Interventions addressing health-related social needs among patients with cancer

Health-related social needs (HRSN) are prevalent among cancer patients, associated with substantial negative health consequences, and drive pervasive inequities in cancer incidence, severity, treatment choices and decisions, and outcomes. To address the lack of clinical trial evidence to guide HRSN interventions among cancer patients, the National Cancer Institute Cancer Care Delivery Research Steering Committee convened experts to participate in a Clinical Trials Planning Meeting with the goal of designing studies to screen for and address HRSNs among cancer patients. In this commentary, we discuss the rationale for, and challenges of, designing and testing HRSN interventions in alignment with the National Academy of Sciences, Engineering, and Medicine 5A's Framework. Evidence for food, housing, utilities, interpersonal safety, and transportation HRSN interventions is analyzed. Evidence regarding HRSNs and delivery of HRSN interventions differ in maturity and applicability to cancer context, with transportation problems having the most maturity and interpersonal safety the least. We offer practical recommendations for HRSN interventions among cancer patients and the caregivers, families, and friends who support their HRSN. Cross-cutting (ie, HRSN-agnostic) recommendations include leveraging navigation (eg, people, technology) to identify, refer, and deliver HRSN interventions; addressing HRSNs through multilevel interventions; and recognizing that HRSNs are states, not traits, that fluctuate over time. HRSN-specific interventions are recommended and pros and cons of addressing more than one HRSN concurrently are characterized. Considerations for collaborating with community partners are highlighted. The need for careful planning, strong partners, and funding is stressed. Finally, we outline a future research agenda to address evidence gaps.