Improving Affordability in Cancer Care Through Economic Screening and Support (I-ACCESS) (I-ACCESS)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
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
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Brianna Connelly
- Telefonnummer: 919-964-2343
- E-mail: brianna_connelly@med.unc.edu
Studiesteder
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-
New York
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New York, New York, Forenede Stater, 10016
- Perlmutter Cancer Center
-
Kontakt:
- Brianna Connelly
- Telefonnummer: 919-964-2343
- E-mail: brianna_connelly@med.unc.edu
-
Kontakt:
- Bridgette
- Telefonnummer: 646-221-6953
- E-mail: Bridgette.Thom@unc.edu
-
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North Carolina
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Burlington, North Carolina, Forenede Stater, 27215
- Cone Health Alamance Regional
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Kontakt:
- Brianna Connelly
- Telefonnummer: 919-964-2343
- E-mail: brianna_connelly@med.unc.edu
-
Kontakt:
- Bridgette Thom
- Telefonnummer: 646-221-6953
- E-mail: Bridgette.Thom@unc.edu
-
Chapel Hill, North Carolina, Forenede Stater, 27599
- University of North Carolina at Chapel Hill
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Hendersonville, North Carolina, Forenede Stater, 28791
- UNC Health Pardee
-
Kontakt:
- Brianna Connelly
- Telefonnummer: 919-964-2343
- E-mail: brianna_connelly@med.unc.edu
-
Kontakt:
- Bridgette Thom
- Telefonnummer: 646-221-6953
- E-mail: Bridgette.Thom@unc.edu
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
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
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / 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
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
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
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 25-1413
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