Technology-Enabled Activation of Skin Cancer Screening for Stem Cell Transplant Survivors and Their Primary Care Providers, TEACH Study
Technology-Enabled Activation of Skin Cancer Screening for Hematopoietic Cell Transplantation Survivors and Their Primary Care Providers (TEACH)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Determine the impact of patient activation and education (PAE, N=360) alone or with physician activation (PAE+Phys, N=360) on skin cancer screening and health promotion practices at 12 months, measured by percentage of survivors who conduct skin self-exam and receive physician skin exam, and time to detection and diagnosis of suspicious lesions.
II. Among primary care physicians of transplant patients, determine the impact of an e-learning teledermoscopy program compared with provision of print materials for identifying suspect lesions.
OUTLINE: Participants are randomized to 1 of 3 groups.
GROUP I: Participants receive a study packet on skin cancer. Participants also receive text messages once every 3 weeks for 9 months.
GROUP II: Participants receive a study packet on skin cancer. Participants also receive text messages once every 3 weeks for 9 months. Participants' physician receives a letter that describes the educational intervention and encourages them to do a skin examination at next patient visit.
GROUP III: Participants receive a study packet on skin cancer. Participants also receive text messages once every 3 weeks for 9 months. Participants' physician receives a letter that describes the educational intervention and encourages them to do a skin examination at next patient visit. Physicians also receive a free dermatoscope with instructions for uploading images of suspect lesions and attend a 30-minute online course comprising additional descriptions of dermoscopic images for skin cancers and "mimickers" common in hematopoietic stem cell transplantation patients, along with clear instructions for using a dermatoscope and steps to integrate dermoscopy into their practice.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Duarte, California, United States, 91010
- City of Hope Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Have undergone autologous or allogeneic hematopoietic stem cell transplantation (HCT) at City of Hope (COH)
- Are 2 years (yrs) to 5 yrs (+/- 3 months [m]) after HCT
- Have seen a primary care provider (PCP) in the previous 12 m (expected > 95% of all eligible) or planning to do so in next 12 m
- Have a mobile phone with the ability to receive text messages
- Can fluently read and write in English or Spanish
- Can understand and sign the study-specific Informed Consent Form (ICF)
Exclusion Criteria:
- Patients who have evidence of active hematologic malignancy or acute illness that would limit study participation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Group I (PAE)
Participants receive a study packet on skin cancer.
Participants also receive text messages once every 3 weeks for 9 months.
|
Ancillary studies
Receive text messages
Other Names:
Receive study packet
Other Names:
|
|
Experimental: Group II (PAE, physician)
Participants receive a study packet on skin cancer.
Participants also receive text messages once every 3 weeks for 9 months.
Participants' physician receives a letter that describes the educational intervention and encourages them to do a skin examination at next patient visit.
|
Ancillary studies
Receive text messages
Other Names:
Receive study packet
Other Names:
Receive physician directed letter and educational package
Other Names:
|
|
Experimental: Group III (PAE, physician, dermatoscope)
Participants receive a study packet on skin cancer.
Participants also receive text messages once every 3 weeks for 9 months.
Participants' physician receives a letter that describes the educational intervention and encourages them to do a skin examination at next patient visit.
Physicians also receive a free dermatoscope with instructions for uploading images of suspect lesions and attend a 30-minute online course comprising additional descriptions of dermoscopic images for skin cancers and "mimickers" common in hematopoietic stem cell transplantation patients, along with clear instructions for using a dermatoscope and steps to integrate dermoscopy into their practice.
|
Ancillary studies
Receive text messages
Other Names:
Receive study packet
Other Names:
Receive physician directed letter and educational package
Other Names:
Complete online course
Receive dermatoscope
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Impact of patient activation and education alone or with physician activation on change in skin cancer screening and health promotion practices
Time Frame: Baseline and 12 months
|
Will administer questionnaires at baseline and 12 months to ask about skin examinations performed within the past 12 months.
Will use logistic regression to adjust for imbalance in patient characteristics and risk factors.
Will also test for group by covariate interactions, depending on group main effect.
|
Baseline and 12 months
|
|
Time interval between a participant's first notice of a suspect mole or lesion and the date on which a definitive diagnosis was made
Time Frame: Up to 12 months
|
Will be a continuous variable, and will employ a generalized linear model to compare the interval between the two study arms, adjusted for covariates of interest.
Will begin with bivariate models to determine potential variables to include in a multivariable regression model.
If the group main effect is significant, interactions of the group main effect with other variables will be examined.
|
Up to 12 months
|
|
Impact of an e-learning teledermoscopy program compared with provision of print materials for identifying suspect lesions
Time Frame: Up to 12 months
|
Will compare the group difference in changes in attitude over time, using generalized estimating equation (GEE) for normally distributed data, with a compound symmetry covariance matrix analysis to account for within-physician correlation.
Will dichotomize the Likert scale (1-5) response and compare the proportion of primary care physicians (PCPs) reporting a higher (>= 4 versus < 4) level of confidence at 12 months (m) compared to baseline between groups, using the longitudinal binomial GEE model with a compound symmetry covariance structure.
Covariate adjustment will be made in these models as necessary.
|
Up to 12 months
|
|
Economic impact on patients - cost-effectiveness analysis
Time Frame: Up to 12 months
|
Evaluated using standard incremental cost-effectiveness analysis methods will be used to assess the impact of assumptions and uncertainty on results and conclusions.
|
Up to 12 months
|
|
Economic impact on patients - sensitivity analysis
Time Frame: Up to 12 months
|
Evaluated using standard incremental sensitivity analysis will be used to assess the impact of assumptions and uncertainty on results and conclusions.
|
Up to 12 months
|
|
Downstream costs
Time Frame: Up to 12 months
|
Will estimate the cost per additional self skin exam completed and the cost per additional PCP exam completed, comparing the two intervention arms.
|
Up to 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Saro H Armenian, City of Hope Medical Center
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Skin Diseases
- Skin Neoplasms
- Investigative Techniques
- Equipment and Supplies
- Health Services
- Health Care Facilities Workforce and Services
- Child Health Services
- Community Health Services
- Preventive Health Services
- Socioeconomic Factors
- Population Characteristics
- Health Personnel
- Self-Help Devices
- Methods
- Early Intervention, Educational
- Educational Status
- Physicians
- Communication Devices for People with Disabilities
Other Study ID Numbers
Other Study ID Numbers
- 20096 (Other Identifier: City of Hope Medical Center)
- NCI-2020-01830 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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