Cancer Patients
Conditions
Keywords
Food pantry, Food voucher, Grocery delivery, 12-099
Brief summary
The investigators have found that many patients getting treatment for cancer have trouble getting enough to eat, or do not always have enough money for food. When a patient has these problems it can lead to difficulties with completing cancer treatment. Across New York City, there are many hospitals that offer their patients food pantry services on location. The investigators would like to compare how food pantries within the hospital and two other food assistance options: monthly food vouchers and weekly grocery deliveries maybe possible solutions to this problem. The patient will be randomly assigned to one of the three different food program groups, which means everyone has an equal chance in being in any group, like a flip of a coin. The investigators hope to learn how to best help patients with trouble getting food and to see if this will help with completing cancer treatment. The original RCT composed of study arms: 1) hospital -based food pantry (control), 2) food voucher program plus access to the food pantry, and 3) grocery delivery program plus access to the food pantry will remain open to accrual at Ralph Lauren Cancer Center. The other three sites of the original RCT, Lincoln Hospital, Queens Cancer Center and Brooklyn Hospital, have reached target accrual. Our modified RCT, to be carried out among an expanded cohort of cancer patients is composed of study arms : 1) Food Voucher Program (Voucher); 2) Home Grocery Delivery Program (Delivery); and 3) Medically-tailored, Hospital-based Food Pantry (Pantry). For this RCT, we will enroll patients across Bronx hospitals- Jacobi Medical Center, St. Barnabas Hospital, and Montefiore Medical Center. For the new study arms, we will enroll patients across Lincoln Medical and Mental Health Center, Jacobi Medical Center, St. Barnabas Medical Center, Montefiore Health System, New York Cancer & Blood Before Specialists, and Bellevue Hospital. Before conducting the RCT across Lincoln Medical and Mental Health Center and the new sites in the Bronx, we will refine written educational materials to be used in the intervention through focus groups.
Interventions
BEHAVIORALsurveys
Each survey will take about 45 minutes.Surveys will include questions on medical treatment, health insurance, work-related information, overall health and well being, eating habits, and satisfaction/use of the food program provided. 3 and 6-month follow-up. All participants will be asked to complete the study contact form. Need Assessment surveys will be administered via telephone or in person. The content of the needs assessment questionnaire has been informed by themes generated through IHCD's ongoing research and community outreach and service activities with the cancer patient population at our participating institutions. The survey will ask participants about the impact on their cancer care and their socioeconomic needs of the COVID-19 crisis.
BEHAVIORALFocus groups
Prior to conducting the updated RCT design with the expanded cohort, we will conduct 4-6 focus groups (to saturation) with underserved breast cancer patients to optimally tailor the written materials, via mail, MSK Secure email, or in person and nutrition education sessions.
Sponsors
Memorial Sloan Kettering Cancer Center
Queens Cancer Center of Queens Hospital
The Brooklyn Hospital Center
Lincoln Medical and Mental Health Center
Jacobi Medical Center
St. Barnabas Medical Center
Montefiore Health System
Columbia University
Roswell Park Cancer Institute
NYU Langone Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Focus Groups Inclusion Criteria: * Breast cancer patient, Stage 1,2, or 3 * Currently undergoing treatment with chemotherapy and/or radiation * Food insecure: score in the range of "very low" or "low" food security status on the USDA Household Food Security Module (score of 3 or higher) * Language spoken: English or Spanish * Age 18 or over Intervention Inclusion Criteria: * Enrolled in ICCAN (for the original arms only: pantry only, pantry + delivery, pantry + voucher) * Within one month (+/- 1 month) of starting chemotherapy or within two weeks (+/- 2 weeks) of starting radiation therapy) (may be prior to or after starting treatment) * Score in the range of 'very low' or 'low' food security status on the USDA Household Food Security Module (score of 3 or higher) * Living independently (no patient in an assisted living facility) * Age 18 or over * Able to provide informed consent and respond to questionnaires in either English, Spanish or Mandarin (Mandarin for the original arms only: pantry only, pantry + delivery, pantry + voucher) * Breast or gynecologic cancer diagnosis, Stage 1, 2, or 3 (for the updated arms only: 1) Food Voucher Program (Voucher); 2) Home Grocery Delivery Program (Delivery); and 3) Medically-tailored, Hospital-based Food Pantry (Pantry) Clinician is eligible if he/she: * Has an MD or DO degree * Is the treating physician providing care to a patient enrolled to the study Secondary Aim 6 Needs Assessment eligibility criteria: * Current or past breast cancer diagnosis * Living independently (no patient in an assisted living facility) * Age 18 or over * Able to provide informed consent and respond to questionnaires in either English, or Spanish
Exclusion criteria
Focus Groups
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| treatment completion | 2 years | Completion of prescribed treatment, increase from 75% to 94%, as assessed by chart review (for the period from recruitment to study completion at 6 months). To determine whether participation in the interventions leads to improvements in cancer treatment completion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life | 2 years | The primary analytic approach for these secondary outcome variables will be a series of Linear Mixed-Effects Models (LMMS) modeling the change scores from baseline to each of the follow-up assessments, separately for each of the questionnaire outcome variables \[51\]. Analyses based on change scores have the advantage of creating easily interpretable results and clearly indicating the direction of individual change (e.g., increased protein intake). |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORFrancesca Gany, MD, MS
Memorial Sloan Kettering Cancer Center
Outcome results
None listed