PROJECT SUMMARY/ABSTRACT In this 5-year proposal, we seek to acquire a comprehensive understanding of economic strain and resilience in cancer patients, using a patient-centered approach. Our goal is to develop and pilot measures of patient-reported economic strain and resilience as novel health related quality of life (HRQOL) outcomes. We define economic strain as the material and non-material economic resource burden exerted by the stressor of cancer treatment; and economic resilience as the intrinsic material and non-material resources a patient may rely on in response to economic strain. Our results will support an investigator-initiated study to assess economic strain and resilience, and related health outcomes, in a national longitudinal cohort of cancer patients. This project will advance my long-term research goal, to advance a patient-centered research framework for understanding and enhancing value in cancer care. This research will provide knowledge to support shared decision-making about cancer treatment, promote treatments that improve quality of life (QOL), and reduce disparities in use of high-value healthcare. During the award period, I plan to combine field research, formal mentorship, and didactics in key content areas to accomplish my goals. My multidisciplinary mentorship team includes highly experienced professors at M. D. Anderson (MDA) with complementary expertise and committed support for my research and career development plan. Dr. Volk is a national expert on qualitative studies of cancer patients’ preferences and values applied to patient-oriented research and decision-making. He has 20 years of experience mentoring junior investigators to independence. Dr. Peterson is Core Director of the Patient-Reported Outcomes, Survey & Population Research (PROSPR) center at MDA. Dr. Shih is a health economist studying comparative effectiveness and impact of treatment choices on cancer outcomes and cost. Drs. Giordano and Hahn engage in health services research and will help me develop as an academic thought-leader in comparative effectiveness oncology research. My statistical mentor is Dr. Shete, an expert in quantitative methods for behavioral and patient-centered cancer outcomes research. To accomplish my research plan and career goals, I will develop new expertise in qualitative and mixed methods, psychometrics, and health economics. This expertise synergizes with my prior training in quantitative approaches to analyze population data. This powerful combination will ultimately offer me the unique opportunity to generate novel information on the value of cancer treatments from the patient perspective and impact their QOL and health outcomes. More than one million US adults receive a cancer diagnosis yearly, and upon diagnosis, patients together with their physicians need to make treatment decisions. Two concepts have emerged as priorities to incorporate into this treatment decision-making process. The first priority is to inc...