Evaluating Coaches for Older Adults Cancer Care and Health
Conditions
Colorectal Cancer - Breast Cancer - Cervical Cancer
Conditions: official terms
Uterine Cervical Neoplasms
Study Type
Interventional
Study Phase
N/A
Study Design
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Screening
Intervention
Name: Coach Intervention (COACH)
Type: Behavioral
Overall Status
Recruiting
Summary
The overall goal of the COACH study is to conduct a comparative effectiveness trial to assess the effectiveness of trained, participant-designated health coaches versus traditional health education efforts on cancer screening among African American older adults. We hypothesize that members of older adults' extended families can be trained to be effective coaches who support them through the cancer control spectrum, i.e., prevention, screening, diagnosis and treatment.
Detailed Description
The overall goal of the COACH study is to conduct a comparative effectiveness trial to assess the effectiveness of trained, participant-designated health coaches versus traditional health education efforts on cancer screening among African American older adults. We hypothesize that members of older adults' extended families can be trained to be effective coaches who support them through the cancer control spectrum, i.e., prevention, screening, diagnosis and treatment.

1. Aims/objectives/research question/hypotheses: The overall goal of the COACH study is to conduct a comparative effectiveness trial to assess the effectiveness of trained, participant-designated health coaches versus traditional health education efforts on cancer screening among African American older adults. This research objective is guided by the theoretical model of the PRECEDE-PROCEED conceptual framework that has been widely adopted in health promotion. The target jurisdictions for this study are Baltimore City (BC) and Prince George's County (PGC), Maryland. The study is anchored in community-based participatory research (CBPR) principles, involving community members in all its phases. The CBPR component is guided by Community Advisory Groups (CAGs) representing key stakeholders in the two jurisdictions. The CAGs are essential in determining the questions included in data collection instruments, mechanisms of recruitment, interpretation of findings, and dissemination of results within the target communities.

This mixed methods study will occur in three phases: (Aim 1) a formative exploratory phase involving in-depth qualitative interviews that will inform Aims 2 and 3; (Aim 2) development and pilot testing of all COACH research protocols, including coach training curriculum, quantitative surveys, recruitment protocols among 50 participants and 25 coaches; and (Aim 3) a full-size randomized trial involving recruitment of total 550 study participants and 275 coaches, randomization, and longitudinal data collection.

Aim 1: Implement formative research to inform COACH intervention (IRB Number 00003825): As of June 2012, we have conducted in-depth interviews reaching saturation with twelve stakeholders; six healthcare providers and six community leaders. The interviews were transcribed and analyzed providing crucial information for the development of the research in Aims 2 and 3.

Aim 2: Development and pilot testing of all COACH protocols among 50 index participants and 25 participant-designated coaches: Using convenience sampling, we will recruit and enroll African American residents (1:1 men to women) of Baltimore City and Prince George's County who are aged 65-74 years. We will conduct a pilot study to assess the coaches' effect (versus traditional health education using an educational brochure) on overcoming the participants' barriers to discussing cancer screening with their primary care providers and, if needed, to getting screened for breast, cervical, and/or colorectal cancers.

Aim 3: Implementation of full randomized COACH trial among 550 total participants and 550 total coaches: Using convenience sampling, we will recruit and enroll African American residents (1:1 men to women) of Baltimore City and Prince George's County who are aged 65-74 years. We will utilize our study's IRB-approved flyer to recruit potential study participants in medical centers, senior housing, neighborhood development centers, markets, and community centers in various neighborhoods in our study's catchment areas. Eligible and interested participants will complete an in-person baseline interview administered by a trained interviewer. The participant will then be randomized, stratifying by county and gender, to one of the following two interventions: (1) printed educational materials only (PEM) or (2) printed educational material plus specialized training for his/her health coach to help the participant overcome his/her barriers to cancer screening (COACH). The coach will then complete a short interviewer-administered questionnaire. If the participant is randomized to COACH, then the coach will be invited to participate in a one-hour in-person, small group training. Participants and coaches will then be queried at 6-months and one year to assess their cancer screening status and other outcomes of interest.

The primary outcome variable of the COACH intervention will be the change in the proportion of participants completing at least one of the recommended screenings, comparing the COACH group to the PEM group during follow up. Another primary outcome will be the change in the proportion of participants who report talking with their healthcare provider regarding at least one of the recommended cancer screening(s) during follow up. Secondary outcome variables will include between-group changes in the time to completion of screenings, changes in cancer screening barriers, and changes in the reported levels of stress for both the participants and coaches.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: 74 Years
Minimum Age: 65 Years
Gender: Both
Criteria: Inclusion Criteria:

- Resident in Baltimore City, MD or Prince George's County, MD

- African American

- 65-74 years of age

- Enrolled in Medicare Parts A and B

- No screening for breast, cervical and/or colorectal cancers within the recommended time period

Exclusion Criteria:

- Diagnosis of colon, cervix or breast cancer within the past 5 years

- A current diagnosis of another cancer

- Enrollment in Medicare managed care

- Residence in a chronic care facility, being otherwise institutionalized

- Inability or unwillingness to give informed consent
Location
Johns Hopkins Center to Reduce Cancer Disparities
Baltimore, Maryland, United States
Status: Recruiting
Contact: Jean G Ford, MD - 443-287-5181 - jford@jhsph.edu
Start Date
June 2012
Completion Date
August 2015
Sponsors
Johns Hopkins Bloomberg School of Public Health
Source
Johns Hopkins Bloomberg School of Public Health
Record processing date
ClinicalTrials.gov processed this data on July 28, 2015
ClinicalTrials.gov page