Social Determinants of Health Research Project

Project Summary- Social Determinants of Health Multilevel Intervention Financial toxicity –hardships caused by the costs of cancer treatment– are common and have substantial impact on cancer outcomes and patient wellbeing. The signature social determinants of health multilevel intervention trial of the Washington University Advancing Cancer Control Equity Research through

Transformative Solutions (WashU-ACCERT) Center aims to improve cancer patients’ quality of life throughout treatment and into survivorship by addressing access to and affordability of cancer care and financial burden associated with cancer treatment costs. This is directly responsive to community-identified concerns around

access to care and affordability. We will achieve this by: adapting the web-based I-CARE (Insurance and Cancer Affordability Resources) tool and pairing it with clinician and system training to support financial services. The patient-focused tool is designed to provide education on insurance, support people with cancer

in making choices about health insurance, accessing resources to offset the financial burden of care, and building self-efficacy for discussing care costs with clinicians. Outcomes will be assessed at the patient, provider, and system level. The specific aims of this research project are to: Aim 1: Engage end-users to adapt I CAN PIC to I-CARE employing a user-centered approach.

Aim 2: Prepare for multi-level implementation using the Expert Recommendations for Implementing Change (ERIC) strategies Aim 3: Implement and evaluate I-CARE in a randomized trial. This project will adapt, implement, and evaluate I-CARE in urban and rural Missouri, reflecting the WashU- ACCERT Center theme on intersectionality of race, ethnicity, and geography and addressing access to health

and healthcare as defined by the Center’s conceptual framework: affordability, availability, accessibility, accommodation, acceptability. Our multidisciplinary research team, including university and community co- leads, comprises experts in patient centered communication, implementation science, community engagement,

cancer equity, and health economics. This project will advance our understanding around the impact of these social determinants of health on adverse cancer outcomes. As part of the WashU-ACCERT Community Responsive Research Program, this adaption, implementation, and evaluation of I-CARE addresses community-identified concerns around access to care and affordability, and will provide critical insights into

advancing equity by addressing social determinants of health and financial toxicity across diverse races and geographies.