Examining the Use of Medical Crowdfunding to Address the Costs of Childhood Cancer

Medical crowdfunding (MCF) has become a way for families of children with cancer to financially cope with the costs of cancer care. This financial coping strategy involves the parent (or financially responsible adult), friend, or family member creating a campaign online and sharing the child and family’s story to potential donors to help them cover costs related to treatment. MCF campaigns consist of the illness narrative, updates of the child’s illness, and comments from donors. These three elements of text are known as online talk. The purpose of this three-manuscript dissertation was to describe the content of online talk, the characteristics of social networks, and the timing of MCF related to the child’s illness trajectory. The first manuscript (Chapter 2) was a systematic scoping review of literature on MCF for individuals with serious, chronic illness describing the content of online talk, methodology of MCF studies, and strategies used to protect human subjects. Main findings include most studies of MCF did not integrate qualitative and quantitative findings, few studies included protections for human subjects, and few studies examined stress appraisals of the financial stressors present. The second manuscript (Chapter 3) was a qualitative descriptive study to describe stressors, appraisals, and other attributes of MCF campaigns in pediatric cancer. Main findings from this chapter were that campaigners for MCF in pediatric cancer share both financial and non-financial stressors and that often included an appraisal of worth or deservingness in their narrative. The third manuscript (Chapter 4) was a quantitative descriptive study that described the prevalence of stressors, appraisals, and other attributes of MCF campaigns in pediatric cancer in a random sample. Main findings from this chapter were that most campaigns were created close to the child’s diagnosis, most campaigns were created by friends or family members, and a subset of those included updates from the parent, and that nearly all campaigns mentioned non-financial and financial stressors, emotional support, appraisal of worth, and gratitude, where few mentioned informational support. The last chapter (Chapter 5) provides a synthesis across the three manuscripts, clinical and policy implications, strengths and limitations, and directions for future research.