KanSurvive 2.0: Testing Enhanced Models of Cancer Survivorship Care for Rural Cancer Survivors in Primary Care Practice

April 7, 2026 updated by: University of Kansas Medical Center
Rural cancer survivors experience a higher risk of negative health outcomes and require coordinated care to address the many effects of cancer and its treatment. Primary care providers recognize the importance of providing high-quality, evidence-based survivorship care and are well-positioned to meet survivor needs, however, these needs are often unmet due to limitations in knowledge, lack of resources, and administrative demands. Practical strategies are needed to help PCPs improve cancer survivorship care, and this proposal will test implementation strategies to optimize the adoption of evidence-based practices for cancer survivorship care in rural primary care settings.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Enrolling by invitation

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Cancer survivors require long-term and coordinated care to address the physical, emotional, and psychosocial effects of cancer and its treatment. Rural cancer survivors are disproportionately affected by chronic illness and face a higher risk of negative health outcomes. Primary care providers (PCPs) recognize the importance of delivering evidence-based practice (EBP) cancer survivorship care and are well-positioned to provide comprehensive and coordinated care, however, the needs of cancer survivors are frequently unmet, and providers describe limitations in knowledge of risk-based surveillance, long-term effects of cancer treatment and their management, inadequate resources, and growing administrative demands as barriers to improving survivorship care. The overall goal of this project is to test the effectiveness of pragmatic strategies to promote high quality, evidence-based guideline concordant care for rural adult cancer survivors in primary care practice and utilizing tools from implementation science to gain a better understanding of the decision making and actions taken that facilitate or hinder implementation across multiple healthcare systems. To achieve this objective, we propose a three-arm cluster-randomized, multi-level intervention to provide education, tele-mentoring, and whether 1) virtual scribes filling the role as trained medical assistants, 2) a team-based approach, 3) or usual care produces more guideline concordant cancer survivorship care. The primary outcome is provider adherence to EBP cancer survivorship guidelines as measured using a previously developed composite scoring system that compares electronic health record (EHR) documented activity to National Comprehensive Cancer Network guidelines. The secondary outcome is to assess intervention sustainability of arm 1 and 2 activities at 12 and 24-months post implementation; measured as a function of virtual scribe or team-based actions to promote prior cancer diagnoses coding (ICD-10), use of EHR tools and health maintenance order sets and annual ordering of appropriate screenings for cancer survivors. Prior to implementation, formative evaluations will assess current systems of care and practice-level barriers and facilitators for the delivery of EBP cancer survivorship care and inform modifications to implementation strategies. Guided by the Normalization Process Theory, we will examine agentic factors (e.g., actions taken/decisions made by the practice) to modify modes of care management and delivery. The RE-AIM evaluation framework will be used to explore potential population-level impact and generalizability of the intervention in real-world clinical settings. The study will be conducted in 16 rural primary care practices in Kansas and was intentionally designed to bring care delivery changes into resource-limited practices and health systems. Results will add new evidence by informing pragmatic strategies to facilitate the adoption and delivery of EBP cancer survivorship in rural primary care.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
16

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Kansas
      • Kansas City, Kansas, United States, 66160
        • University of Kansas Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion criteria:

  1. Rural primary care practice (PCP) located within rural urban continuum codes (RUCC) 4-9 in Kansas
  2. PCPs must have multiple providers
  3. PCPs must have at least on medical assistant
  4. PCPs must have an employed medical scribe or be willing to consider employing a medical scribe using study compensation and practice revenue
  5. Cancer survivor data is eligible for extraction if the patient is a breast, prostate, lung, and/or colorectal cancer survivor and considered to have a "reasonable likelihood" of 24-month survival by a practice provider.

