Pediatric RISE: Development of a Poverty-Targeted Cash Support Intervention for Pediatric Cancer.

Abstract

Background: Poverty is independently associated with relapse and death in childhood cancer despite highly standardized treatment. Prior data show that direct cash support interventions are feasible and improve child outcomes; however, no such interventions exist within pediatric oncology. To address this, we aimed to pilot and refine Pediatric RISE (Resource Intervention to Support Equity), a novel, direct cash support intervention in pediatric oncology.

Procedure: This was a single-arm pilot study among low-income children with cancer at a single center. Participants received twice-monthly cash disbursements and optional benefits counseling for 3 months. Parent surveys and qualitative interviews evaluated acceptability, satisfaction, and barriers to utilization to inform refinement.

Results: Families received all intended cash disbursements and used funds for essential resources with a reduction in household material hardship. Parents described RISE as useful and acceptable. There was no parent-reported loss or reduction of means-tested government benefits. Parents reported a need for larger disbursements and extended duration to mitigate treatment-associated income losses.

Conclusion: RISE was acceptable and valuable, with appropriate mitigation of the risk of means-tested government benefit loss or reduction by intervention design. Parent feedback informed refinement, including an increase in cash disbursement dollar amount and duration. The refined RISE intervention is currently being evaluated in a multi-site, randomized signal-finding study.