AYA-NAV, A Patient-Informed, Tailored Needs Navigation Intervention for Adolescents and Young Adults With Cancer: A Pilot Study.
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IntroductionAdolescents and young adults (AYAs; 15-39 years old) with cancer experience poorer health outcomes and lower engagement in survivorship care often due to disproportionate financial toxicity and unmet health-related social needs (HRSN; e.g., food insecurity, housing instability, transportation barriers). Research has shown that needs navigation, the systematic screening, referral, and follow-up to resolve these barriers, is a potential strategy to reduce financial hardship. We assessed the feasibility of AYA-NAV, a centralized needs navigation intervention, through a pilot study involving AYAs with cancer.MethodsA prospective pilot study at a comprehensive cancer center screened AYAs for financial toxicity (i.e., COmprehensive Score for financial Toxicity (COST) score ≤22) and unmet HRSN. Patients who screened positive received the intervention, AYA-NAV, including case management support and digital HRSN navigation. Participants completed monthly check-ins with the study navigator to assess needs and, if appropriate, request navigation support. Participants completed surveys at 6 months to explore changes in COST or HRSN.ResultsThirty AYAs consented (23 female, mean age: 32.3 years, range: 18-39 years) to participate. Twenty-six (87%) screened positive for either financial toxicity or unmet HRSN, and 23 of them received AYA-NAV (88%). Retention at 6 months was 15 of 23 (65%). Participants who received AYA-NAV indicated that the intervention was acceptable and appropriately addressed needs through various referrals to community organizations. Among AYAs who participated in AYA-NAV and completed a 6-month questionnaire, COST scores increased significantly (P = 0.024).ConclusionsDelivery of AYA-NAV is feasible among AYAs with cancer. These findings inform refinements to AYA-NAV and support the need for a larger, randomized study to determine the efficacy of AYA-NAV on improving financial toxicity, HRSN, and other health outcomes.