcare costs of patients who receive hematopoietic stem cell transplantation (HSCT) are substantial. At the same time, increasing use pediatric HSCT leaves more caregivers recipients at risk for financial burden—an understudied area research. Methods Financial burden experienced by received autologous or allogeneic transplants was assessed using an explanatory mixed‐methods design including a one‐time survey and semi‐structured interviews. through adapted...
The COVID-19 pandemic has popularized computer-based decision-support models, which are commonly used to inform decision making amidst complexity. Understanding what organizational makers prefer from these models is needed model development during this and future crises.
Abstract Background: We evaluate the cost-effectiveness of human papillomavirus (HPV) self-collection (followed by scheduling assistance for those who were HPV+ or inconclusive) compared with only and usual care among underscreened persons a cervix (PWAC). Methods: A decision tree analysis was used to estimate incremental ratios (ICER), cost per additional PWAC screened, from Medicaid/state clinic perspectives. hypothetical cohort represented 90,807 low-income, individuals. Costs health...
Financial navigation services support patients with cancer and address the direct indirect financial burden of diagnosis treatment. These are commonly delivered through a variety frontline oncology personnel (FOSP) including navigators, social workers, supportive care providers, other clinic staff, but perspective FOSPs is largely absent from current literature on in oncology. We surveyed national sample to understand their perspectives patient burden, resource availability, barriers...