Table 1 Modifiable secondary outcomes amendable to individual or healthcare delivery interventions

Aim 1

Personal Financial Wellness Scale

Determine trajectory of financial distress

Mixed model

Financial distress may be amenable to financial navigation (Shankaran, 2018) and other types of intervention

Aim 2

Personal Financial Wellness Scale

Identify socio-demographic, clinical, financial and institutional factors associated with financial distress over time

Mixed model

Predictors of financial distress will inform identification of at-risk groups to target with future interventions

Aim 2

Household income relative to the Federal Poverty Level (%FPL)

Household Material Hardship (HMH)

Bankruptcy

Out-of-pocket costs

Describe treatment-related material hardship during treatment for pediatric ALL as assessed by 1) worsening or new HMH, 2) percent change in annual household income, 3) change in % FPL 4) consideration of or actual filing for bankruptcy and 5) parent-reported out-of-pocket costs

Descriptive statistics

Worsening HMH is amenable to resource-matching interventions (Garg, 2007 & 2015). %FPL and out-of-pocket costs may predict risk for and characterize HMH

Aim 2

Coping behaviors survey

Describe parent financial and health coping behaviors

Descriptive statistics

Parent coping behaviors such as cutting back on needed health care due to cost may be amenable to behavior change interventions

Lack of information about available resources or not following through on referrals may be amenable to resource-matching and/or financial navigation

Aim 2

Institution Survey

Describe institutional financial resources and factors

Descriptive statistics

Implementation strategies may promote systematic financial screening and provision of referrals to available resources as needed