Community Health Worker Support for Cancer Survivorship
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Medstar Health Research Institute
Disqualifiers: Non-Black race, others
No Placebo Group
Trial Summary
What is the purpose of this trial?The objective of the proposed study is to scale social risk factor screening and referral for cancer survivors and to solidify information exchange between clinical and community settings in order to improve survivor health and well-being. This will be completed through three primary aims: 1) To ascertain workflow and map community resources needed to facilitate social risk factor screening and referral for breast and prostate cancer survivors in Washington, District of Columbia. 2) To determine impact of Community Health Worker (CHW) support on Black breast and prostate cancer survivor health and wellbeing as measured through quality of life (QOL) and social connection. 3) To determine impact of anti-racism training for staff and clinicians at three cancer centers on patient-reported discrimination.
Do I need to stop my current medications to join the trial?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Community Health Worker Support for Cancer Survivorship?
Research shows that community health worker (CHW) interventions can improve health-related quality of life and mental health, especially among low-income and minority patients with cancer. CHWs help patients access timely care and improve communication during hospital discharge, which can lead to better health outcomes.
12345Is Community Health Worker support safe for humans?
The research does not provide specific safety data for Community Health Worker support, but it is generally considered safe as it involves providing guidance and support rather than medical treatment.
45678How does the Community Health Worker Support treatment for cancer survivorship differ from other treatments?
This treatment is unique because it involves community health workers (CHWs) who provide support and guidance to cancer survivors, helping them navigate complex health systems and access necessary services. Unlike traditional medical treatments, this approach focuses on improving psychosocial outcomes and addressing health inequities, particularly in marginalized communities.
19101112Eligibility Criteria
This trial is for Black or African American individuals who have been diagnosed with stage I-III breast or prostate cancer and completed curative treatment, or those with stage IV of these cancers about 6 months post-diagnosis.Inclusion Criteria
I have completed treatment for stage I-III breast or prostate cancer.
I was diagnosed with stage IV breast or prostate cancer about 6 months ago.
People who identify as Black or African American.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Community Health Worker Intervention
Participants receive support from a community health worker to assess social needs and provide support
6 months
Regular check-ins with community health worker
Follow-up
Participants are monitored for health-related quality of life and social connectedness
6 months
Sustainability Assessment
Annual assessment of program sustainability using the Program Sustainability Assessment Tool
12 months
Participant Groups
The study aims to improve health and well-being for cancer survivors by screening social risk factors, referring them to community resources, providing Community Health Worker support, and implementing anti-racism training for healthcare staff.
1Treatment groups
Experimental Treatment
Group I: Intervention participantsExperimental Treatment1 Intervention
Among patients who completed the social needs screening as a part of standard of care, all stage I-IV Black cancer survivors will be invited to participate in a six-month community health worker intervention. The community health worker will assess social needs and provide six months of support.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
MedStar Washington Hospital CenterWashington, United States
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Who Is Running the Clinical Trial?
Medstar Health Research InstituteLead Sponsor
George Washington UniversityCollaborator
Howard UniversityCollaborator
Georgetown UniversityCollaborator
References
Community health worker interventions to promote psychosocial outcomes among people living with HIV-A systematic review. [2019]Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.
Effect of a Community Health Worker-Led Intervention Among Low-Income and Minoritized Patients With Cancer: A Randomized Clinical Trial. [2023]To determine whether a community health worker (CHW)-led intervention could improve health-related quality of life (HRQoL; primary outcome) more than usual care among low-income and racial and ethnic minoritized populations newly diagnosed with cancer.
Patient-centered community health worker intervention to improve posthospital outcomes: a randomized clinical trial. [2018]IMPORTANCE Socioeconomic and behavioral factors can negatively influence posthospital outcomes among patients of low socioeconomic status (SES). Traditional hospital personnel often lack the time, skills, and community linkages required to address these factors. OBJECTIVE To determine whether a tailored community health worker (CHW) intervention would improve posthospital outcomes among low-SES patients. DESIGN, SETTING, AND PARTICIPANTS A 2-armed, single-blind, randomized clinical trial was conducted between April 10, 2011, and October 30, 2012, at 2 urban, academically affiliated hospitals. Of 683 eligible general medical inpatients (ie, low-income, uninsured, or Medicaid) that we screened, 237 individuals (34.7%) declined to participate. The remaining 446 patients (65.3%) were enrolled and randomly assigned to study arms. Nearly equal percentages of control and intervention group patients completed the follow-up interview (86.6% vs 86.9%). INTERVENTIONS During hospital admission, CHWs worked with patients to create individualized action plans for achieving patients' stated goals for recovery. The CHWs provided support tailored to patient goals for a minimum of 2 weeks. MAIN OUTCOMES AND MEASURES The prespecified primary outcome was completion of primary care follow-up within 14 days of discharge. Prespecified secondary outcomes were quality of discharge communication, self-rated health, satisfaction, patient activation, medication adherence, and 30-day readmission rates. RESULTS Using intention-to-treat analysis, we found that intervention patients were more likely to obtain timely posthospital primary care (60.0% vs 47.9%; P = .02; adjusted odds ratio [OR], 1.52; 95% CI, 1.03-2.23), to report high-quality discharge communication (91.3% vs 78.7%; P = .002; adjusted OR, 2.94; 95% CI, 1.5-5.8), and to show greater improvements in mental health (6.7 vs 4.5; P = .02) and patient activation (3.4 vs 1.6; P = .05). There were no significant differences between groups in physical health, satisfaction with medical care, or medication adherence. Similar proportions of patients in both arms experienced at least one 30-day readmission; however, intervention patients were less likely to have multiple 30-day readmissions (2.3% vs 5.5%; P = .08; adjusted OR, 0.40; 95% CI, 0.14-1.06). Among the subgroup of 63 readmitted patients, recurrent readmission was reduced from 40.0% vs 15.2% (P = .03; adjusted OR, 0.27; 95% CI, 0.08-0.89). CONCLUSIONS AND RELEVANCE Patient-centered CHW intervention improves access to primary care and quality of discharge while controlling recurrent readmissions in a high-risk population. Health systems may leverage the CHW workforce to improve posthospital outcomes by addressing behavioral and socioeconomic drivers of disease. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01346462.
