Study Procedures
Interviews were conducted in English or Spanish using Zoom or WhatsApp
per participant preference. Participants completed a brief
sociodemographic survey to assess age, race and ethnicity, sex, role
(AYA or caregiver), health literacy,31 income,
education/employment, and insurance type. The interview guide was
developed by our study team in consultation with key stakeholders,
including an AYA advocate and clinicians with experience caring for AYA
patients (Supplemental material).32 The interview
guide drew on published frameworks of financial toxicity and
burden2,33,34 to allow for open-ended responses from
participants regarding how they may or may not have experienced material
hardship, psychological responses, or coping behaviors due to financial
factors. Additionally, interviewers were trained to probe about
potential processes or resources that might reduce financial toxicity or
address unmet needs.35 All study materials were
available in English or Spanish. Participants were contacted during the
analysis for member checking, a methodologic approach to ensure accuracy
and enhanced credibility of results.36