Addressing Disparities in Cancer Care for Latino Medicare Beneficiaries

Study Overview
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Brief Summary
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To reduce Cancer health care disparities that exists among minority Medicare beneficiaries and to demonstrate cost effectiveness of patient navigation in reducing the burden of cancer.

Detailed Description
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The Latino population is the fastest growing minority population in the United States . Cancer ranks as the second leading cause of death among Latinos in the United States (24%), second only to heart disease . This project will evaluate whether an innovative facilitation program (targeting cancers of the prostate, colon/rectum, breast, and cervix) will improve cancer outcomes among Latino Medicare beneficiaries in the city of Newark, New Jersey. The overall aim of this project is to institute an innovative cancer care facilitation program for elderly Latinos in the city of Newark, NJ. The goal is to reduce the disparities observed in screening, time to diagnosis and treatment services, by utilizing a multidisciplinary team approach to health care, incorporating systems thinking methodology. Using the Multilevel Approach to Community Health (MATCH) planning model , the program will incorporate community outreach, education, and access to screening, and patient assistance in all aspects of the health care continuum. It will also include cultural and linguistic competency training for all those involved in the facilitation process. To accomplish this goal, we propose four objectives: To establish a multidisciplinary team that will utilize a systems thinking approach to design and structure the delivery of cancer screening, diagnosis and treatment facilitation services. To build a collaborative consortium between program partners to improve screening outcomes, that will encourage the utilization of services in the community. To improve the delivery of cancer prevention and treatment facilitation by providing cultural and linguistic competency training to the multidisciplinary team, providers, and the community. To demonstrate the effectiveness of the intervention in reducing the burden of cancer, by increasing screening rates, improving time to diagnosis and delivery of treatment services, patient satisfaction, and appropriate use of Medicare services.

Official Title
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Addressing Disparities in Cancer Care for Latino Medicare Beneficiaries

Conditions
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Cancer

Intervention / Treatment
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* Behavioral: cancer screening and health education
* Behavioral: facilitation of Services to improve cancer screening


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cancer-Negative Group Be of Hispanic/Latino Origin Fluent in English and/or Spanish Recipient of, Medicare Part A & B, or combined Medicare/Medicaid Not having a previous diagnosis of cancer Be capable of giving written informed consent prior to any study related procedures. Be available and willing to complete all study assessments as specified. Cancer-Positive Group Be of Hispanic/Latino Origin Fluent in English and/or Spanish Recipient of, Medicare Part A & B, or combined Medicare/Medicaid Having a previous diagnosis of cancer of the breast, cervix, colon and/or rectum, prostate, or lung. Be capable of giving written informed consent prior to any study related procedures. Be available and willing to complete all study assessments as specified. Exclusion Criteria: Member of the Medicare Advantage Plan, any Medicare managed care plan (Those who join the Medicare Advantage plan or a managed care plan during the course of the study will become ineligible to continue.) Medicaid only beneficiaries Institutionalized Unable to provide written informed consent
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Comparison Group<br>The control or lesser intervention group, will receive cancer screening information on a quarterly basis, with no facilitation of services. | Behavioral: cancer screening and health education<br>* The control group will receive cancer screening and health education materials on a quarterly basis but will not have access to patient navigation services.<br>* Other names: cancer screening and education;|
| Active Comparator: Intervention group<br>The intervention group are those participants who were randomly assigned to receive facilitation of services in the form of patient navigation for the duration of the study. | Behavioral: cancer screening and health education<br>* The control group will receive cancer screening and health education materials on a quarterly basis but will not have access to patient navigation services.<br>* Other names: cancer screening and education;Behavioral: facilitation of Services to improve cancer screening<br>* The intervention group will receive cancer education and faciliation of services in the form of patient navigation<br>* Other names: screening;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduce the disparities observed in utilization of cancer screening services |  | 2-4 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improve the time to diagnosis and treatment services (resulting in reduced cost of cancer care |  | 4 years | 
| Improve patient satisfaction and informed decision making. |  | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Patient Navigator, Community health, Communication