Integrating Community Health Workers into Hospital Systems Through a Social Work Partnership: A Report from the Field. [2023]While studies support the effectiveness of community health worker (CHW) services, best approaches for CHW integration in health systems are not well understood. We describe early outcomes from a partnership between a safety-net hospital systems' social work department and CHWs to address adverse social determinants of health of high-risk patients.
Improving cancer care for underserved populations in an academic and community practice setting: protocol for a community health worker pilot navigation programme. [2022]Delaying cancer treatment following diagnosis impacts health outcomes, including increasing patient distress and odds of mortality. Interventions to promote timely healthcare engagement may decrease patient-reported stress and improve quality of life. Community health workers (CHWs) represent an enabling resource for reducing delays in attending initial oncology treatment visits. As part of an ongoing programme evaluation coordinated by the Merck Foundation, we will implement a pilot navigation programme comprising CHW-conducted needs assessments for supporting patients and their caregivers. We aim to investigate (1) the programme's influence on patients' healthcare utilisation within the period between their first diagnosis and initial treatment visit and (2) the logistic feasibility and acceptability of programme implementation.
Exploring the role of community health workers in providing cancer navigation: perceptions of African American older adults. [2022]To obtain experiential data regarding African American older adult survivors' perceptions of and recommendations on the role of community health workers (CHWs) in providing a cancer navigation intervention.
Development of a Framework to Describe Functions and Practice of Community Health Workers. [2021]There is evidence to support the effectiveness of community health workers (CHWs), as they practice in a wide range of health care settings; yet, the perceived value of CHWs suffers from a lack of uniform credentialing and from a dearth of billing and payment structures to recognize their individual work. In turn, credentialing and billing for the work of CHWs is hampered by widely variable regulation, conflicting job titles and position descriptions, and general confusion about CHW identity, sometimes complicated by service boundaries that overlap with those of other health care and social service occupations. This article presents evidence from a rapid review of the CHW literature from 2003 to 2018. It includes clinical trials, meta-analyses, and policy reports summarizing more than 200 CHW interventions intended to improve patient health status or care delivery. The evidence is used to identify CHW roles, responsibilities, behaviors, and competencies. Four categories of CHW practice are developed from the evidence: peer CHW, general CHW, clinical CHW, and health navigator. A framework is proposed to recognize unique CHW roles, promote and further integrate varied levels of CHW function into health care-related organizations, and to inform decisions regarding certification, education, and payment for CHW services in the United States.
A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research. [2019]We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research. The majority of 17 included studies took place in the agriculture industry (76%). CHWs were often involved in study implementation/design and research participant contact. Rationale for CHW involvement in research was due to local connections/acceptance, existing knowledge/skills, communication ability, and access to participants. Barriers to CHW involvement in research included competing demands on CHWs, recruitment and training difficulties, problems about research rigor and issues with proper data collection. Involving CHWs in occupational health and safety research has potential for improving inclusion of diverse, vulnerable and geographically isolated populations. Further research is needed to assess the challenges and opportunities of involving CHWs in this research and to develop evidence-based training strategies to teach CHWs to be lay-health researchers.
Community health workers' attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities. [2021]Community Health Workers (CHW) are a category of social workers described in many countries' health systems as responsible for engaging people in their residences and communities, and other non-clinical spaces to enable access to health services, especially in low-income areas. These professionals have been exposed to numerous new risks during the COVID-19 pandemic.
Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. [2022]Community health workers (CHW) are lay individuals who are trained to serve as liaisons between members of their communities and health care providers and services.
Community health workers in Canada and other high-income countries: A scoping review and research gaps. [2022]Community health workers (CHWs) have been deployed to provide health-related services to their fellow community members and to guide them through often complex health systems. They help address concerns about how marginalized populations in many countries experience health inequities that are due, in part, to lack of appropriate primary health care services, possibly resulting in inappropriate use of higher-cost health services or facilities. This paper reviews studies on CHW interventions in a number of high-income countries, including Canada, to identify research gaps on CHW roles.
Challenges in the sociocultural milieu of South Asia: a systematic review of community health workers. [2021]Community health workers (CHWs) connect patients in rural and remote communities to health service organizations. This diverse group of healthcare workers has helped improve healthcare access and outcomes and enhance the quality of life for people in hard-to-reach communities. However, CHWs face numerous challenges rooted in the sociocultural milieu of the region and country in which they reside.