Reducing Cancer Disparities for American Indians in the Rural Intermountain West
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Utah
- Enrollment
- 1,800
- Locations
- 2
- Primary Endpoint
- Proportion of individuals receiving recommended screening for prostate, breast, colorectal, and cervical cancer.
Study Overview
Brief Summary
The purpose of this demonstration is to evaluate the effectiveness of using community outreach workers (navigators) to help American Indians living in rural areas overcome barriers to appropriate cancer screening, diagnosis, and treatment.
Detailed Description
Even for American Indians who have coverage with Medicare, disparities have been noted in the provision of cancer screening, diagnosis, and treatment. These disparities have been related to a variety of health-system, health-financing, geographic, and cultural barriers. We hypothesize that the use of lay community outreach workers will be an effective means of identifying and overcoming these barriers in order to improve the proportion of Medicare-eligible American Indians who receive recommended screening and diagnosis for prostate, breast, colon, and cervical cancer, and the proportion of individuals receiving appropriate treatment for prostate, breast, colon, cervical, and lung cancer. Community clusters randomized to this form of cancer navigation will be compared with community clusters randomized to receive educational outreach only.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Screening
- Masking
- None
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Enrolled in Medicare Part B
- •Self-reported American Indian
Exclusion Criteria
- •Have cancer other than study cancer
- •Medicare Part C enrolled
Arms & Interventions
Screening Navigation
Individuals without a study cancer who receive services of a navigator.
Intervention: Navigation Services (Behavioral)
Treatment Navigation
Individuals with a study cancer who receive navigation services.
Intervention: Navigation Services (Behavioral)
Screening Education
Rather than receiving navigation, these participants receive general cancer education appropriate to Medicare enrollees.
Intervention: Cancer education (Behavioral)
Treatment Education
Rather than receiving navigation services, these participants receive cancer education appropriate to Medicare recipients.
Intervention: Cancer education (Behavioral)
Outcomes
Primary Outcomes
Proportion of individuals receiving recommended screening for prostate, breast, colorectal, and cervical cancer.
Time Frame: four years
Secondary Outcomes
- Proportion of individuals receiving recommended diagnostic follow-up for prostate, breast, colorectal, and cervical cancer.(four years)
- Proportion of individuals receiving recommended treatment for prostate, breast, colorectal, cervical, and lung cancer.(four years)
- Cost-effectiveness of using community navigators to improve cancer care among rural Native Americans.(10 years)
Investigators
Randall W. Rupper
Assistant Professor
University of Utah