{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:37Z","timestamp":1792785997700,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Kentucky Cabinet for Health and Family Services","id":[{"id":"https:\/\/ror.org\/045rcvm30","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Kentucky Pediatric Cancer Research Trust Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the impact of a virtual oncology financial and legal navigation (OFLN) intervention on cancer-related financial toxicity (FT) and health-related quality of life (QOL) in pediatric and adolescent and young adult (PAYA) cancer patients and caregivers, as well as to assess the intervention\u2019s acceptability and feasibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-arm trial was conducted in a PAYA oncology clinic between March 2024 and May 2025. Pre- and post-intervention surveys included the Comprehensive Score for Financial Toxicity (COST), Patient-Reported Outcomes Measurement Information System global health, anxiety and depression scales, National Comprehensive Cancer Network\u2019s Distress Thermometer, and intervention acceptability, appropriateness, and feasibility of measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority (36 patients and 88 caregivers) identified as female (73%), non-Hispanic White (85%), rural residents (61%), with incomes above the federal poverty level (71%). Participants reported moderate levels of FT at baseline with a mean COST of 20.9 (SD = 11.14) for patients and 19.3 (SD = 10.12) for caregivers and high levels of anxiety, depression, and distress. Among caregivers, there was a significant (P\u2009=\u2009.01) post-intervention increase in COST (indicating decreased FT). Almost all patients reported decreases in subjective stress and anxiety (94%) and feeling better prepared to navigate financial\/legal issues. Participants rated the intervention highly across implementation outcomes of acceptability (76%), appropriateness (76%), and feasibility (75%), which was also supported by 89% enrollment and 95% retention rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings demonstrate that virtual OFLN has the potential to increase access to supportive care services, especially in rural communities. Additional research supporting scalability and uptake for widespread implementation is needed.<\/jats:p>\n                    <jats:p>ClinicalTrials.gov ID: NCT07409662<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkag085","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:45:16Z","timestamp":1787226316000},"source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the impact of virtual oncology financial and legal navigation on cancer-related financial toxicity"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9184-1048","authenticated-orcid":false,"given":"Jean S","family":"Edward","sequence":"first","affiliation":[{"name":"School of Nursing, University of Louisville , Louisville, KY,","place":["United States"]},{"name":"Brown Cancer Center, University of Louisville , Louisville, KY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn 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