Community Health Worker Support for Cancer Survivorship

Recruiting at 1 trial location

Overseen By Mandi Pratt-Chapman, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medstar Health Research Institute

Disqualifiers: Non-Black race, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

1116 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to support cancer survivors by utilizing Community Health Workers (CHWs) to enhance their health and well-being. The focus is on improving the quality of life and social connections for Black individuals who have survived breast or prostate cancer. Additionally, the trial explores how anti-racism training for health staff can reduce patient-reported discrimination. Suitable participants include Black or African American individuals who have completed treatment for stage I-III breast or prostate cancer or are about six months from a stage IV diagnosis. As an unphased trial, participants can contribute to innovative approaches that enhance survivor support and reduce discrimination.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that Community Health Worker support is safe for cancer survivors?

Research has shown that support from Community Health Workers (CHWs) is generally safe and well-received. Studies have found that CHWs can improve health outcomes for people with various conditions, including cancer, by offering support and resources to manage health needs. For example, one study found that CHW support improved recovery after hospital stays for people with low incomes. Another study showed that CHWs effectively help manage long-term health issues in low-income communities.

These findings suggest that CHW support is safe for cancer survivors, as no major reports of negative effects exist. The focus remains on improving health and well-being through personalized support, which is a gentle and low-risk approach. Overall, CHW support appears to be a safe way to enhance the quality of life for cancer survivors. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Community Health Worker support program for cancer survivors because it offers a personalized approach that addresses social needs, which are often overlooked in traditional cancer care. Unlike standard treatments that focus solely on medical interventions, this program provides continuous, tailored support through trained community health workers who help navigate non-medical challenges like transportation, housing, or access to healthy food. This holistic strategy aims to enhance overall well-being and improve quality of life for Black cancer survivors, potentially leading to better long-term outcomes.

What evidence suggests that Community Health Worker support is effective for cancer survivorship?

Research has shown that support from community health workers (CHWs) can greatly benefit cancer survivors. In this trial, participants will receive a six-month intervention from CHWs. One study found that cancer patients who received CHW support were 62% less likely to be readmitted to the hospital. Another study found that low-income minority patients experienced a significantly improved quality of life with CHW assistance. CHWs also help individuals access primary care more effectively and enhance mental health. These findings suggest that CHW support can address the social and health needs of cancer survivors, potentially leading to better overall well-being. ^{3 6 7 8 9}

Who Is on the Research Team?

Hannah Arem, PhD

Principal Investigator

Medstar Health Research Institute

Mandi Pratt-Chapman, PhD

Principal Investigator

George Washington University

Are You a Good Fit for This Trial?

This trial is for Black or African American individuals who have been diagnosed with stage I-III breast or prostate cancer and completed curative treatment, or those with stage IV of these cancers about 6 months post-diagnosis.

Inclusion Criteria

I have completed treatment for stage I-III breast or prostate cancer.

I was diagnosed with stage IV breast or prostate cancer about 6 months ago.

People who identify as Black or African American.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Community Health Worker Intervention

Participants receive support from a community health worker to assess social needs and provide support

6 months

Regular check-ins with community health worker

Follow-up

Participants are monitored for health-related quality of life and social connectedness

6 months

Sustainability Assessment

Annual assessment of program sustainability using the Program Sustainability Assessment Tool

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Community Health Worker support

Trial Overview The study aims to improve health and well-being for cancer survivors by screening social risk factors, referring them to community resources, providing Community Health Worker support, and implementing anti-racism training for healthcare staff.

How Is the Trial Designed?

Group I: Intervention participants Experimental Treatment 1 Intervention

Among patients who completed the social needs screening as a part of standard of care, all stage I-IV Black cancer survivors will be invited to participate in a six-month community health worker intervention. The community health worker will assess social needs and provide six months of support.

Who Is Running the Clinical Trial?

Medstar Health Research Institute

Lead Sponsor

Trials

202

Recruited

187,000+

George Washington University

Collaborator

Trials

263

Recruited

476,000+

Howard University

Collaborator

Trials

44

Recruited

15,200+

Georgetown University

Collaborator

Trials

355

Recruited

142,000+

Published Research Related to This Trial

Community health workers (CHWs) have proven effective in various health care settings, but their perceived value is diminished due to inconsistent credentialing and lack of billing structures for their services.

The article proposes a framework to better define CHW roles and competencies, which could help integrate them into health care systems and improve recognition and payment for their contributions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a Framework to Describe Functions and Practice of Community Health Workers. Corder-Mabe, J., Johnson, S., Mazmanian, PE., et al.[2021]

Community health worker (CHW) interventions show promise in improving psychosocial outcomes for people living with HIV, particularly in areas like quality of life and self-efficacy, based on a review of 14 randomized controlled trials.

However, these interventions have not been effective in reducing depressive symptoms or stigma related to HIV, indicating a need for future studies to expand their focus and incorporate measures of intervention fidelity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community health worker interventions to promote psychosocial outcomes among people living with HIV-A systematic review. Han, HR., Kim, K., Murphy, J., et al.[2019]

A tailored community health worker (CHW) intervention significantly improved posthospital outcomes for low-socioeconomic status patients, increasing timely primary care follow-up from 47.9% to 60.0% and enhancing the quality of discharge communication.

The intervention also led to better mental health improvements and patient activation, while reducing the likelihood of multiple 30-day readmissions, indicating that CHWs can effectively address socioeconomic and behavioral factors affecting recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient-centered community health worker intervention to improve posthospital outcomes: a randomized clinical trial. Kangovi, S., Mitra, N., Grande, D., et al.[2018]

A survey of 775 Community Health Workers (CHWs) in Brazil revealed that the COVID-19 pandemic has intensified challenges in their roles, particularly due to a rise in misinformation and denial about the virus, which hampers public health efforts.

The study highlights that the unique difficulties faced by CHWs in low-income communities during the pandemic have been largely overlooked in Brazilian health policies, suggesting a need for more tailored support and strategies for these essential workers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community health workers' attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities. do Rosário Costa, N., Bellas, H., da Silva, PRF., et al.[2021]

Community health worker (CHW) interventions significantly increase screening mammography rates among women aged 40 and older, with a risk ratio of 1.06, indicating a positive impact on women's health.

The effectiveness of CHW programs is particularly strong in medical settings, urban areas, and when CHWs are matched with participants by race or ethnicity, suggesting that tailored approaches enhance the success of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Wells, KJ., Luque, JS., Miladinovic, B., et al.[2022]

Community health workers (CHWs) play a crucial role in providing health services and addressing health inequities in marginalized populations, but their contributions in Canada remain largely unrecognized and unregulated.

Research indicates that CHW interventions can effectively reduce health inequities and lower healthcare costs, highlighting the need for better integration of CHWs into the health and social services systems to maximize their impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community health workers in Canada and other high-income countries: A scoping review and research gaps. Najafizada, SA., Bourgeault, IL., Labonte, R., et al.[2022]

The partnership between a safety-net hospital's social work department and community health workers (CHWs) aims to improve health outcomes for high-risk patients by addressing social determinants of health.

Early outcomes suggest that integrating CHWs into health systems can effectively support patients facing adverse social conditions, although the best practices for this integration are still being explored.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrating Community Health Workers into Hospital Systems Through a Social Work Partnership: A Report from the Field. Markossian, TW., McCabe, K., Ginn, J., et al.[2023]

Community health workers (CHWs) play a significant role in occupational health and safety research, particularly in the agriculture industry, where 76% of the studies reviewed were conducted.

Involving CHWs can enhance research by improving access to diverse and vulnerable populations, but challenges such as training and recruitment need to be addressed to maximize their effectiveness in this role.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research. Swanberg, JE., Nichols, HM., Clouser, JM., et al.[2019]

A community health worker (CHW)-led intervention significantly improved health-related quality of life (HRQoL) for low-income and racial and ethnic minoritized cancer patients compared to usual care, with notable improvements observed at both 4-month and 12-month follow-ups.

The study involved 160 participants and demonstrated that the CHW's support in advance care planning and addressing health-related social needs contributed to better HRQoL outcomes, highlighting the effectiveness of integrating CHWs into cancer care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a Community Health Worker-Led Intervention Among Low-Income and Minoritized Patients With Cancer: A Randomized Clinical Trial. Patel, MI., Kapphahn, K., Wood, E., et al.[2023]

The pilot navigation program using community health workers (CHWs) aims to reduce delays in cancer treatment by providing tailored support to patients and caregivers, potentially improving healthcare utilization and reducing patient distress.

The study will assess the program's effectiveness by measuring the time to initial oncology treatment and patient satisfaction, with evaluations conducted at 3 and 6 months post-intervention, ensuring a systematic approach to implementation and feedback.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving cancer care for underserved populations in an academic and community practice setting: protocol for a community health worker pilot navigation programme. Suen, JJ., Parrillo, E., Hassoon, A., et al.[2022]

African American older adult cancer survivors (aged 65 and older) expressed limited prior knowledge of community health workers (CHWs), but recognized their potential to assist in navigating cancer treatment and addressing unmet needs.

Participants highlighted the importance of individualized interventions and provided specific recommendations for CHWs, emphasizing the need for coordination in cancer care to better support older African Americans during their diagnosis and treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the role of community health workers in providing cancer navigation: perceptions of African American older adults. Wenzel, J., Jones, R., Klimmek, R., et al.[2022]

Community health workers (CHWs) in South Asia face significant sociocultural challenges, including religious norms, gender roles, caste systems, and generational differences, which impact their ability to connect patients to healthcare services.

Understanding these challenges is crucial for program planning and deployment of CHWs, as it can enhance the effectiveness and reach of healthcare initiatives in rural and remote communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Challenges in the sociocultural milieu of South Asia: a systematic review of community health workers. Majid, U., Zahid, M., Harold, K., et al.[2021]

Citations

1. withpower.com withpower.com/trial/community-health-worker-support-for-cancer-survivorship-b37d4

Community Health Worker Support for Cancer Survivorship A tailored community health worker (CHW) intervention significantly improved posthospital outcomes for low-socioeconomic status patients, increasing timely ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9247857/

Effect of a Community Health Worker Intervention on Acute ... In this randomized clinical trial that included 128 adults with cancer, patients in the community health worker–led intervention had a 62% decreased risk of ...

3. ascopubs.org ascopubs.org/doi/10.1200/JCO.23.01723

Community Health Worker Navigation for Patients With ... Low-income minority patients with cancer randomly assigned to a community health worker intervention had significantly improved health related quality of life ...

4. chcs.org chcs.org/community-health-workers-offer-critical-supports-for-patients-with-complex-health-and-social-needs-an-evidence-review/

Community Health Workers Offer Critical Supports ... Studies show CHW interventions improve rates of cancer screening and rates of access to primary care or rates of post-hospital follow-up for ...

5. astho.org astho.org/globalassets/pdf/community-health-workers-summary-evidence.pdf

Community Health Workers: Evidence of Their Effectiveness Increased likelihood of obtaining primary care, increased mental health improvements, and reduced likelihood of multiple 30-day readmissions from 40% to 15.2%.

6. sciencedirect.com sciencedirect.com/science/article/pii/S2451865424001340

Feasibility of self-monitoring and community health worker ... A self-monitoring and CHW intervention is a feasible approach to monitor hypertension among Black cancer patients.

7. ahrq.gov ahrq.gov/downloads/pub/evidence/pdf/comhealthwork/comhwork.pdf

Outcomes of Community Health Worker Interventions To conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5607679/

Community Health Worker Support for Disadvantaged ... Objectives. To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12248872/

The role of Community Health Workers in a Collaborative ... The survey assessed CHWs' comfort level with proposed intervention-related tasks (e.g., working with patients diagnosed with cancer). Interviews and focus ...