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Patient Navigation for Improving Transition Success Among Multiply Disadvantaged Young Adult Survivors of Childhood Cancer

2. juni 2026 opdateret af: David Freyer, DO, MS, Children's Hospital Los Angeles

The goal of this clinical trial is to improve the successful healthcare transition from pediatric to adult-focused care for childhood cancer survivors. The main questions it aims to answer are

  • Receipt of the intervention (vs. standard of care control) will increase the proportion of CCS achieving transition success to adult-focused survivorship care from 50% to 70%.
  • Receipt of the intervention (vs. standard of care control) will significantly reduce patients' unmet HRSN.
  • Intervention effectiveness will be moderated by sociodemographic factors (gender, race/ethnicity, insurance status), medical risk for late effects, HRSN burden, and patient-reported outcomes (quality of life, self-efficacy).

Researchers will compare those that receive intervention versus standard of care.

Patients are randomized to either an intervention group, receiving structured PN-led sessions and tailored support for care transitions, or a control group receiving standard follow-up by a nurse case manager. High-HRSN patients in the intervention arm get monthly check-ins and coordinated handoffs to adult care providers for continuity.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

190

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

Studiesteder

  • Forenede Stater
    • California
      • Los Angeles, California, Forenede Stater, 90027
        • Children's Hospital Los Angeles
        • Ledende efterforsker:
          • David Freyer, DO, MS
        • Kontakt:
          • David Freyer, DO, MS
        • Underforsker:
          • Kimberly Miller, PhD

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

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • diagnosed between the ages of 0-19 years with cancer or with any condition treated with cancer-like therapy.
  • currently in follow up at survivorship clinic or had a survivorship launch visit during the 12 months prior to study activation.
  • current age 20-29 (>95% of patients will be age 20-21)
  • meet LIFE Clinic transition readiness criteria, as clinically applied:
  • at least 5 years off treatment
  • medically stable
  • demonstrate a workable understanding of transition
  • have an identified primary care provider
  • able to speak and read English or Spanish
  • can provide informed consent.

Exclusion Criteria:

  • do not meet transition criteria
  • speak a language other than English or Spanish
  • are significantly impaired and cannot provide informed consent.

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
Aktiv komparator: Control
Recontacting patients by a nurse case manager after transition launch to determine transition success.
Adfærdsmæssigt: Control
Standard of Care
Eksperimentel: Navigation
Patients in the intervention have phone or video session with patient navigator at enrollment, 6, 12 and 18 months, or more frequently as dictated by high-risk social needs.
Adfærdsmæssigt: Navigation
Follow Up

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of participants with Transition to Adult-Focused Survivorship Care
Tidsramme: Within 18 months following transition "launch" (study enrollment/baseline)

The proportion of participants who complete a qualifying adult-focused survivorship care visit, defined as:

For higher-risk survivors: a visit to the designated adult survivorship clinic For lower-risk survivors: a visit to a primary care provider that includes discussion of cancer history and/or late effects

Transition success is:

Self-reported by participants and Validated by study staff through contact with the receiving provider

Participants without a cancer-focused component to the visit (e.g., urgent care, vaccination-only visits) will not be considered successful transitions.

The outcome will be analyzed as a binary proportion (success vs. no success).
Within 18 months following transition "launch" (study enrollment/baseline)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in HRSN score from baseline to each follow-up time point in each study arm.
Tidsramme: Baseline to 18 months post-enrollment

Change in the number of unmet health-related social needs assessed using the CMS Accountable Health Communities (AHC) HRSN Screening Tool, including domains such as:

Housing instability, Food insecurity, Transportation barriers, Utility assistance needs, and Employment, education, mental health, and disability (supplemental items)

Count 6 (all social needs endorsed) to 0 (no social needs endorsed)
Baseline to 18 months post-enrollment
Change in Global Health-Related Quality of Life Score using Likert scale
Tidsramme: Baseline to 18 months post-enrollment

Change in patient-reported quality of life measured using the PROMIS Global Health Scale (10-item instrument), generating:

Physical health summary score Mental health summary score

0 (poor self reported health) -10 (best self reported health)
Baseline to 18 months post-enrollment
Change in General Self-Efficacy using Likert scale
Tidsramme: Baseline to 18 months post-enrollment

Change in perceived self-efficacy measured using the PROMIS General Self-Efficacy 10-item scale.

Scores reflect participants' confidence in managing health and behavior and are reported as standardized scores.

1 ( Lowest Confidence ) - 5 ( Highest Confidence )
Baseline to 18 months post-enrollment
Change in mean scores for Patient-Reported Access to and Experience with Healthcare as measures by CAHPS (Consumer Assessment of Healthcare Providers and Systems)
Tidsramme: Baseline to 18 months post-enrollment

Patient-reported measures derived from CAHPS (Consumer Assessment of Healthcare Providers and Systems) assessing:

Global rating of healthcare Access barriers Insurance-related difficulties

Outcomes reported as mean scores

Count 0 (Worst Possible Assessment) to 10 (Best Possible Assessment)
Baseline to 18 months post-enrollment
Change in count for barriers to care as measured by Likert scale barriers to care questionnaire
Tidsramme: Baseline to 18 months post-enrollment

39-item questionnaire that includes subscales of pragmatics, health knowledge and beliefs, expectations about care, skills, and marginalization.

Likert scale with 0-100 range, where 0 indicates the most barriers and 100 indicates no barriers.
Baseline to 18 months post-enrollment
Change in Emotional Social Support score using a Likert scale.
Tidsramme: Baseline to 18 months post-enrollment

Patient-reported social support measured using PROMIS short forms:

Emotional support (4 items each) Likert scale with 0-5 range, where 0 indicates the lowest social support and 5 indicates highest social support.
Baseline to 18 months post-enrollment
Change in Informational Support score using a Likert scale.
Tidsramme: Baseline to 18 months post-enrollment

Patient-reported social support measured using PROMIS short forms:

Informational support (4 items each)

Likert scale with 0-5 range, where 0 indicates the lowest social support and 5 indicates highest social support.
Baseline to 18 months post-enrollment

Samarbejdspartnere og efterforskere

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

Sponsor

Children's Hospital Los Angeles

Samarbejdspartnere

National Cancer Institute (NCI)

Efterforskere

  • Ledende efterforsker: David Freyer, DO, MS, Children's Hospital Los Angeles
  • Ledende efterforsker: Kimberly Miller, PhD, Children's Hospital Los Angeles

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. juli 2026

Primær færdiggørelse (Anslået)

1. oktober 2029

Studieafslutning (Anslået)

1. september 2030

Datoer for studieregistrering

Først indsendt

2. juni 2026

Først indsendt, der opfyldte QC-kriterier

2. juni 2026

Først opslået (Faktiske)

5. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CHLA-25-00386
  • R01CA303651 (U.S. NIH-bevilling/kontrakt)
  • NCI-2025-09161 (Anden identifikator: CTRP)

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