Project CASCADE: Community and Academic Synergy for Cancer Survivorship Care Delivery Enhancement (CASCADE)

October 7, 2025 updated by: Bijal.A.Balasubramanian, The University of Texas Health Science Center, Houston

Enhancing Primary Care Capacity for Cancer Survivorship Care Delivery in Community Health Clinics

The purpose of this study is to implement a clinic-level cancer survivorship care delivery intervention in partnership with community health center clinicians, patients, and community representatives to test effectiveness of the intervention to improve patient and clinician outcomes and to evaluate implementation of the intervention using an iterative, concurrent mixed-methods approach guided by the Practice Change Model.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

5584

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 Locations

  • United States
    • Texas
      • Houston, Texas, United States, 77030
        • The University of Texas Health Science Center, Houston

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 (participants):

-at least one visit to the Community Health Centers (CHCs) in the prior year

Exclusion Criteria (participants):

- no history of cancer recorded in the problem list or past medical history in the medical record

Inclusion Criteria (clinicians):

-employed clinicians (e.g. physicians, nurses, pharmacists, or other allied health professionals) and non-clinician staff of the participating CHC clinics

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: Step 1 (2 clinics)-6 months control then 12 months intervention
Behavioral: Survivorship care delivery intervention

Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), the intervention includes three evidence-based components:

  1. Training: This will include provider-to-provider tele-mentoring using Enhancing Community Health Outcomes (ECHO).
  2. Tracking: This includes systematically assessing cancer history and monitoring survivors' care to plan and organize subsequent care.
  3. Coordinating care for cancer survivors. Each clinic leader will designate a staff member (or members) as the care coordinator champion after exploring current clinic staff, skills, and capacity of various staff roles.
Experimental: Step 2 (2 clinics)-12 months control then 12 months intervention
Behavioral: Survivorship care delivery intervention

Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), the intervention includes three evidence-based components:

  1. Training: This will include provider-to-provider tele-mentoring using Enhancing Community Health Outcomes (ECHO).
  2. Tracking: This includes systematically assessing cancer history and monitoring survivors' care to plan and organize subsequent care.
  3. Coordinating care for cancer survivors. Each clinic leader will designate a staff member (or members) as the care coordinator champion after exploring current clinic staff, skills, and capacity of various staff roles.
Experimental: Step 3 (2 clinics)-18 months control then 12 months intervention
Behavioral: Survivorship care delivery intervention

Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), the intervention includes three evidence-based components:

  1. Training: This will include provider-to-provider tele-mentoring using Enhancing Community Health Outcomes (ECHO).
  2. Tracking: This includes systematically assessing cancer history and monitoring survivors' care to plan and organize subsequent care.
  3. Coordinating care for cancer survivors. Each clinic leader will designate a staff member (or members) as the care coordinator champion after exploring current clinic staff, skills, and capacity of various staff roles.
Experimental: Step 4 (2 clinics)- 24 months control then 12 months intervention
Behavioral: Survivorship care delivery intervention

Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), the intervention includes three evidence-based components:

  1. Training: This will include provider-to-provider tele-mentoring using Enhancing Community Health Outcomes (ECHO).
  2. Tracking: This includes systematically assessing cancer history and monitoring survivors' care to plan and organize subsequent care.
  3. Coordinating care for cancer survivors. Each clinic leader will designate a staff member (or members) as the care coordinator champion after exploring current clinic staff, skills, and capacity of various staff roles.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of eligible cancer survivors screened for second primary cancers
Time Frame: every 6 months from baseline to end of study (about 36 months from baseline)
Data derived from electronic health records
every 6 months from baseline to end of study (about 36 months from baseline)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in proportion of primary care clinician knowledge of cancer survivorship care
Time Frame: baseline, six months following end of intervention period
Assessed by self-administered survey
baseline, six months following end of intervention period
Change proportion of survivors that report better experience of provider communication as assessed by the adapted Consumer Assessment of Healthcare Providers and Systems (CAHPS 4.0)
Time Frame: baseline, six months following end of intervention period
baseline, six months following end of intervention period
Change proportion of survivors that report better experience of care coordination as assessed by the adapted Consumer Assessment of Healthcare Providers and Systems (CAHPS 4.0)
Time Frame: baseline, six months following end of intervention period
baseline, six months following end of intervention period
Proportion of survivors who received guideline-recommended surveillance for the most prevalent cancers (breast colorectal, prostate, cervical, and lung)
Time Frame: every 6 months from baseline to end of study (about 36 months from baseline)
Per national guidelines [National Comprehensive Cancer Network (NCCN), U.S. Preventive Services Task Force (USPSTF)]; data derived from electronic health records
every 6 months from baseline to end of study (about 36 months from baseline)

Collaborators and Investigators

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

Sponsor

The University of Texas Health Science Center, Houston

Collaborators

National Cancer Institute (NCI)

Investigators

  • Principal Investigator: Bijal Balasubramanian, MBBS, PhD, The University of Texas Health Science Center, Houston
  • Principal Investigator: Simon Craddock Lee, PhD, 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 (Actual)

September 1, 2025

Primary Completion (Estimated)

May 31, 2029

Study Completion (Estimated)

May 31, 2029

Study Registration Dates

First Submitted

March 12, 2025

First Submitted That Met QC Criteria

March 12, 2025

First Posted (Actual)

March 19, 2025

Study Record Updates

Last Update Posted (Estimated)

October 9, 2025

Last Update Submitted That Met QC Criteria

October 7, 2025

Last Verified

October 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • HSC-SPH-24-0777
  • U01CA290663 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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.

Clinical Trials on Cancer Survivorship

Clinical Trials on Survivorship care delivery intervention

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Ireland

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe