Enhancing Primary Care Capacity for Cancer Survivorship Care Delivery in Community Health Clinics
Trial Snapshot
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- Enrollment
- 5,584
- Locations
- 2
- Primary Endpoint
- Proportion of eligible cancer survivors screened for second primary cancers
Study Overview
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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts 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
Arms & Interventions
Step 4 (2 clinics)- 24 months control then 12 months intervention
Intervention: Survivorship care delivery intervention (Behavioral)
Step 1 (2 clinics)-6 months control then 12 months intervention
Intervention: Survivorship care delivery intervention (Behavioral)
Step 2 (2 clinics)-12 months control then 12 months intervention
Intervention: Survivorship care delivery intervention (Behavioral)
Step 3 (2 clinics)-18 months control then 12 months intervention
Intervention: Survivorship care delivery intervention (Behavioral)
Outcomes
Primary Outcomes
Proportion of eligible cancer survivors screened for second primary cancers
Time Frame: every 6 months from baseline to end of study (about 36 months from baseline)
Data derived from electronic health records
Secondary Outcomes
- Change in proportion of primary care clinician knowledge of cancer survivorship care(baseline, six months following end of intervention period)
- 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))
Investigators
Bijal.A.Balasubramanian
Professor
The University of Texas Health Science Center, Houston