Exclusion criteria:

  1. PCPs not located within RUCC 4-9 in Kansas
  2. PCPs without multiple providers
  3. PCPs without a medical assistant
  4. PCPs without a medical scribe or unwilling to consider employing one
  5. Cancer survivorship data is ineligible for extraction is the patient is <18 years of age or >75 years of age, is currently receiving hospice services, or has a history of cancer other than breast, prostate, lung, or colorectal.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Virtual Scribe Medical Assistant
Virtual scribe medical assistants will engage in KanSurvive 2.0 Project ECHO education assist with clinical documentation, identifying cancer survivors, and scrubbing electronic health records to identify care gaps and opportunities for quality improvement with practice facilitation.
Other: KanSurvive telementoring and education
Telementoring, education, and case-based learning covering evidence-based practice guidelines for breast, colorectal, lung, and prostate cancer survivorship.
Other: Practice facilitation for quality improvement
Practice facilitation will be delivered to assist with quality improvement efforts using monthly Plan Do Study Act (PDSA) cycles.
Other: Survivorship Care Manual
Printed and digital manuals will be distributed to each participating primary care practice to share with the cancer survivors they see in their clinic. The manual guides patients on how to engage more effectively with their PCP and oncology care team and reviews recommended follow-up, within a format of a "service manual" and written in lay language.
Other: Virtual scribe services
Participating practices who opt-in to receive virtual scribe services.
Active Comparator: Team Based Care
Rural primary care practice teams will assist with clinical documentation, identifying cancer survivors, and reviewing electronic health records to identify care gaps and opportunities for quality improvement with practice facilitation.
Other: KanSurvive telementoring and education
Telementoring, education, and case-based learning covering evidence-based practice guidelines for breast, colorectal, lung, and prostate cancer survivorship.
Other: Practice facilitation for quality improvement
Practice facilitation will be delivered to assist with quality improvement efforts using monthly Plan Do Study Act (PDSA) cycles.
Other: Survivorship Care Manual
Printed and digital manuals will be distributed to each participating primary care practice to share with the cancer survivors they see in their clinic. The manual guides patients on how to engage more effectively with their PCP and oncology care team and reviews recommended follow-up, within a format of a "service manual" and written in lay language.
Placebo Comparator: Enhanced Usual Care
This attention control arm will engage in KanSurvive 2.0 Project ECHO education and receive an obesity management toolkit.
Other: KanSurvive telementoring and education
Telementoring, education, and case-based learning covering evidence-based practice guidelines for breast, colorectal, lung, and prostate cancer survivorship.
Other: Survivorship Care Manual
Printed and digital manuals will be distributed to each participating primary care practice to share with the cancer survivors they see in their clinic. The manual guides patients on how to engage more effectively with their PCP and oncology care team and reviews recommended follow-up, within a format of a "service manual" and written in lay language.
Other: Obesity management toolkit
The Enhanced Usual Care arm will receive a short, virtual training and toolkit on the management of obesity in primary care practice and how it relates to cancer survivorship.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Provider Adherence to Cancer Survivorship Guidelines Measured by EHR-Based Composite Adherence Score
Time Frame: Assessed at baseline, 6, 12, and 24 months
The primary outcome is provider adherence to evidence-based cancer survivorship guidelines, measured using a composite score derived from electronic health record (EHR) data abstraction. The composite score assesses concordance between documented care and National Comprehensive Cancer Network (NCCN) survivorship guidelines across multiple domains (e.g., tumor surveillance, distress screening, BMI assessment, tobacco use screening, family history of cancer documentation, osteoporosis screening, and hereditary cancer risk assessment). Scores are calculated based on the proportion of eligible guideline-concordant care processes completed for each patient and aggregated at the clinic level.
Assessed at baseline, 6, 12, and 24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Kansas Medical Center

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
National Cancer Institute (NCI)

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Allen K Greiner, MD, MPH, University of Kansas Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 30, 2029

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 15, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 7, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 14, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 14, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 7, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • STUDY00160108
  • U01CA290664 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Research resources generated within this project will be explicitly developed in an effort to improve cancer survivorship outcomes in rural primary care practice. We will develop a strategic plan with the KU Cancer Center and NCI to widely disseminate any product, intellectual property, or data to promote scientific activity and health promotion work that will be of assistance to similar patient populations. As such, we will work to fully share these materials and items with qualified individuals across the greater scientific community and with rural practices, providers and community members. All program materials and data generated within the overall study will be shared to the fullest extent possible. De-identified data from this project will be preserved and shared in a public repository to validate and replicate research findings described in the Aims.

IPD Sharing Time Frame

Start date: June 2026 End date: June 2029

IPD Sharing Access Criteria

De-identified study data will be made available as public use data to the research community via Open Science Framework.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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