The LIFT UP study: feasibility of systematically identifying and addressing resource needs in those with metastatic...

Social determinants of health (SDOH) and health-related social needs (HRSN) impact cancer outcomes, yet few programs systematically address these needs. We examined the feasibility of routine assessment of SDOH/HRSN within a clinical metastatic breast cancer (MBC) program and subsequent linkage to support services.

We approached patients with MBC seen at an NCI-designated center from January-October 2023 who were ≤ 6 months from MBC consultation or diagnosis. Enrolled participants were administered a baseline survey of SDOH/HRSN, referred to appropriate services, and surveyed again at 3-6 months. Outcomes included feasibility of SDOH/HRSN documentation (defined as ≥ 80% of participants completing baseline surveys); prevalence of needs; and use of and satisfaction with support services.

Among the 112 patients approached, 98 (87.5%) enrolled and 73 (74.5%) completed the baseline survey. Median age was 58 years (range 29-84), with 82.2%, 8.2%, and 1.4% identifying as White, Black, or Hispanic, respectively. Overall, 71.2% reported 1 + need; 28.8% had 3 + needs. Reported concerns included transportation costs (32.9%), medical costs (20.8%), medication payments (15.5%), and utility bills (19.2%); 13.7% and 6.9% reported food or housing insecurity, respectively. Although all participants needing resources were referred, 27.3% accessed referred services, and 59.1% of reported needs were partially or fully met on follow-up assessment. Patients and clinicians expressed positive feelings about the intervention.

Our findings highlight the challenges and importance of systematically assessing SDOH/HRSN in a clinical setting, with a high degree of unmet needs reported among MBC patients. Future work will address utilization barriers and resource customization.