A Pilot Trial to Evaluate the Effectiveness of Navigation, Interactive Web Education, or the Combination of Both to Promote Guideline-Concordant Colorectal Cancer Surveillance Care
Summary
This pilot clinical trial looks at whether patient navigation services, an interactive web education intervention, called Current Together After Cancer (CTAC), or both navigation and CTAC works to improve the uptake of surveillance in patients with stage I-III colorectal cancer (CRC). Post-treatment surveillance is critical to detect recurrence early, yet many CRC survivors do not receive recommended surveillance care. Surveillance is a complex process that includes laboratory tests, cross-sectional imaging, and endoscopic procedures. Patient navigation services, interactive web education, or a combination of both may improve surveillance care for patients with stage I-III colorectal cancer.
Detailed description
OUTLINE: Patients are assigned to 1 of 3 arms based on the clinic location they receive cancer care at. ARM A (VIRGINIA MASON): Patients receive access to navigation services, including education on surveillance care, reminders to complete care and assistance in scheduling surveillance, within 3 months of standard of care surgical resection for stage I-III CRC. ARM B (FRED HUTCH \[SOUTH LAKE UNION\]): Patients receive access to the CTAC intervention, which includes self-directed, interactive web-based education about surveillance and a checklist of care, within 3 months of standard of care surgical resection for stage I-III CRC. ARM C (FRED HUTCH \[OVERLAKE + EVERGREEN\]): Patients receive access to navigation services, including education on surveillance care, reminders to complete care and assistance in scheduling surveillance, and access to the CTAC intervention, which includes self-directed, interactive web-based education about surveillance and a checklist of care, within 3 months of standard of care surgical resection for stage I-III CRC. Patients are followed up at 3 months post study-enrollment and 12-18 months after surgical resection.
Arms & interventions
- OtherEducational Intervention
Complete self-directed interactive education
- OtherElectronic Health Record Review
Ancillary studies
- OtherInternet-Based Intervention
Receive access to CTAC
- BehavioralPatient Navigation
Receive patient navigation services
- OtherSurvey Administration
Ancillary studies
Outcome measures
Primary
Completion of colonoscopy (stage I colorectal carcinoma patients)
Time frame: Up to 18 months post-surgical resection
Completing any colonoscopy, carcinoembryonic antigen tumor marker (CEA), and cross-sectional imaging (stage II-III colorectal carcinoma patients)
Will compare rates of surveillance care completion 1-year (up to 18 months accounting for delays that may be due to inability accessing endoscopy) post-surgical resection across groups using chi-square tests. Will use a multivariable logistic regression model to test for factors that may be associated with increased or decreased surveillance care including patient-level demographic factors (e.g., age, sex, etc.) and available clinic-level factors (e.g., clinic size, etc.).
Time frame: Up to 18 months post-surgical resection
Secondary
Knowledge of colorectal cancer (CRC) surveillance
Time frame: At baseline, and 3 months post enrollment
Self-efficacy to complete CRC surveillance
Time frame: At baseline, and 3 months post enrollment
Acceptability of the intervention
Time frame: At 3 months post enrollment
Intervention appropriateness
Time frame: At 3 months post enrollment
Feasibility of the intervention
Time frame: At 3 months post enrollment
Eligibility criteria
Study locations (2)
Benaroya Research Institute at Virginia Mason
Seattle, Washington, 98101
Fred Hutch/University of Washington Cancer Consortium
Seattle, Washington, 98109