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

1. september 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

190

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Forente stater
    • California
      • Los Angeles, California, Forente stater, 90027
        • Children's Hospital Los Angeles
        • Hovedetterforsker:
          • David Freyer, DO, MS
        • Ta kontakt med:
          • David Freyer, DO, MS
        • Underetterforsker:
          • Kimberly Miller, PhD

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen

Tar imot friske frivillige

Nei

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Control
Recontacting patients by a nurse case manager after transition launch to determine transition success.
Atferdsmessig: Control
Standard of Care
Eksperimentell: 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.
Atferdsmessig: Navigation
Follow Up

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Children's Hospital Los Angeles

Samarbeidspartnere

National Cancer Institute (NCI)

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

1. oktober 2029

Studiet fullført (Antatt)

1. september 2030

Datoer for studieregistrering

Først innsendt

2. juni 2026

Først innsendt som oppfylte QC-kriteriene

2. juni 2026

Først lagt ut (Faktiske)

5. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

3. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

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

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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