Childcare Support for Cervical Cancer Prevention
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Female
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Texas Southwestern Medical Center
Disqualifiers: Pregnancy, Under 18
No Placebo Group
Trial Summary
What is the purpose of this trial?Aim 1: Determine the prevalence of unmet childcare needs among women with abnormal cervical cancer screening and establish the relevance of childcare as a social determinant of health in the context of cervical dysplasia.
Aim 2: Conduct a pilot pragmatic patient-randomized control trial (RCT) to evaluate the effectiveness of an intervention linking eligible patients to our childcare facility compared to standard of care on retention in care, defined as show-rate for the initial visit in the gynecology dysplasia clinic. The intervention will consist of 1) patient navigation to our childcare facility prior to the initial visit in the gynecology dysplasia clinic and 2) placement of an electronic medical record (EMR) referral to our childcare facility.
Hypothesis: The study team hypothesizes that women receiving the intervention will have increased retention in care compared to women randomized to standard of care among women with abnormal cervical cancer screening referred to gynecology for diagnostic work-up.
These two aims will demonstrate the significance of childcare as a social determinant of health in the cervical cancer screening and diagnostic continuum by assessing the burden of unmet childcare needs among women with cervical dysplasia and measuring the effect of health system-integrated childcare as an intervention for unmet childcare needs on retention in care and subsequent completion of diagnostic work-up among women with cervical dysplasia. This study will rigorously provide the first evidence illustrating the effect of health systems' investment in addressing unmet childcare needs on preventive care like cervical cancer screening. The findings of this proposed pilot study will be utilized to develop future large-scale studies with extramural funding, building a longitudinal program of research on addressing childcare as a social determinant of health in this and other similar clinical contexts (e.g., breast cancer screening and treatment).
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Childcare Resource for cervical cancer prevention?
The research highlights the importance of family support and practical assistance, such as childcare, in managing the psychosocial aspects of cancer treatment. This suggests that providing childcare resources could help alleviate stress for families, potentially improving overall health outcomes.
12345How does the childcare support treatment for cervical cancer prevention differ from other treatments?
This treatment is unique because it focuses on providing childcare support to help prevent cervical cancer, which is different from traditional medical treatments that directly target the disease. By ensuring access to quality childcare, it indirectly supports the health and well-being of families, potentially reducing stress and improving overall health outcomes.
678910Eligibility Criteria
This trial is for women with abnormal cervical cancer screening results who are new patients at the Parkland gynecology dysplasia clinic. It aims to help those facing childcare issues which may affect their ability to attend medical appointments.Inclusion Criteria
I am a woman referred to the Parkland dysplasia clinic for an abnormal cervical cancer screening result.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants receive navigation to the childcare facility and an EMR referral to improve retention in care
Up to 2 years
Initial visit to gynecology dysplasia clinic
Follow-up
Participants are monitored for retention in care and completion of diagnostic procedures
Up to 2 years
Follow-up visits in gynecology
Participant Groups
The study tests if helping these women get childcare (through navigation and an electronic medical record referral) before their first clinic visit can improve their attendance compared to standard care without this support.
2Treatment groups
Active Control
Group I: InterventionActive Control1 Intervention
The intervention is comprised of two components to link randomized patients to our health system childcare facility: 1) navigation by the research assistant to the childcare facility and 2) placement of the facility EMR referral. Navigation will occur an eligible patient is randomized to the intervention group. Navigation will consist of the research assistant educating the patient about the childcare facility and providing information about how to access the childcare facility during the telephone contact and via mailed written materials.
Group II: Standard CareActive Control1 Intervention
Patients randomized to the control group will undergo current standard of care with regards to childcare, which currently consists of passive sources of information about our childcare facility (Parkland website, signage in the hospital, or via word of mouth). Currently, there is no formalized mechanism for patients referred to gynecology from primary care to receive information about childcare aside from the above passive sources of information.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Parkland HealthDallas, TX
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Who Is Running the Clinical Trial?
University of Texas Southwestern Medical CenterLead Sponsor
References
Important aspects of care and assistance for children 0-7 years of age being treated for cancer. Parent and nurse perceptions. [2013]Aspects of care and assistance that are important for children aged 0-7 years who are being treated for cancer were examined. Parents ( N=57) and nurses ( N=59) were asked: "What caring aspects are important in ensuring that your child/the child feels cared for?" and "What help, if any, does your child/the child need outside the hospital?". Data were analysed by content analysis. The following aspects of care were identified: amusement, clinical competence, continuity, emotional support, family participation, honest communication, information, participation in decision making, satisfaction of basic needs, social competence, the parents are well cared for, and time. Parents most frequently mentioned social competence and amusement, while nurses most frequently mentioned continuity and information. The following aspects of assistance were identified: accessible care, amusement, emotional support, family life, meeting friends, normal life, practical support, rehabilitation and school support. At least a third of the children did not need any assistance, according to parents and nurses. Parents most frequently mentioned family life, meeting friends and practical support. Nurses most frequently mentioned normal life and family life. Taken together, the results indicate that not only a family but many more people need to be involved to help children with cancer to be cured not only in a biological but also a psychosocial sense.
