- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06181344
Implementation and Evaluation of a Fear of Cancer Recurrence Screening, Referral and Management Program
December 28, 2023 updated by: The University of Hong Kong
Implementation and Evaluation of a Fear of Cancer Recurrence Screening, Referral and Management Program for Chinese Cancer Survivors: a Stepped Wedge and Cluster Randomized Trial
The purpose of this study is to evaluate the process and outcomes of an implementation program designed to implement fear of cancer screening, referral and management into routine cancer care clinics, using a stepped-wedge cluster randomized controlled trial.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
This study aims to test if a systematic fear of cancer screening program that employs implementation strategies including training, reflecting, evaluating, facilitating and adapting, increases the proportion of eligible patients screened and referred compared to usual control with no implantation strategies used.
This study hypothesize that the implementation program will increase (i) the proportion of eligible patients screened and (ii) the proportion of patients with high fear of cancer referred for psychosocial support.
For process evaluation, this study aims to use qualitative methods to assess the patients' and service providers' experience of the implementation program, and identify contextual factors (e.g., potential barriers and facilitators) likely to influence its adoption, implementation, and sustainability.
Study Type
Interventional
Enrollment (Estimated)
1980
Phase
- 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 Contact
- Name: Danielle Ng, PhD
- Phone Number: +852 39179897
- Email: dwlng@hku.hk
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
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- All patients diagnosed with non-metastatic breast, gynecological, or colorectal cancer, and who have completed primary and adjuvant treatment within the past two years will be eligible for the proposed screening program.
Exclusion Criteria:
- All cancer patients beyond two years post-treatment; and diagnosed with metastatic cancer or non-breast, non-gynecological, and non-colorectal cancer.
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: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: implementation condition
Under implementation condition, a fear of cancer recurrence screening program will be implemented in routine oncological clinics using 5 implementation strategies including training, audit and feedback, facilitation and adaptable workflow.
|
Five implementation strategies will be conducted individually for each of the study unit at the timepoint when the study unit is being randomly allocated to the implementation condition.
For each study unit, all nurses will first receive a half-day training.
Each study unit under the implementation condition will receive weekly audit and feedback reports to summarize the proportion of eligible patients, proportion of eligible patients being screened, proportion of patients appropriately referred to JCICC.
The senior research assistant with a nursing background will receive training and mentoring from the PI and will be the guided facilitator.
The guided facilitator will conduct weekly site visits to address operational issues arise during the implementation.
Lastly, while the choice of symptom assessment tool and referral criteria are standardized and cannot be modified, the routine workflow for each study unit can be adjusted according to its context and resources.
|
No Intervention: Control condition
In the control condition, the clinical outpatient operation is performed as usual.
The FCR screening tool and referral forms will be provided to the study sites and nursing staff are encouraged to adopt fear of cancer recurrence screening.
Patients referred to JCICC will be managed following the predefined clinical pathway triage system.
A briefing session about the purpose of the implementation program and the introduction of the FCR screening tool will be given to the staff at each study unit before the start of the first 4-months control condition.
The briefing session will be recorded for the purpose of fidelity assessment.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in the number of eligible patient screened
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The primary outcome (the measurement of the reach) is the changes in the number of eligible patients screened.
Using a standardized reporting form, each study site will be asked to submit a weekly record of a total number of eligible patients per clinic and the number of patients screened.
|
Pre- and post-implementation phase, up to 24 months
|
Change in the number of eligible patient referred
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The primary outcome (the measurement of the reach) is the changes in the number of eligible patients referred based on the predefined scores.
Using a standardized reporting form, each study site will be asked to submit a weekly record of a total number of eligible patients per clinic and the number of patients referred.
|
Pre- and post-implementation phase, up to 24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in referral uptake
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The secondary outcome is the change in uptake of the referral, i.e. the proportion of referred patients accepting services.
|
Pre- and post-implementation phase, up to 24 months
|
Process evaluation in providers by conducting qualitative interviews
Time Frame: Pre- and post-implementation phase, up to 24 months
|
Using qualitative approach with service providers (i.e. the nurses) to identify facilitators and barriers for the implementation of the symptom distress screening program, as well as their overall experience.
All nursing staff from the study units involved in the symptom distress screening will be invited to join the qualitative study at the post-implementation phase.
|
Pre- and post-implementation phase, up to 24 months
|
Process evaluation in patients by conducting qualitative interviews
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The investigators will also conduct qualitative interviews to explore patients' experiences with symptom distress screening and referral if appropriate.
Patients who are referred for support services will be approached by the research assistant who will explain the purpose of the study and nature of participation, with an emphasis on confidentiality and anonymity.
If agreeing to participate, the RA will obtain a written consent and each subject will subsequently participate in in-depth interview by a trained interviewer.
For patients who decline to be referred for support services, the investigators will ask the nursing staff to invite the patients to join the qualitative study.
The investigators will recruit patients from both implementation and control conditions as it will enable us to compare patients' experience.
|
Pre- and post-implementation phase, up to 24 months
|
Number of staff receiving training
Time Frame: Pre- and post-implementation phase, up to 24 months
|
All nurses will first receive a half-day training on how to administer the symptom distress screening tool, evaluate patients' reported symptom distress, refer patients to and follow-up for referred patients.
The investigators will record the number of invited staff attending the half-day training workshop.
|
Pre- and post-implementation phase, up to 24 months
|
Change in staff knowledge about the implementation of the screening programme assessed using categorical Likert scales
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The investigators will assess the staff knowledge at pre- and post-training workshop and again at the end of the implementation study using a 6 points-categorical Likert scale (0-5) for participants' knowledge about the implementation of the screening program.
Such information will be served as implementation indicators to facilitate the interpretation of the study findings.
|
Pre- and post-implementation phase, up to 24 months
|
Change in staff's belief in the symptom distress screening programme assessed using categorical Likert scales
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The investigators will assess the staff's belief at pre- and post-training workshop and again at the end of the implementation study using a 6 points-categorical Likert scale (0-5) for participants' beliefs towards the symptom distress screening programme.
Such information will be served as implementation indicators to facilitate the interpretation of the study findings.
|
Pre- and post-implementation phase, up to 24 months
|
Change in staff self-efficacy in administrating the symptom distress screening programme assessed using categorical Likert scales
Time Frame: Pre- and post-implementation phase, up to 24 months
|
The investigators will assess the staff's self-efficacy at pre- and post-training workshop and again at the end of the implementation study using a 6 points-categorical Likert scale (0-5).
Such information will be served as implementation indicators to facilitate the interpretation of the study findings.
|
Pre- and post-implementation phase, up to 24 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Danielle Ng, PhD, The University of Hong Kong
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)
September 1, 2024
Primary Completion (Estimated)
December 31, 2025
Study Completion (Estimated)
August 31, 2026
Study Registration Dates
First Submitted
December 12, 2023
First Submitted That Met QC Criteria
December 12, 2023
First Posted (Actual)
December 26, 2023
Study Record Updates
Last Update Posted (Actual)
January 3, 2024
Last Update Submitted That Met QC Criteria
December 28, 2023
Last Verified
December 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UW23-458
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
All IPD that underlie results in a publication will be available from the PI upon reasonable reques
IPD Sharing Time Frame
Starting 6 months after publication
IPD Sharing Access Criteria
Information will be available from the PI upon reasonable request.
The author to review requests is the PI.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
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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