- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05430191
Equitable Implementation of Cascade Screening for Familial Hypercholesterolemia
Leveraging Behavioral Economics to Equitably Implement Cascade Screening in Individuals With Familial Hypercholesterolemia in Partnership With the Family Heart Foundation
Design, refine, and pilot the two implementation approaches using behavioral economics and then seek further feedback prior to the proposed clinical trial, consistent with these recommendations.
Aim 1. Co-design both implementation strategies using behavioral economics in partnership with the Family Heart Foundation and key partners from diverse backgrounds.
Aim 2. Pilot strategies with 20 patients with high cholesterol and/or with familial hypercholesterolemia (FH) to ascertain feasibility, acceptability, appropriateness.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Aim 1. Conduct interviews with patients with high cholesterol and/or FH and clinicians to identify common barriers and facilitators for individuals to engage in cascade screening. These activities will occur in the first 7 months and will serve as inputs into the design of the implementation strategies to ensure that strategies address determinants identified in the interviews.
Aim 2. To maximize success, pilot test the implementation strategies and the planned data collection approaches.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Contact
- Name: Rinad Beidas, PhD
- Phone Number: 617-519-6676
- Email: rinad.beidas@pennmedicine.upenn.edu
Study Contact Backup
- Name: Adina Lieberman, MPH
- Phone Number: 856-237-7014
- Email: adina.lieberman@pennmedicine.upenn.edu
Study Locations
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania, Perelman School of Medicine
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Aim 1 (Interviews). We will conduct interviews with 15 patients with high cholesterol and/or FH to understand barriers and facilitators to cascade screening. 17 clinicians are being interviewed through our sister protocol in an effort to reduce interview burden on clinicians. Duration of participation will last the length of one qualitative interview.
Aim 2 (Pilot Testing Strategies). Participants will include 20 patients with high cholesterol and/or FH. At least half will identify as racial and/or ethnic minorities (i.e., Black or African American, Asian), female, and/or have low income. Patients will be randomized to receive the Penn- or FHF-mediated strategy. Duration of participation will last up to 3 months for each participant.
Description
Inclusion Criteria:
- Patients with high cholesterol and/or FH (i.e., probands; Aim 1 Interviews, Aim 2 Pilot Testing Strategies, Aim 2 Interviews). Adults aged 18 and older with clinically diagnosed FH and/or high cholesterol who are treated within Penn Medicine.
- Family Members (Aim 2 Pilot Testing Strategies, Aim 2 Interviews). Adults aged 18 and older who have a family member who has been identified as a patient with high cholesterol and/or FH who is treated within Penn Medicine (i.e., family members of probands).
Exclusion Criteria:
- none
Study Plan
How is the study designed?
Design Details
- Observational Models: Other
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
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Qualitative Interviews
Conduct 15 interviews with patients diagnosed with FH.
Interviews will be 30-60 minutes in length and will focus on how individuals understand cascade screening, barriers to engagement including reasons why individuals do and do not share health information with family members, and preferred approaches to engaging family members, with a focus on acceptability, appropriateness, and feasibility of the planned implementation strategies.
Interviewers will also attend to structural factors such as medical mistrust and experiences of racism in health care, and ask about preferences and logistics to incorporate preference into the future clinical trial design.
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Penn-mediated implementation strategy
The Penn-mediated implementation strategy will be designed and then iterated upon during mini-pilots.
As part of this strategy, the patients would receive text messages and/or emails containing information about FH and cascade screening from Penn Medicine.
This would include a request for the patient to identify first-degree biological relatives.
They would be given a choice of either contacting their family members directly or sharing their contact information so someone from Penn Medicine can contact them.
If the proband chooses to contact their family members, they receive educational information to share with them.
Family members would be offered FH screening at no cost by blood lipid panel.
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FH is a genetic condition that causes high LDL cholesterol starting at birth.
When one individual with FH is diagnosed, it is important that biological family members are also screened, since there is a 50% chance that each first-degree relative will have also inherited FH.
More distant relatives may also have inherited FH.
This evidence-based process is known as cascade screening.
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Family Heart Foundation-mediated implementation strategy
The Family Heart Foundation (FHF)-mediated implementation strategy will be designed and then iterated upon during mini-pilots.
As part of this strategy, the patient would be contacted by a FHF patient navigator.
The patient navigator would ask to set up a time to talk to the patient to talk about options for contacting family members, introduce them to the services they can provide to the patient and/or family members and obtain some details about the patient's family.
The patient would come up with a plan to either contact their family members directly or have the patient navigator contact them.
Family members will be offered FH screening at no cost by blood lipid panel.
The patient and/or family members will be able to contact the patient navigator at any time with questions.
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FH is a genetic condition that causes high LDL cholesterol starting at birth.
When one individual with FH is diagnosed, it is important that biological family members are also screened, since there is a 50% chance that each first-degree relative will have also inherited FH.
More distant relatives may also have inherited FH.
