Clinical trial NCT06883838: Project CASCADE: Community and Academic Synergy for Cancer Survivorship Care Delivery Enhancement
Official title: Enhancing Primary Care Capacity for Cancer Survivorship Care Delivery in Community Health Clinics
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Cancer Survivorship
Keywords: cancer survivorship
community health centers
care delivery
primary care
Lead sponsor: The University of Texas Health Science Center, Houston
Sponsor class: OTHER
Collaborators: name: National Cancer Institute (NCI)
First posted: 2025-03-19
Enrollment: 5584
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: Stepped-wedge cluster randomized trial (SW-CRT). There will be 4 clusters (CHCs) having 2 practices each.
Primary purpose: HEALTH_SERVICES_RESEARCH

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.


Eligibility criteria: 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

Primary outcomes:
measure: Proportion of eligible cancer survivors screened for second primary cancers
timeFrame: every 6 months from baseline to end of study (about 36 months from baseline)
Secondary outcomes:
measure: Change in proportion of primary care clinician knowledge of cancer survivorship care
timeFrame: baseline, six months following end of intervention period
measure: 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)
timeFrame: baseline, six months following end of intervention period
measure: 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)
timeFrame: baseline, six months following end of intervention period
measure: Proportion of survivors who received guideline-recommended surveillance for the most prevalent cancers (breast colorectal, prostate, cervical, and lung)
timeFrame: every 6 months from baseline to end of study (about 36 months from baseline)
Other outcomes:
Locations:
city: Houston
country: United States
facility: The University of Texas Health Science Center, Houston
state: Texas
Study officials:
affiliation: The University of Texas Health Science Center, Houston
name: Bijal Balasubramanian, MBBS, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: The University of Kansas Medical Center
name: Simon Craddock Lee, PhD
role: PRINCIPAL_INVESTIGATOR
References: