Project CASCADE: Community and Academic Synergy for Cancer Survivorship Care Delivery Enhancement

N/AEnrolling By InvitationNCT06883838

The University of Texas Health Science Center, Houston5,584 enrolled

Overview

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 Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

5,584

Conditions

Cancer Survivorship

Interventions

Survivorship care delivery interventionBEHAVIORAL

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.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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

Locations (1)

The University of Texas Health Science Center, Houston

Houston, Texas, United States

Outcomes

Primary Outcomes

Proportion of eligible cancer survivors screened for second primary cancers

Data derived from electronic health records

Time frame: every 6 months from baseline to end of study (about 36 months from baseline)

Secondary Outcomes

Change in proportion of primary care clinician knowledge of cancer survivorship care

Assessed by self-administered survey

Time frame: 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)

Time frame: 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)

Time frame: 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)

Per national guidelines \[National Comprehensive Cancer Network (NCCN), U.S. Preventive Services Task Force (USPSTF)\]; data derived from electronic health records

Time frame: every 6 months from baseline to end of study (about 36 months from baseline)

Data from ClinicalTrials.gov

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