Community Health Worker Support for Cancer Survivorship

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

Trial Summary

What is the purpose of this trial?

The objective of the proposed study is to scale social risk factor screening and referral for cancer survivors and to solidify information exchange between clinical and community settings in order to improve survivor health and well-being. This will be completed through three primary aims: 1) To ascertain workflow and map community resources needed to facilitate social risk factor screening and referral for breast and prostate cancer survivors in Washington, District of Columbia. 2) To determine impact of Community Health Worker (CHW) support on Black breast and prostate cancer survivor health and wellbeing as measured through quality of life (QOL) and social connection. 3) To determine impact of anti-racism training for staff and clinicians at three cancer centers on patient-reported 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 data supports the effectiveness of the treatment Community Health Worker Support for Cancer Survivorship?

Research shows that community health worker (CHW) interventions can improve health-related quality of life and mental health, especially among low-income and minority patients with cancer. CHWs help patients access timely care and improve communication during hospital discharge, which can lead to better health outcomes. ^{1 2 3 4 5}

Is Community Health Worker support safe for humans?

The research does not provide specific safety data for Community Health Worker support, but it is generally considered safe as it involves providing guidance and support rather than medical treatment. ^{4 5 6 7 8}

How does the Community Health Worker Support treatment for cancer survivorship differ from other treatments?

This treatment is unique because it involves community health workers (CHWs) who provide support and guidance to cancer survivors, helping them navigate complex health systems and access necessary services. Unlike traditional medical treatments, this approach focuses on improving psychosocial outcomes and addressing health inequities, particularly in marginalized communities. ^{1 9 10 11 12}

Research Team

Hannah Arem, PhD

Principal Investigator

Medstar Health Research Institute

Mandi Pratt-Chapman, PhD

Principal Investigator

George Washington University

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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]

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]

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) 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 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 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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Community health worker interventions to promote psychosocial outcomes among people living with HIV-A systematic review. [2019]

2. United States 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. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Patient-centered community health worker intervention to improve posthospital outcomes: a randomized clinical trial. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Integrating Community Health Workers into Hospital Systems Through a Social Work Partnership: A Report from the Field. [2023]

5. England 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. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Exploring the role of community health workers in providing cancer navigation: perceptions of African American older adults. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Development of a Framework to Describe Functions and Practice of Community Health Workers. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research. [2019]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Community health workers' attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. [2022]

11. Switzerland pubmed.ncbi.nlm.nih.gov

Community health workers in Canada and other high-income countries: A scoping review and research gaps. [2022]

12. Australia pubmed.ncbi.nlm.nih.gov

Challenges in the sociocultural milieu of South Asia: a systematic review of community health workers. [2021]