Outcomes research, pediatric oncology
Dr. Bona’s research is focused on understanding the contribution of social determinants, such as poverty, to pediatric cancer outcomes. Despite advances in pediatric oncology treatment, nearly 20% of children still die of their disease, and children with cancer experience significant suffering throughout the course of illness regardless of whether that illness culminates in cure or death. Understanding the contribution of social determinants of health to pediatric cancer outcomes may provide targetable factors involved in residual morbidity and mortality. It is widely recognized that poverty is correlated with negative health outcomes, including mortality, in both pediatric primary care and chronic illness. It is not known how poverty impacts pediatric oncology outcomes. Data elucidating the relationship between family poverty and childhood cancer outcomes have the potential to shift current clinical practice paradigms which rely exclusively on biological factors for risk stratification.
Dr. Bona’s current research is utilizing data from a longitudinal prospective cohort study of newly diagnosed pediatric cancer patients to identify the natural history of poverty in pediatric cancer and develop a novel screening tool to identify pediatric cancer families at risk for material hardship—one concrete measure of poverty. She is concurrently utilizing the Pediatric Health Information System database to test the relationship between family income poverty and pediatric oncology patterns of care. This work will lay the foundation for a multi-center trial examining the impact of family material hardship on pediatric oncology outcomes. Her research is funded by grants from the National Palliative Care Research Center, St. Baldrick’s Foundation, and the Conquer Cancer Foundation of the American Society of Clinical Oncology.