A Novel Benefits Navigator Intervention to Address Unmet Social Needs in Pediatric Oncology

About This Grant

Children with cancer live in poverty have worse quality of life and are more likely to relapse and die. Unmet social needs – housing, food, utility, or transportation insecurity – are highly prevalent during pediatric cancer care and associated with poor outcomes. Despite the fact that social needs are modifiable drivers of health outcomes, pediatric oncology lacks interventions to systematically address unmet social needs. The overall objective of this application is to refine and pilot test a novel benefits navigator intervention, ASSIST, to address unmet social needs in pediatric oncology. Iterative parent input informed the ASSIST intervention prototype and logical next steps include intervention refinement and pilot testing. Following a stepwise approach for rigorous intervention development, Aim 1 will refine the ASSIST intervention prototype based on parent and community advisory board input, with a focus on optimizing intervention components and delivery to address identified barriers to uptake. Aim 2 will pilot test the refined ASSIST intervention among children with newly diagnosed cancer to examine feasibility, acceptability, and proof-of-concept of preliminary efficacy among endpoints including benefits receipt, decreased food insecurity, and decreased parent distress. Aim 3 will leverage a national dataset of children with acute lymphoblastic leukemia treated on Children’s Oncology Group trial AALL1731 to identify patterns and predictors of Supplemental Nutrition Assistance Program (SNAP) non-participation among eligible families as an exemplar means-tested benefit that reduces unmet social needs. Results will inform the approach for a subsequent multicenter efficacy evaluation of the ASSIST intervention. Dr. Umaretiya has foundational methodologic training and a strong academic track record that make her an excellent K08 candidate. This proposal will facilitate her transition to an independent physician-scientist focused on supportive care intervention development and evaluation through training in 1) community-engaged methodology, 2) supportive care clinical trial design, 3) measurement of parent- and patient-reported outcomes, and 4) longitudinal data analysis. Dr. Umaretiya’s proposal is supported by a highly skilled and successful mentorship team with expertise in these areas. She will complete this proposal in the unparalleled environment at UT Southwestern Medical Center, with strong institutional support, robust research infrastructure, and a large patient population. At the conclusion of this award, Dr. Umaretiya will have a feasible, pilot-tested intervention, pilot data, and essential training to support an R01 for a multicenter randomized efficacy trial to test the hypothesis that the ASSIST intervention will improve parent- and child-outcomes during cancer care. This application is highly significant in its aim to improve pediatric oncology outcomes by addressing unmet social needs. This program of research will innovatively shift the paradigm of pediatric oncology outcomes research from description to intervention, aligned with national calls from the National Cancer Institute, American Society for Clinical Oncology, and American Cancer Society.