Improving Affordability in Cancer Care Through Economic Screening and Support (I-ACCESS) (I-ACCESS)
研究概览
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名：Brianna Connelly
- 电话号码：919-964-2343
- 邮箱：brianna_connelly@med.unc.edu
学习地点
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New York
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New York、New York、美国、10016
- Perlmutter Cancer Center
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接触：
- Brianna Connelly
- 电话号码：919-964-2343
- 邮箱：brianna_connelly@med.unc.edu
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接触：
- Bridgette
- 电话号码：646-221-6953
- 邮箱：Bridgette.Thom@unc.edu
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North Carolina
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Burlington、North Carolina、美国、27215
- Cone Health Alamance Regional
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接触：
- Brianna Connelly
- 电话号码：919-964-2343
- 邮箱：brianna_connelly@med.unc.edu
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接触：
- Bridgette Thom
- 电话号码：646-221-6953
- 邮箱：Bridgette.Thom@unc.edu
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Chapel Hill、North Carolina、美国、27599
- University of North Carolina at Chapel Hill
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Hendersonville、North Carolina、美国、28791
- UNC Health Pardee
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接触：
- Brianna Connelly
- 电话号码：919-964-2343
- 邮箱：brianna_connelly@med.unc.edu
-
接触：
- Bridgette Thom
- 电话号码：646-221-6953
- 邮箱：Bridgette.Thom@unc.edu
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-
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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
学习计划
研究是如何设计的？
设计细节
- 主要用途：卫生服务研究
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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其他：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.
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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.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Screening completion
大体时间：From enrollment to the end of the intervention at 8 months.
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Ratio of the number of completed screens to the number of eligible patients
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From enrollment to the end of the intervention at 8 months.
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Rate of referral assistance
大体时间：From enrollment to the end of the intervention at 8 months.
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Ratio of the number of patients referred to counseling to the number of patients screened positive for financial distress
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From enrollment to the end of the intervention at 8 months.
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Type of referral
大体时间：From enrollment to the end of the intervention at 8 months.
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Count/percent of reason for referral (out-of-pocket costs, non-medical expense, benefit counseling, medication cost, other)
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From enrollment to the end of the intervention at 8 months.
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Counseling content
大体时间：From enrollment to the end of the intervention at 8 months.
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Count/percent of counseling disposition (general, insurance, external referral, other)
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From enrollment to the end of the intervention at 8 months.
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Applications for assistance
大体时间：From enrollment to the end of the intervention at 8 months.
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Count/percent of external referrals (including, but not limited to, foundation/charity support, local non-medical expense resources)
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From enrollment to the end of the intervention at 8 months.
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Referrals to external resources
大体时间：From enrollment to the end of the intervention at 8 months.
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Count/percent of external referrals (including, but not limited to, foundation/charity support, local non-medical expense resources)
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From enrollment to the end of the intervention at 8 months.
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Predictive accuracy of tool
大体时间：From enrollment through the end of data analysis at 12 months
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Sensitivity, specificity, positive predictive value, and negative predictive value of tool vs. documented bill-paying challenges
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From enrollment through the end of data analysis at 12 months
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Acceptability of Intervention Measure
大体时间：4-6 months after implementation of I-ACCESS
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Patient and clinician perception of intervention acceptability
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4-6 months after implementation of I-ACCESS
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Intervention Appropriateness Measure
大体时间：4-6 months after implementation of I-ACCESS
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Patient and clinician perception of intervention appropriateness
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4-6 months after implementation of I-ACCESS
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Feasibility of Intervention Measure
大体时间：4-6 months after intervention completion
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Patient and clinician perception of intervention feasibility
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4-6 months after intervention completion
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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