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CCS Transitions to Adult Care

6. november 2026 opdateret af: Rebecca Eary, University of Texas Southwestern Medical Center

Novel Linkages and Navigation to Improve Childhood and Adolescent Cancer Survivors' Care Transitions: A Pilot Randomized Controlled Trial Across Three Health Care Systems

In response to RFA-CA-24-027: Addressing Barriers to Healthcare Transitions for Survivors of Childhood and Adolescent Cancers, this study targets barriers at multiple levels and stages in care transition. The study will use a pilot randomized controlled trial testing an interventiont to improve transitions to adult survivorship care among active childhood cancer survivors (CCS) who are newly adults.

Aim: Develop and test a multilevel intervention to improve rates of follow-up visit completion among CCS transitioning from pediatric survivorship care to one of three adult onco-primary care clinics.

Hypothesis: Adult CCS receiving nurse navigation, education, and electronic referral will be more likely to complete follow-up visits at an adult onco-primary care clinic than those on standard referral pathways (electronic referral only).

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

100

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

Studiesteder

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

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Are scheduled for a final pediatric survivorship visit after the study's enrollment start (target: March 2027) but within 1 month of eligibility assessment date,
  • Completed cancer treatment >30 months prior to eligibility assessment date,
  • Are at least 18 years old at eligibility assessment date, and
  • Are able to independently understand, and willing to sign, a written informed consent document.

Exclusion Criteria:

  • Were treated for non-cancer diagnoses (e.g., received chemotherapy or radiation for another non-cancer condition, e.g., aplastic anemia), or
  • Do not want to attend onco-primary care at UTSW (i.e., have a different planned clinician or clinic for survivorship care).
  • Speak or write a language other than English or Spanish

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Enhanced Referral Pathway (ERP)

Participants randomized to the ERP arm will receive the SRP, tailored patient education, and patient navigation mapped to the four components of patient navigation

A nurse navigator trained in patient navigation and motivational interviewing will contact CCS (childhood cancer survivor) randomized to the ERP arm and provide a brief introduction to the importance of survivorship care and schedule the patient for an appointment at an adult onco-primary care clinic. The nurse navigator will also schedule at an initial one-hour telehealth visit with the CCS for ~1 month after their last Pediatric ACE visit. During the initial telehealth visit, the navigator will provide tailored patient education and individualized navigation based on the baseline survey results for each adult CCS. The navigator will assess additional educational needs or barriers to determine whether additional visits are needed. Every CCS in the ERP arm will have at least one telehealth visit, but may have as many as five, as needed.

Ingen indgriben: Standard Referral Pathway (SRP)

For the SRP, clinicians will send an electronic Care Everywhere referral to the adult onco-primary care program, via the ACE coordinator, an existing clinical staff member in onco-primary care. The coordinator will attempt to contact the adult participant 3 times by telephone or MyChart, which includes text messages. Once contact is made, the ACE coordinator will assess current insurance status and schedule a visit in one of the three onco-primary care clinics depending on patient preference, location, and insurance type

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of participants with who attend an adult onco-primary care visit
Tidsramme: Within 24 months after study enrollment

The proportion of participants in each arm who attend an onco-primary care visit.

Visit attendance will be assessed through clinic scheduling data.

The outcome will be analyzed as a binary proportion (attended vs. did not attend)

Within 24 months after study enrollment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of participants with who schedule an adult onco-primary care visit
Tidsramme: Within 24 months after study enrollment

The proportion of participants in each arm who schedule an onco-primary care visit.

Visit scheduling will be assessed through clinic scheduling data.

The outcome will be analyzed as a binary proportion (scheduled vs. did not schedule)

Within 24 months after study enrollment
Change in transition readiness
Tidsramme: Assessed at baseline, after navigation appointment, and annually until study end

Change in score on the the Transition Readiness Assessment for Youth scale.

The scale includes twenty readiness items rated as No (0), I want to learn (1), or Yes (2).

The items will be summed and the outcome will be analyzed as a scale variable ranging from 0 (lowest readiness) to 40 (highest readiness)

Assessed at baseline, after navigation appointment, and annually until study end
Change in health care self-efficacy
Tidsramme: Assessed at baseline, after navigation appointment, and annually until study end

Assessed via the Healthcare Self-Efficacy Scale (3-item instrument).

The items are rated on a 3-point Likert-type scale: (1) not confident, (2) confident, (3) very confident.

The items will be averaged and the outcome will be anaylzed as scale variable ranging from 1 (least confident) to 3 (most confident).

Assessed at baseline, after navigation appointment, and annually until study end
Proportion of participants with who attended a primary care visit
Tidsramme: Assessed at baseline, after navigation appointment, and annually until study end

The proportion of participants who complete a qualifying primary care visit, defined as: a visit with any primary care or a visit to an onco-primary care clinic.

Self-reported by participants and assessed through onco-primary care clinic scheduling data.

The outcome will be analyzed as a binary proportion (attended primary care vs. did not attend primary care).

Assessed at baseline, after navigation appointment, and annually until study end

Samarbejdspartnere og efterforskere

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

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Rebecca Eary, DO, MPH, University of Texas Southwestern Medical Center
  • Ledende efterforsker: Amy E Hughes, PhD, MPH, University of Texas Southwestern Medical Center
  • Ledende efterforsker: L. Aubree Shay, PhD, MSSW, The University of Texas Health Science Center, Houston

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

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. april 2027

Primær færdiggørelse (Anslået)

31. august 2030

Studieafslutning (Anslået)

31. august 2030

Datoer for studieregistrering

Først indsendt

6. november 2026

Først indsendt, der opfyldte QC-kriterier

6. november 2026

Først opslået (Faktiske)

12. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. november 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • STU20261556
  • R01CA303339 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

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