A qualitative study on the role of financial toxicity on adoption of healthy lifestyle behavior after breast cancer among Black and Latina women.

273 Background: This study aims to understand the role of financial toxicity on lifestyle behavior change for Black and Latina breast cancer survivors. More specifically, we sought to identify the strategies that survivors employed to overcome the effects of financial hardship on behavior change. Methods: A secondary analysis was conducted on qualitative interview data of 26 breast cancer survivors who self-identified as Black or Latina and 10 healthcare providers from an oncology setting. Transcripts were coded using deductive and inductive approaches by a team of three coders and aggregated into thematic categories using content analysis. Results: Barriers identified by survivors included the high cost of healthy food and gym memberships, challenges with unemployment during cancer treatment, and transportation. To address these barriers, survivors relied on strategies that utilized three levels of access: interpersonal, community, and institutional. At the interpersonal level, access to resources was mediated by the self, friends, and family. This strategy involved getting family members to help with bills and incorporating alternative approaches to exercise such as working out at home or going on walks with family. At the community level, access to resources was mediated by local organizations and support groups. This strategy involved receiving free food from church, free exercise programming from local organizations, and/or using government-based resources to mitigate food and housing insecurity. Finally, at the institutional level, access to resources was mediated by the multidisciplinary oncology care team to identify availability and eligibility and apply for various types of resources. This strategy involved social workers facilitating knowledge and assistance for grants to access financial resources and transportation for appointments. Conclusions: The study found that financial toxicity among Black and Latina breast cancer survivors influences their ability to afford, implement, and maintain healthy behavior changes after cancer. Participant identified strategies offer potential venues for interventions that couple financial toxicity mitigation strategies with lifestyle behavior change after breast cancer for Black and Latina women.