This evidence-based process is known as cascade screening.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Aim 1 Qualitative Interview Outcome: Perspectives on cascade screening
Time Frame: 1-time interview to last 1 hour
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We will learn about the perspectives on cascade screening from clinicians and patients with high cholesterol and/or FH (probands) via qualitative interview.
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1-time interview to last 1 hour
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Aim 2 Mini-Pilot Outcome: Engagement
Time Frame: 3 months
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We define engagement as the number of patients with FH and/or high cholesterol (probands) who respond to at least one outreach attempt.
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3 months
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Aim 2 Mini-Pilot Outcome: Reach
Time Frame: 3 months
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We define reach as the proportion of probands who have at least one family member who completes cascade screening.
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3 months
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Aim 2 Mini-Pilot Outcome: Perspectives on implementation strategies
Time Frame: 1-time interview to last approximately 15-30 minutes
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We will learn about the perspectives on the implementation strategies (health system-mediated, Family Heart Foundation-mediated) - including their perceived acceptability, appropriateness, and feasibility - of patients with high cholesterol and/or FH (probands) and family members via qualitative interview.
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1-time interview to last approximately 15-30 minutes
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 851061
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Familial Hypercholesterolemia
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National Medical Research Center for Therapy and...Moscow State University of Medicine and DentistryRecruitingMedication Adherence | Adherence, Medication | Treatment Adherence | Familial Hypercholesterolemia | Motivational Interviewing | Adherence, Patient | Treatment Adherence and Compliance | Patient Compliance | Adherence | Hypercholesterolemia, Familial | Patient Adherence | Hypercholesterolemia, Autosomal Dominant and other conditionsRussian Federation
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Regeneron PharmaceuticalsSanofiTerminatedHeterozygous Familial Hypercholesterolemia | Non-familial HypercholesterolemiaUnited States, Bulgaria, Estonia, Russian Federation, South Africa, Ukraine
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Merck Sharp & Dohme LLCTerminatedHypercholesterolemia, Familial | Heterozygous Familial Hypercholesterolemia
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Institut Investigacio Sanitaria Pere VirgiliRecruitingFamilial Hypercholesterolemia | Familial Hypercholesterolemia - Homozygous | Familial Hypercholesterolemia - HeterozygousSpain
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Novartis PharmaceuticalsActive, not recruitingFamilial Hypercholesterolemia - HomozygousGreece, Lebanon, Turkey, France, Canada, Malaysia, Netherlands, United States
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Novartis PharmaceuticalsRecruitingHeterozygous or Homozygous Familial HypercholesterolemiaNetherlands, Israel, Hungary, Italy, Germany, Spain, France, Norway, South Africa, Turkey, United Kingdom, Canada, Switzerland, Brazil, Lebanon, Slovenia, United States, Russian Federation, Taiwan
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Novartis PharmaceuticalsCompletedElevated Cholesterol | Homozygous Familial Hypercholesterolemia | Heterozygous Familial Hypercholesterolemia | ASCVDUnited States, Canada, Czechia, Denmark, Germany, Hungary, Netherlands, Poland, South Africa, Spain, Sweden, Ukraine, United Kingdom
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REGENXBIO Inc.National Heart, Lung, and Blood Institute (NHLBI)TerminatedHomozygous Familial Hypercholesterolemia (HoFH)United States, Canada, Italy, Netherlands
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University of British ColumbiaVancouver Coastal Health Research Institute; Genome British ColumbiaRecruitingAcute Coronary Syndrome | Familial Hypercholesterolemia | STEMI | NSTEMI - Non-ST Segment Elevation MI | Familial Hypercholesterolemia - Heterozygous | Familial Hypercholesterolemia Due to Genetic Defect of Apolipoprotein B | Familial Hypercholesterolemia Due to Heterozygous LDL Receptor Mutation and other conditionsCanada
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Organon and CoCompletedPrimary Hypercholesterolemia | Homozygous Familial Hypercholesterolemia
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NYU Langone HealthRecruitingMLH1 Gene Mutation | RAD51C Gene Mutation | BRIP1 Gene Mutation | MSH6 Gene Mutation | PMS2 Gene Mutation | BRCA-Mutated Ovarian Carcinoma | MSH2 A636P | EPCAMUnited States
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University of Maryland, BaltimoreNational Human Genome Research Institute (NHGRI)Terminated
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University of Maryland, BaltimoreRecruitingFamilial Hypercholesterolemia | Long QT Syndrome | Genetic Testing | EthicsUnited States
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Claremont Graduate UniversityAHMC Health FoundationCompletedType 2 DiabetesUnited States
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WaveForm Technologies Inc.UnknownContinuous Glucose Monitoring
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University of Puget SoundCompleted
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WaveForm Technologies Inc.CompletedEfficacy of a 21-Day Wear Period for the Cascade CGMCroatia, Slovenia
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Canterbury Christ Church UniversityInterreg 2 Seas Mers ZeeenWithdrawn