Individual abstract within a Delegate Designed Symposium Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Financial Toxicity in Regional and Rural Cancer Survivors in Australia: From Co-Design to Implementation of a Holistic Support Program (FINHOPe)  (142197)

Katharina MD Merollini 1 2 , Lizzy Johnston 3 4 5 , Karina Rune 1 , Doreen Nabukalu 1 , Corey Linton 1 , Hattie Wright 1 2 , Cindy Davies 1 , Grace Rose 1 2 , Susannah Ayre 3 5
  1. University of the Sunshine Coast, Sippy Downs, Queensland, Australia
  2. Sunshine Coast Health Institute, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  3. Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
  4. School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
  5. School of Exercise and Nutrition Science, School of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia

Aims

To co-design a holistic, practice-ready support program and implementation strategy for regional and rural cancer survivors experiencing financial toxicity (FT) in Australia.

Methods

Using the British Design Council’s Double Diamond Framework, nine interactive workshops were conducted with cancer survivors, family members, clinicians, and community support service providers.  Purposive sampling ensured diverse stakeholder representation, with sample size guided by data saturation within and across phases. The process included three phases: (1) define barriers and facilitators to accessing FT support, (2) design a prototype support program, and (3) develop an implementation strategy for integration into community-based cancer support organisations. Analyses were informed by the Consolidated Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing Change (ERIC). Thematic analysis mapped barriers and enablers to CFIR constructs (define phase), content analysis synthesised participant preferences (design phase); and ERIC guided the refinement of a feasible, service-embedded implementation approach (develop phase).

Results

The define phase included nine participants who identified barriers and enablers across 17 CFIR constructs. Key barriers included cancer and treatment related side effects, unanticipated costs, uncertainty about navigating available support and lack of integration of financial support. Key enablers included clear communication, support from family members and service accessibility. The design phase involved sixteen participants who co-designed a practical model of care incorporating specialist financial counselling, accessible information and decision support tools, tailored information pathways, and administrative support service. The develop phase will involve fifteen participants and aims to refine and shape a tailored, practice-ready implementation strategy for community cancer support services.

Conclusions

This FINHOPe co-designed, scalable model of care and implementation strategy enables real-world delivery within community cancer services, supporting early identification and management of FT. It addresses a critical equity gap for regional and rural survivors and aligns with national survivorship priorities identified in the Australian Cancer Plan.