Community Health Worker Based Intervention to Improve Palliative Care

Conditions

Advanced Cancer, Cancer, End Stage Cancer, Malignancy

Keywords

palliative care, community health worker

Brief summary

The study aims to find out if community health worker (CHW) support will improve palliative care outcomes in African American patients with advanced cancer, by comparing the quality of life of patients who are receiving standard care to those whose standard care is supplemented with CHW support.

Detailed description

This research is being done to establish the effectiveness of a Community Health Worker based palliative care intervention among African American patients with advanced solid organ malignancies and their care givers. The investigators' long-term goal is to reduce the research-to-practice gap in utilization of evidence-based palliative care (PC) in African Americans with advanced cancer. The objectives of this study are to establish the effectiveness of a CHW-based palliative care intervention and develop generalizable knowledge on how contextual factors influence implementation.

Monton O, Drabo EF, Masroor T, Fuller S, Woods AP, Siddiqi A, Malone TB, Johnston FM.

2025-11-04

10.1136/bmjopen-2024-096402

African American patient and caregiver attitudes and perceptions of community health workers as lay patient navigators in palliative care.

Monton O, Fuller S, Siddiqi A, Woods AP, Masroor T, Joyner R, Elk R, Owczarzak J, Johnston FM.

2024-08-052 citations

10.21037/apm-23-602

Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial.

Siddiqi A, Monton O, Woods A, Masroor T, Fuller S, Owczarzak J, Yenokyan G, Cooper LA, Freund KM, Smith TJ, Kutner JS, Colborn KL, Joyner R, Elk R, Johnston FM.

2023-09-185 citations

10.1186/s12904-023-01250-0

Interventions

OTHERCommunity Health Worker (CHW) based palliative care

Those in the intervention group will receive support from a dedicated CHW trained in motivational interviewing, components of palliative care communication, and social determinants of health.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

SUPPORTIVE_CARE

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

Patient Inclusion Criteria: * Self-identified African American patients with advanced (AJCC stage III or IV) solid organ malignancy * \>=18 years old * English speaking * Intact cognition and ability to provide informed consent Patient

Exclusion criteria

* Participants \< 18 years of age * Participants who are already receiving palliative care services Caregiver Inclusion Criteria: * Adult (\>=18 years old) caregivers providing informal (unpaid) care to an eligible African American cancer patient (related or unrelated) * English speaking * Intact cognition and ability to provide informed consent Caregiver

Design outcomes

Primary

Measure	Time frame	Description
Number of participants who completed Advance Directives	6 months after enrollment	Advanced care planning

Secondary

Measure	Time frame	Description
Functional Assessment of Chronic Illness Therapy-Palliative Subscale (FACIT-PAL) score	6 months after enrollment	Quality of Life; Score range: 0-184 \[per scoring document, for total score\] Higher scores signify better quality of life
Number of participants who utilize hospice care	6 months after enrollment	Hospice care utilization within 14 days of death (Yes/No)
Goals of care as assessed by Quality of communication (QOC) scale	6 months after enrollment	Goals of Care; Score range: 0-10 \[scored 0-10 for each of 19 components\] Higher scores signify: higher quality communication with physician
Symptom Intensity as assessed by the Edmonton Symptom Assessment Score (ESAS)	6 months after enrollment	Symptom; Score range: 0-10 \[scored 0-10 for 10 components\] Higher scores signify: higher intensity of cancer symptoms (worse symptoms)
Depression as assessed by the Center for Epidemiologic Studies Depression Scale (CES-D)	6 months after enrollment	Symptom; The score is the sum of the 20 questions. Possible range is 0-60. A score of 16 points or more is considered depressed.
Quality of life assessed by the 5-Level EuroQol 5-Dimensional (EQ-5D-5L)	6 months after enrollment	it assesses five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and a visual analogue scale (VAS). Each dimension has five levels ranging from 1 (no problem) to 5 (extreme problem). Score range 0 to 100, higher score indicates better quality of life.

Countries

United States

Contacts

PRINCIPAL_INVESTIGATORFabian M Johnston, MD, MHS

Atrium Health Wake Forest Baptist

Outcome results

None listed