{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:48:51Z","timestamp":1792151331445,"version":"4.4.0"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Financial toxicity (FT) among cancer survivors is prevalent and associated with excess morbidity and mortality. Although financial navigation (FN) has reduced FT in limited academic and urban settings, evaluation of FN within broader practice settings is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pragmatic hybrid II implementation-effectiveness clinical trial (Lessening the Impact of Financial Toxicity [LIFT]) in eight oncology practice sites, tailoring FN for four rural sites and four nonrural sites. All patients with cancer within 5 years of diagnosis, or those living with advanced disease, with a Comprehensive Score for financial Toxicity (FACIT-COST) score of \u226422 (indicating moderate-to-severe FT) who understood English were eligible. The primary effectiveness outcome was change in FACIT-COST score, pre- versus post-LIFT implementation. Patient-level secondary outcomes included the following: uptake (number served by FN\/number screened positive for FT), acceptability, responsiveness, alignment with needs, patient-centeredness, and timeliness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 258 patients consented, 233 screened FT-positive, 179 received FN, 134 completed post-intervention measures, and 21 died before study completion. Participants were, on average, 53.0 years (standard deviation [SD], 13.0), mostly female (65.7%), and non-Hispanic White (56.0%) or Black (33.6%), with 9.0% identifying as Hispanic and 39.6% from a rural ZIP code. After LIFT, FACIT-COST scores significantly improved by an average 8.1 (SD, 10.0) points (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001), Pre: 6.6 (SD, 5.1), Post: 14.7 (SD, 10.2), with significant increases at both rural (6.3 [SD, 9.2],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) and nonrural sites (9.3 [SD, 10.4],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Intervention uptake was high, with nearly three quarters of those who screened positive for FT receiving FN. LIFT was broadly perceived as acceptable, responsive, aligned with patient needs, and timely.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patient-centered interventions like FN can clearly reduce FT in diverse patient populations across clinical settings and should be considered best practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-26-00617","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:00:19Z","timestamp":1792148419000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a Multisite Oncology Financial Navigation Intervention: The Lessening the Impact of Financial Toxicity Clinical Trial"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3399-9047","authenticated-orcid":false,"given":"Stephanie B.","family":"Wheeler","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9947-8535","authenticated-orcid":false,"given":"Austin R.","family":"Waters","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Divison of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2481-4485","authenticated-orcid":false,"given":"Camille R.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Manning","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3526-3938","authenticated-orcid":false,"given":"Allison M.","family":"Deal","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6510-1767","authenticated-orcid":false,"given":"Kevin","family":"Pignone","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-9330","authenticated-orcid":false,"given":"Lisa P.","family":"Spees","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4739-090X","authenticated-orcid":false,"given":"Arrianna Marie","family":"Planey","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6239-1666","authenticated-orcid":false,"given":"Bridgette","family":"Thom","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6903-0177","authenticated-orcid":false,"given":"Katherine E.","family":"Reeder-Hayes","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-4800","authenticated-orcid":false,"given":"Sarah A.","family":"Birken","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0692-8286","authenticated-orcid":false,"given":"Mindy","family":"Gellin","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda R.","family":"Padilla","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8611-8012","authenticated-orcid":false,"given":"Donald L.","family":"Rosenstein","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC"},{"name":"Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_3_10_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djw205"},{"key":"e_1_3_10_3_2","volume-title":"Survivor Views 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USDA Economic Research Service, 2025. https:\/\/www.ers.usda.gov\/data-products\/rural-urban-commuting-area-codes"},{"key":"e_1_3_10_17_2","volume-title":"Comprehensive Cancer Support Program\u2014Statewide Engagement. UNC Lineberger Comprehensive Cancer Center","author":"UNC Lineberger Comprehensive Cancer Center","unstructured":"UNC Lineberger Comprehensive Cancer Center: Comprehensive Cancer Support Program\u2014Statewide Engagement. 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