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Improving Affordability in Cancer Care Through Economic Screening and Support (I-ACCESS) (I-ACCESS)

17. juni 2026 opdateret af: UNC Lineberger Comprehensive Cancer Center
Screening and referral program to proactively identify financial hardship in adult patients with cancer and connect those at-risk with education, counseling, and resources. Patients with cancer will be screened as part of routine care and referred to available resources at their institution, following the referral processes developed and mapped in Aim 1.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In Aim 1, we will interview up to 30 clinical leaders and front-line staff across the two healthcare systems and community-based practices to understand workflows and opportunities for I-ACCESS integration. Assessment constructs will focus on understanding structural characteristics (including information technology infrastructure), available resources, culture, compatibility, relational connections, communications, and access to knowledge. These data will inform the creation of tailored process maps to outline processes and procedures to prepare each site for I-ACCESS implementation and elucidate when, how, and by whom I-ACCESS screening should be done.

In Aim 2, we will implement I-ACCESS as part of routine clinical practice for eight months at each site. Using a pre-/post-approach, we will examine whether I-ACCESS screening increases the number of financial counseling and oncology social work referrals (primary outcome). We will also examine counseling dispositions, receipt of services among those referred to financial support, and the predictive accuracy of the screening tool (secondary outcomes).

In Aim 3, we will analyze approximately 225 patient and 25 clinician surveys, informed by the Practical, Robust, Implementation and Sustainability Model, to gather feedback on I-ACCESS delivery, procedures, and barriers/facilitators to implementation. Based upon survey findings, we will then focus on key implementation determinants and outcomes through in-depth, semi-structured interviews with up to 40 stakeholders. Stakeholders will include patients, caregivers, healthcare providers, financial counselors, clinical support staff, and hospital administration at participating clinical sites.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

220

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • New York
    • North Carolina
      • Burlington, North Carolina, Forenede Stater, 27215
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • University of North Carolina at Chapel Hill
      • Hendersonville, North Carolina, Forenede Stater, 28791

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Patients: Treatment for cancer at study site, over age 18 years, speak/read English or Spanish; Caregivers: Identified caregiver of a patient with cancer offered financial hardship screening, over age 18 years, speak/read English or Spanish; Staff/Clinicians: Involvement with I-ACCESS pilot implementation; over age 18 years, speak/read English or Spanish

Exclusion Criteria:

  • Unable to read of speak English or Spanish
  • Under the age of 18 years old

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Andet: Financial Screener
Determine the effectiveness of the I-ACCESS screening tool in facilitating patient referrals for financial hardship counseling across diverse clinical practice settings. Patients who meet inclusion criteria will be screened for financial toxicity for financial toxicity using a 2-question screener tool developed from the COST ( a financial toxicity screening measure). Patients who screen positive for financial toxicity will be appropriately referred to available counseling resources.
Patients who screen positive for financial toxicity on the 2-question screener tool, will be referred to available counseling or navigation resources available at each site.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Screening completion
Tidsramme: From enrollment to the end of the intervention at 8 months.
Ratio of the number of completed screens to the number of eligible patients
From enrollment to the end of the intervention at 8 months.
Rate of referral assistance
Tidsramme: From enrollment to the end of the intervention at 8 months.
Ratio of the number of patients referred to counseling to the number of patients screened positive for financial distress
From enrollment to the end of the intervention at 8 months.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Type of referral
Tidsramme: From enrollment to the end of the intervention at 8 months.
Count/percent of reason for referral (out-of-pocket costs, non-medical expense, benefit counseling, medication cost, other)
From enrollment to the end of the intervention at 8 months.
Counseling content
Tidsramme: From enrollment to the end of the intervention at 8 months.
Count/percent of counseling disposition (general, insurance, external referral, other)
From enrollment to the end of the intervention at 8 months.
Applications for assistance
Tidsramme: From enrollment to the end of the intervention at 8 months.
Count/percent of external referrals (including, but not limited to, foundation/charity support, local non-medical expense resources)
From enrollment to the end of the intervention at 8 months.
Referrals to external resources
Tidsramme: From enrollment to the end of the intervention at 8 months.
Count/percent of external referrals (including, but not limited to, foundation/charity support, local non-medical expense resources)
From enrollment to the end of the intervention at 8 months.
Predictive accuracy of tool
Tidsramme: From enrollment through the end of data analysis at 12 months
Sensitivity, specificity, positive predictive value, and negative predictive value of tool vs. documented bill-paying challenges
From enrollment through the end of data analysis at 12 months
Acceptability of Intervention Measure
Tidsramme: 4-6 months after implementation of I-ACCESS
Patient and clinician perception of intervention acceptability
4-6 months after implementation of I-ACCESS
Intervention Appropriateness Measure
Tidsramme: 4-6 months after implementation of I-ACCESS
Patient and clinician perception of intervention appropriateness
4-6 months after implementation of I-ACCESS
Feasibility of Intervention Measure
Tidsramme: 4-6 months after intervention completion
Patient and clinician perception of intervention feasibility
4-6 months after intervention completion

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2027

Primær færdiggørelse (Anslået)

1. april 2029

Studieafslutning (Anslået)

1. september 2029

Datoer for studieregistrering

Først indsendt

17. juni 2026

Først indsendt, der opfyldte QC-kriterier

17. juni 2026

Først opslået (Faktiske)

24. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 25-1413

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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