Table 4.
Transportation insecurity knowledge gaps and proposed research agenda for data infrastructure and research initiatives
| Gap | Research initiative |
|---|---|
| Lack of cancer-specific data about the prevalence and risk factors for transportation insecurity | Improved data infrastructure at National Cancer Institute–designated or Commission on Cancer–accredited cancer centers |
| Integration of social needs screening information from electronic health records | |
| Data and other linkages with safety-net facilities | |
| Inclusion of social needs questions in large national surveys and cohort studies | |
| Development of transportation insecurity risk models | |
| Lack of evidence-based guidelines for screening for transportation insecurity among patients with cancer | Development of validated tools for patients with cancer receiving treatment |
| Evaluation of longitudinal data about trajectory of transportation insecurity | |
| Evaluation of relevant outcome measures of social needs screening, including appointment or treatment adherence, delays, and health outcomes | |
| Assessment of the frequency and type of co-occurring unmet social needs | |
| Lack of data about the association of transportation insecurity with outcomes among patients with cancer | Patient: evaluation of treatment adherence; clinical, psychosocial, quality of life, and financial outcomes; clinical trial participation, survival |
| Informal caregiver: evaluation of psychosocial, quality of life, and financial outcomes | |
| Provider: evaluation of the effect on missed appointments, guideline-adherent treatment | |
| Payor: economic consequences | |
| Health system: economic consequences | |
| Society: evaluation of disparities in cancer outcomes | |
| Estimation of economic costs of transportation insecurity from the perspective of patients, providers, health systems, and society more broadly | |
| Lack of data about the effectiveness and cost-effectiveness of policy, health system, not-for-profit, and corporate interventions to address transportation insecurity | Assessment of the effectiveness of existing efforts in reducing treatment no-shows, adherence to treatment plans, enrollment in clinical trials, and downstream health outcomes |
| Assessment of the cost and cost-effectiveness of ongoing initiatives | |
| Assessment of the role of managing social needs that co-occur with transportation insecurity |