ICAN Health System Intervention for Rural Cancer Care Quality

Overseen By Mary Schroeder, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mary Charlton

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve cancer care quality in rural Iowa hospitals by testing the Iowa Cancer Affiliate Network (ICAN) intervention. The focus is on education, training, and support to help hospitals meet national cancer care standards. The research team will provide ongoing assistance to enhance cancer services. The trial targets administrators, clinicians, and data staff involved in cancer care at select rural hospitals. As an unphased trial, it offers a unique opportunity to advance cancer care quality in rural communities.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that the ICAN intervention is safe for improving rural cancer care quality?

Research has shown that the Iowa Cancer Affiliate Network (ICAN) intervention focuses on improving cancer care quality rather than providing a medical treatment like a drug or device. It serves as a support system for rural hospitals, emphasizing education, training, and enhancing cancer care quality.

Since ICAN does not directly treat patients, no safety data exists regarding health risks for individuals. The intervention aims to help hospitals meet the quality standards set by the American College of Surgeons Commission on Cancer (CoC). It provides resources and support to hospital staff instead of introducing new drugs or procedures to patients.

Regarding safety, participants face no risk in the usual sense, as they will not receive a new medicine or treatment. Instead, the intervention seeks to improve how hospitals care for cancer patients, making the process safer and more effective overall. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the ICAN Health System Intervention for rural cancer care because it aims to enhance the quality of cancer treatment in rural hospitals, which often face unique challenges. Unlike typical care options, which may include standard chemotherapy, radiation, or surgical interventions, this approach focuses on improving the healthcare system itself. It offers training and education for hospital staff, boosts cancer data collection and reporting, and fosters clinical peer-to-peer support. This comprehensive, system-level intervention could lead to more consistent and higher-quality cancer care in rural settings, making a significant impact where resources are limited.

What evidence suggests that the ICAN intervention is effective for improving rural cancer care quality?

Research has shown that the Iowa Cancer Affiliate Network (ICAN) program can improve cancer care in rural areas. In this trial, some hospitals will join the ICAN program, which aims to enhance local care quality by providing training, education, and support to rural hospitals. Studies using Iowa Cancer Registry data reveal that many rural patients, especially those with breast and colorectal cancers, receive most or all of their treatment locally. The ICAN program helps hospitals meet quality standards set by the American College of Surgeons Commission on Cancer. Early reports indicate that hospitals in similar programs have improved their adherence to cancer care quality measures. As a result, patients might receive better, more consistent care closer to home. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for administrators, clinicians, and data monitoring staff involved in cancer care at one of the four selected hospitals. It aims to improve quality standards in rural hospitals that have not been accredited by the Commission on Cancer.

Inclusion Criteria

Administrators, clinicians, and data monitoring staff who help provide cancer related care at one of the four hospitals that have been included in our study.

Exclusion Criteria

N/A

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Implementation of the ICAN intervention, including education, training, and regular check-ins with hospital stakeholders

36 months

Regular in-person and virtual check-ins

Evaluation

Evaluation of compliance with CoC quality measures using Iowa Cancer Registry data

4 years

Follow-up

Participants are monitored for safety and effectiveness after the intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Iowa Cancer Affiliate Network (ICAN)

Trial Overview The Iowa Cancer Affiliate Network (ICAN) intervention is being tested. It involves education, training, regular check-ins with hospital stakeholders via in-person and Zoom meetings, and resources to help meet American College of Surgeons' cancer care standards.

How Is the Trial Designed?

Group I: Intervention Hospital Administrators, Providers, and Data Monitoring Staff Experimental Treatment 1 Intervention

This is a health-system-level intervention, designed as two-arm intervention trial, where four participating hospitals will be offered support in the areas of training and education, cancer data collection and reporting, quality improvement and clinical peer-to-peer support. Hospitals that are eligible for the intervention had to be located in an Iowa county classified as non-metropolitan according to rural urban continuum codes (RUCC) 4 through 9 and diagnose or treat at least 100 cancer patients each year. We selected 4 of the 9 rural hospitals meeting this criteria to administer the intervention.

Group II: Control arm Active Control 1 Intervention

Hospitals that are eligible for the intervention had to be located in an Iowa county classified as non-metropolitan according to rural urban continuum codes (RUCC) 4 through 9 and diagnose or treat at least 100 cancer patients each year. The remaining 5 hospitals meeting this criteria that were not selected for the intervention will serve as controls.

Who Is Running the Clinical Trial?

Mary Charlton

Lead Sponsor

Trials

1

Recruited

30+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

The breast cancer nurse navigator (BCNN) program at the University of New Mexico Comprehensive Cancer Center significantly improved patient preparedness and engagement for treatment among 54 navigated patients compared to 32 non-navigated patients.

Patients who received navigation reported higher satisfaction with their care, as evidenced by a decreased desire for after-treatment summaries, suggesting that the BCNN program effectively addresses gaps in cancer care for underserved populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient-Reported Measures of a Breast Cancer Nurse Navigator Program in an Underserved, Rural, and Economically Disadvantaged Patient Population. Williams, MA., Nielsen, DR., Dayao, Z., et al.[2022]

Citations

1. shri.public-health.uiowa.edu shri.public-health.uiowa.edu/ican/

Iowa Cancer Affiliate Network In the News… Recent Study Aims to Improve the Quality of Cancer Care in Rural Areas · Charlton to Lead Study Aimed at Improving Quality of Rural Cancer Care.

2. reporter.nih.gov reporter.nih.gov/search/8PH9e-P7ukaGfHBTe360eA/project-details/10085116

Project Details Our analyses of Iowa Cancer Registry data indicate that 40% of rural patients with breast and colorectal cancers receive most or all definitive treatment in ...

3. withpower.com withpower.com/trial/phase-malignancies-2023-671dd

ICAN Health System Intervention for Rural Cancer Care ... The investigators will use data routinely collected by the Iowa Cancer Registry to compare aggregate compliance with quality measures for cancer care between ...

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/full/10.1002/lrh2.10448

Leveraging public health cancer surveillance capacity to ... The network intervention in Iowa supported 5 rural cancer centers across the state, each concurrently pursuing quality accreditation standards.

5. ama-assn.org ama-assn.org/public-health/population-health/statewide-push-deliver-top-cancer-care-rural-iowans

A statewide push to deliver top cancer care to rural Iowans As a resource, I-CAN provides detailed data on cancer quality measures, facilitates educational initiatives, and helps develop critical services ...

6. link.springer.com link.springer.com/article/10.1007/s10552-025-02070-8

A survey of cancer affiliate network hubs in the US: goals ... Rural hospitals are less likely than urban hospitals to provide comprehensive oncology services including genetic counseling, nutritional ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9189248/

Improving Cancer Care Locally: Study of a Hospital Affiliate ... The Markey Cancer Center Affiliate Network (MCCAN) is committed to enhancing access to high-quality cancer care for patients close to home and uses evidence- ...