Cancer Survivorship
Conditions
Keywords
cancer survivorship, community health centers, care delivery, primary care
Brief summary
The purpose of this study is to implement a clinic-level cancer survivorship care delivery intervention in partnership with community health center clinicians, patients, and community representatives to test effectiveness of the intervention to improve patient and clinician outcomes and to evaluate implementation of the intervention using an iterative, concurrent mixed-methods approach guided by the Practice Change Model.
Interventions
BEHAVIORALSurvivorship care delivery intervention
Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), the intervention includes three evidence-based components: 1. Training: This will include provider-to-provider tele-mentoring using Enhancing Community Health Outcomes (ECHO). 2. Tracking: This includes systematically assessing cancer history and monitoring survivors' care to plan and organize subsequent care. 3. Coordinating care for cancer survivors. Each clinic leader will designate a staff member (or members) as the care coordinator champion after exploring current clinic staff, skills, and capacity of various staff roles.
Sponsors
The University of Texas Health Science Center, Houston
National Cancer Institute (NCI)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Stepped-wedge cluster randomized trial (SW-CRT). There will be 4 clusters (CHCs) having 2 practices each.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(participants): -at least one visit to the Community Health Centers (CHCs) in the prior year
Exclusion criteria
(participants): \- no history of cancer recorded in the problem list or past medical history in the medical record Inclusion Criteria (clinicians): -employed clinicians (e.g. physicians, nurses, pharmacists, or other allied health professionals) and non-clinician staff of the participating CHC clinics
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of eligible cancer survivors screened for second primary cancers | every 6 months from baseline to end of study (about 36 months from baseline) | Data derived from electronic health records |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in proportion of primary care clinician knowledge of cancer survivorship care | baseline, six months following end of intervention period | Assessed by self-administered survey |
| Change proportion of survivors that report better experience of provider communication as assessed by the adapted Consumer Assessment of Healthcare Providers and Systems (CAHPS 4.0) | baseline, six months following end of intervention period | — |
| Change proportion of survivors that report better experience of care coordination as assessed by the adapted Consumer Assessment of Healthcare Providers and Systems (CAHPS 4.0) | baseline, six months following end of intervention period | — |
| Proportion of survivors who received guideline-recommended surveillance for the most prevalent cancers (breast colorectal, prostate, cervical, and lung) | every 6 months from baseline to end of study (about 36 months from baseline) | Per national guidelines \[National Comprehensive Cancer Network (NCCN), U.S. Preventive Services Task Force (USPSTF)\]; data derived from electronic health records |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORBijal Balasubramanian, MBBS, PhD
The University of Texas Health Science Center, Houston
PRINCIPAL_INVESTIGATORSimon Craddock Lee, PhD
University of Kansas Medical Center
Outcome results
None listed