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

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.

Interventions

• Behavioral Survivorship care delivery intervention
  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) a

Primary outcome measures

• 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)]

Secondary outcome measures (4)

• Change in proportion of primary care clinician knowledge of cancer survivorship care [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) [Time frame: every 6 months from baseline to end of study (about 36 months from baseline)]

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

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Crossover

Masking

Open label

Primary purpose

Health services research

Study locations

United States · 1 center

• The University of Texas Health Science Center, Houston — Houston

Publications

• Millett ME, Malthaner LQ, McCallister K, Craig DW, Eary R, Valerio-Shewmaker MA, Shay LA, Rajan SS, Ma HY, Ghosh S, Crabtree BF, Lee SJC, Balasubramanian BA. Community and Academic Synergy for Cancer Survivorship Care Delivery Enhancement (Project CASCADE): a study protocol for a pragmatic, stepped-wedge, cluster-randomized trial in Texas primary care community health centers. BMC Prim Care. 2025 PMID 41454266

Identifiers

NCT: NCT06883838 · HSC-SPH-24-0777 · U01CA290663

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