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

17 juni 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

220

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Hälsovårdsforskning
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Övrig: 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.
Beteende: Financial counseling and navigation
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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Screening completion
Tidsram: 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
Tidsram: 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.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Type of referral
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 4-6 months after intervention completion
Patient and clinician perception of intervention feasibility
4-6 months after intervention completion

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

UNC Lineberger Comprehensive Cancer Center

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 september 2027

Primärt slutförande (Beräknad)

1 april 2029

Avslutad studie (Beräknad)

1 september 2029

Studieregistreringsdatum

Först inskickad

17 juni 2026

Först inskickad som uppfyllde QC-kriterierna

17 juni 2026

Första postat (Faktisk)

24 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

24 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

17 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 25-1413

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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