Important aspects of care and assistance for parents of children, 0-18 years of age, on or off treatment for cancer. Parent and nurse perceptions. [2003]Important aspects of care and assistance for parents of children (0-18 years) diagnosed with cancer were investigated. Parents (N=114) and nurses (N=121) were asked the following questions: 'What caring aspects are important for you/the parent to feel cared for?' and 'What help, if any, do you/the parent need outside the hospital?' Nurses were asked to answer for a certain parent. Data were analyzed by content analysis. The following aspects of care were identified: accessible care, clinical competence, continuity, emotional support, information, participation in care, participation in decision making, physical ambience, shift in parenting roles, social competence, temporary assistance, own child is well cared for, and time. Most parents mentioned the importance of social competence and information, most nurses mentioned the importance of information and emotional support. The following aspects of assistance were identified: accessible care, emotional support, financial support, instrumental support, and support to live a normal family/social life. A third of the parents and a fourth of the nurses were of the opinion that the parent did not need any assistance. Most parents who mentioned a need of assistance mentioned a need for emotional and instrumental support. Most nurses mentioned a parental need for emotional support and accessible care.
Important aspects of care and assistance for children with cancer. [2017]This study examined aspects of care and assistance that are important for 8- to 12-year-old children with cancer. Data were gathered through interviews with 25 children, 31 parents, and 32 nurses. Each participant was asked: "What caring aspects are important for you/your child/the child to feel cared for?" and "What help, if any, do you/your child/the child need outside the hospital?" Data were analyzed by content analysis. The following important caring aspects were identified: amusement, clinical competence, continuity, family participation, honest communication, information, participation in decision making, satisfaction of basic needs, social competence, and time. Children most frequently mentioned the importance of social competence, amusement, and satisfaction of basic needs. Parents and nurses most frequently mentioned the importance of information, social competence, and participation in decision making. The following important assistance aspects were also identified: emotional support, family life, meeting friends, practical support, rehabilitation, and school support. Two-thirds of the children did not mention that they needed any help outside the hospital. According to parents and nurses, one third of the children needed emotional support, whereas none of the children mentioned a need for this.
PediCARE: Development of a poverty-targeted intervention for pediatric cancer. [2022]Poverty is associated with inferior psychosocial outcomes, higher rates of relapse, and decreased overall survival in children with cancer. Despite this, there are few evidence-based, poverty-targeted interventions and none specific to pediatric oncology. To address this gap, we developed and refined the Pediatric Cancer Resource Equity (PediCARE) intervention, a household material hardship (HMH) targeted intervention providing transportation and groceries to pediatric oncology families.
Experiences of Young Children With Cancer and Their Parents With Nurses' Caring Practices During the Cancer Trajectory. [2020]Children with cancer require repeated hospitalizations and the family's everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents' experiences of nurses' caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson's theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses' caring practices aim to support children and parents in the transition to a "new normal." Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child's and parents' life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.
Universal access to quality childcare is good policy and a positive determinant of health. Let's invest. [2021]Research shows that affordable nonprofit childcare results in a variety of beneficial developmental outcomes for children, as well as benefitting families and society at-large. As leaders and influencers, paediatricians are well positioned to advocate for access to affordable, nonprofit childcare. This commentary aims to provide a framework and evidence base for Canadian paediatricians interested in learning more about this issue and how they can support increased access to nonprofit childcare.
Making a difference for children: the medical community's role in improving child care. [2019]The quality of child care for the majority of children in the United States is poor to mediocre. The lack of good quality child care has serious consequences for family stability, work force productivity, and child health and development. The medical community, especially pediatricians, family practitioners, nurses, and nurse practitioners, can play five key roles in helping to ensure that every child has a solid early foundation: 1) they can become trusted sources of support for parents, who are often isolated from their extended families and unsure about their new roles as parents; 2) they can give child care providers in the community information about health and safety practices; 3) they can provide preventive and diagnostic services to children in child care programs; 4) they can act as advocates for improved services to children and families; and 5) they can refer parents and siblings for care. This paper describes some of these efforts and calls for their replication in communities throughout the country. It also describes policies in other countries that have improved children's health and development and reduced child poverty and its related impact on health.
Assessing health system provision of well-child care: The Promoting Healthy Development Survey. [2019]Preventive care guidelines for children include parent education and counseling, developmental assessment, and screening for psychosocial and safety risks. Health care providers are in a unique position to identify and follow up on potential problems and to influence parenting knowledge, attitudes, and behavior to ensure the healthy development of young children. Few quality measures are available to assess health care system performance in this important area.
Well baby visits: screening and health promotion. [2021]Traditional child care consists of periodic health examinations and treatment for episodic illness. It is important to ensure that prevention, detection and early treatment of developmental problems are always done, especially in children with frequent illnesses. Educational and psychosocial factors, nutrition and physical assessment must also be stressed to promote child and family health. The authors have developed flow sheets for screening visits at age two weeks to two years, to check growth, nutrition, education, parenting, behavior, development, symptoms, examination procedures, and assessment. The sheets are a memory and charting aid in a busy office, allow other office staff to participate, and can be modified to suit the practice and the patient.
Sure Start Children's Centres: time to make them better known. [2016]Health services have traditionally been available to local communities through general practices, health visitors and midwives. Since the introduction of the Sure Start Local programme in 1997 and Sure Start Children's Centres in 2004, an increasing number of children's centres are working with their local NHS to provide health services for the under fives, and improve the accessibility of these services to local families. Sure Start Children's Centres were set up in England as part of the Department for Children, Schools and Families' Children's Plan to improve outcomes for children and their families and contribute to the strategic objectives of Every Child Matters. Children's centres offer a range of integrated services from child health and maternity services to parenting and childcare provisions. They also deliver key health promotion activities and programmes that contribute to the public health priorities of Primary Care Trusts, e.g. breast-feeding, smoking in pregnancy, physical activity and healthy eating. There are now 3,500 children's centres offering easily accessible services to more than 2.4 million children and families across England. Health professionals are asked work proactively together to raise awareness of these among local communities so that more families can benefit from the services they offer.