Increasing Access to Definitive Treatment for Prostate Cancer by Removing Transportation Barriers for UnderservedPatients: A Multilevel Feasibility Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Brigham and Women's Hospital
- Enrollment
- 150
- Locations
- 1
- Primary Endpoint
- Number of participants receiving definitive treatment within 90 days of diagnosis
Study Overview
Brief Summary
Investigators will address the overarching challenge of advancing health equity and reducing disparities in prostate cancer by informing efforts to reduce travel burden in prostate cancer (PCa) treatment access among Black men.
Detailed Description
The following are the three aims of the proposal:
Aim 1: Determine how travel distance for PCa treatment impacts the outcome
Aim 2: Pilot a trial by offering ridesharing services for Black men seeking definitive PCa treatment in Greater Boston to reduce missed appointments. The investigators will implement a pre/post evaluation design with matched historical controls to estimate the impact of rideshares on reducing missed appointments among Black men seeking care at the Mass General Brigham Prostate Cancer Outreach Clinic. The investigators will also calculate the reduction in time from diagnosis to receipt of treatment associated with the intervention.
What is the Prostate Cancer Outreach Clinic?
In 2018, MGB launched the United Against Racism initiative, a long-term, multi-million-dollar commitment to address the many impacts that racism has on MGB patients, employees, and the broader community. One of these projects, the Mass General Brigham Prostate Cancer Outreach Clinic (PCOC), founded by Dr. Quoc-Dien Trinh (PI), as a response to widening inequities in PCa care in Massachusetts. The PCOC serves as a catalyst to increase access for marginalized communities through high-quality, accessible, and affordable PCa care in MGB's flagship hospitals including Massachusetts General Hospital, Brigham and Women's Hospital, and Brigham and Women's Faulkner Hospital.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 22 Years to — (Adult, Older Adult)
- Sex
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Black man
- •Intermediate-or high-risk prostate cancer
- •Seeking prostate cancer definitive treatment (surgery or radiation) at the Mass General Brigham Prostate Cancer Outreach Clinic
- •Reside in a census tract in Massachusetts recognized as having a high travel burden based on results of Aim1 of the Project OR identifies as having difficulties or challenges when it comes to transportation, particularly in relation to getting to and from medical appointments
Exclusion Criteria
- Not provided
Arms & Interventions
Ride Share Participants
Investigators will recruit Black men with intermediate or high-risk PC who are seeking definitive treatment at Mass General Brigham Prostate Cancer Outreach Clinic, as Black men are more likely to report travel burden when accessing care and, therefore, most likely to benefit from ridesharing services.
Investigators will implement a pre/post-evaluation design with matched historical controls to estimate the impact of rideshares on reducing missed appointments. Historical controls will be sampled from the pre-intervention period of April 2022 to September 2024 and the post-intervention period between October 2024 and November 2025, where October 2024 represents the initiation of the intervention. Participants who identify as Black, reside in a census tract in Massachusetts, and have been recognized as having a high travel burden based on results from Aim 1 will be eligible to receive the rideshare intervention
Intervention: Ride Share (Other)
Outcomes
Primary Outcomes
Number of participants receiving definitive treatment within 90 days of diagnosis
Time Frame: Within 90 days of diagnosis
Surgery or radiation within 90 days of diagnosis, among men with prostate cancer diagnosed at localized or regional-intermediate stage. Investigators will identify patients with localized or regional intermediate- or high-risk PCa receiving definitive therapy (surgery and radiation to the prostate) within 90 days of diagnosis. Although there are no existing guidelines that recommend specific thresholds of timely receipt of treatment, initiating treatment within 90 days of diagnosis is considered enough time to account for logistics and the possible delay caused by seeking a second opinion. Registries only record the first treatment, so Investigators will rely on these measures to assess differences in travel burden to different locations, depending on the type of treatment. Investigators will estimate delays in treatment initiation by calculating the days between diagnosis and treatment initiation
Secondary Outcomes
- Rate of Missed appointments(Within 18 months of surgery date)
- Exit Interview(30 months after surgery date)
Investigators
Quoc-Dien Trinh, MD, MBA
Principal Investigator
Brigham and Women's Hospital