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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
160
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.
University of Alabama at Birmingham
Birmingham, Alabama, United States
Johns Hopkins University School of Medicine
Baltimore, Maryland, United States
TidalHealth Peninsula Regional, Inc.
Salisbury, Maryland, United States
Atrium Health Wake Forest Baptist
Winston-Salem, North Carolina, United States
Number of participants who completed Advance Directives
Advanced care planning
Time frame: 6 months after enrollment
Functional Assessment of Chronic Illness Therapy-Palliative Subscale (FACIT-PAL) score
Quality of Life; Score range: 0-184 \[per scoring document, for total score\] Higher scores signify better quality of life
Time frame: 6 months after enrollment
Number of participants who utilize hospice care
Hospice care utilization within 14 days of death (Yes/No)
Time frame: 6 months after enrollment
Goals of care as assessed by Quality of communication (QOC) scale
Goals of Care; Score range: 0-10 \[scored 0-10 for each of 19 components\] Higher scores signify: higher quality communication with physician
Time frame: 6 months after enrollment
Symptom Intensity as assessed by the Edmonton Symptom Assessment Score (ESAS)
Symptom; Score range: 0-10 \[scored 0-10 for 10 components\] Higher scores signify: higher intensity of cancer symptoms (worse symptoms)
Time frame: 6 months after enrollment
Depression as assessed by the Center for Epidemiologic Studies Depression Scale (CES-D)
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.
Time frame: 6 months after enrollment
Quality of life assessed by the 5-Level EuroQol 5-Dimensional (EQ-5D-5L)
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.
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Time frame: 6 months after enrollment