Mobilizing social support networks to improve cancer screening

The COACH randomized controlled trial study design

Olive Mbah, Jean G. Ford, Miaozhen Qiu, Jennifer Wenzel, Lee R Bone, Janice Bowie, Ahmed Elmi, Jimmie L. Slade, Michele Towson, Adrian S Dobs

Research output: Contribution to journalArticle

Abstract

Background: Disadvantaged populations face many barriers to cancer care, including limited support in navigating through the complexities of the healthcare system. Family members play an integral role in caring for patients and provide valuable care coordination; however, the effect of family navigators on adherence to cancer screening has not previously been evaluated. Training and evaluating trusted family members and other support persons may improve cancer outcomes for vulnerable patients. Methods: Guided by principles of community based participatory research (CBPR), "Evaluating Coaches of Older Adults for Cancer Care and Healthy Behaviors (COACH)" is a community-based randomized controlled trial to assess the effectiveness of a trained participant-designated coach (support person or care giver) in navigating cancerscreening for older African American adults, 50-74 years old. Participants are randomly assigned as dyads (participant + coach pair) to receiving either printed educational materials only (PEM-control group) or educational materials plus coach training (COACH-intervention group). We defined a coach as family member, friend, or other lay support person designated by the older adult. The coach training is designed as a one-time, 35- to 40-minute training consisting of: 1) a didactic session that covers the role of the coach, basic facts about colorectal, breast and cervical cancers (including risk factors, signs and symptoms and screening modalities), engaging the healthcare provider in cancer screening, insurance coverage for screening, and related healthcare issues, 2) three video skits addressing misconceptions about and planning for cancer screening, and 3) an interactive role-play session with the trainer to reinforce and practice strategies for encouraging the participant to get screened. The primary study outcome is the difference in the proportion of participants completing at least one of the recommended screenings (for breast, cervix or colorectal cancer) between the control and intervention groups. Discussion: Building on trusted patient contacts to encourage cancer screening, COACH is a highly sustainable intervention in a high-risk population. It has the potential to minimize the effect of mistrust of the medical establishment on screening behaviors by mobilizing participants' existing support networks. If effective, the intervention could have a high impact on health care disparities research across multiple diseases.

Original languageEnglish (US)
Article number907
JournalBMC Cancer
Volume15
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Early Detection of Cancer
Social Support
Randomized Controlled Trials
Neoplasms
Uterine Cervical Neoplasms
Colorectal Neoplasms
Healthcare Disparities
Community-Based Participatory Research
Breast Neoplasms
Delivery of Health Care
Mentoring
Control Groups
Insurance Coverage
Health Services Research
Vulnerable Populations
African Americans
Health Personnel
Caregivers
Population
Signs and Symptoms

Keywords

  • African Americans
  • Cancer screening
  • CBPR
  • Family patient navigators
  • Older adults

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

Mobilizing social support networks to improve cancer screening : The COACH randomized controlled trial study design. / Mbah, Olive; Ford, Jean G.; Qiu, Miaozhen; Wenzel, Jennifer; Bone, Lee R; Bowie, Janice; Elmi, Ahmed; Slade, Jimmie L.; Towson, Michele; Dobs, Adrian S.

In: BMC Cancer, Vol. 15, No. 1, 907, 2015.

Research output: Contribution to journalArticle

Mbah, Olive ; Ford, Jean G. ; Qiu, Miaozhen ; Wenzel, Jennifer ; Bone, Lee R ; Bowie, Janice ; Elmi, Ahmed ; Slade, Jimmie L. ; Towson, Michele ; Dobs, Adrian S. / Mobilizing social support networks to improve cancer screening : The COACH randomized controlled trial study design. In: BMC Cancer. 2015 ; Vol. 15, No. 1.
@article{5db6aa6e29684205b3404ae29718f25e,
title = "Mobilizing social support networks to improve cancer screening: The COACH randomized controlled trial study design",
abstract = "Background: Disadvantaged populations face many barriers to cancer care, including limited support in navigating through the complexities of the healthcare system. Family members play an integral role in caring for patients and provide valuable care coordination; however, the effect of family navigators on adherence to cancer screening has not previously been evaluated. Training and evaluating trusted family members and other support persons may improve cancer outcomes for vulnerable patients. Methods: Guided by principles of community based participatory research (CBPR), {"}Evaluating Coaches of Older Adults for Cancer Care and Healthy Behaviors (COACH){"} is a community-based randomized controlled trial to assess the effectiveness of a trained participant-designated coach (support person or care giver) in navigating cancerscreening for older African American adults, 50-74 years old. Participants are randomly assigned as dyads (participant + coach pair) to receiving either printed educational materials only (PEM-control group) or educational materials plus coach training (COACH-intervention group). We defined a coach as family member, friend, or other lay support person designated by the older adult. The coach training is designed as a one-time, 35- to 40-minute training consisting of: 1) a didactic session that covers the role of the coach, basic facts about colorectal, breast and cervical cancers (including risk factors, signs and symptoms and screening modalities), engaging the healthcare provider in cancer screening, insurance coverage for screening, and related healthcare issues, 2) three video skits addressing misconceptions about and planning for cancer screening, and 3) an interactive role-play session with the trainer to reinforce and practice strategies for encouraging the participant to get screened. The primary study outcome is the difference in the proportion of participants completing at least one of the recommended screenings (for breast, cervix or colorectal cancer) between the control and intervention groups. Discussion: Building on trusted patient contacts to encourage cancer screening, COACH is a highly sustainable intervention in a high-risk population. It has the potential to minimize the effect of mistrust of the medical establishment on screening behaviors by mobilizing participants' existing support networks. If effective, the intervention could have a high impact on health care disparities research across multiple diseases.",
keywords = "African Americans, Cancer screening, CBPR, Family patient navigators, Older adults",
author = "Olive Mbah and Ford, {Jean G.} and Miaozhen Qiu and Jennifer Wenzel and Bone, {Lee R} and Janice Bowie and Ahmed Elmi and Slade, {Jimmie L.} and Michele Towson and Dobs, {Adrian S}",
year = "2015",
doi = "10.1186/s12885-015-1920-7",
language = "English (US)",
volume = "15",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Mobilizing social support networks to improve cancer screening

T2 - The COACH randomized controlled trial study design

AU - Mbah, Olive

AU - Ford, Jean G.

AU - Qiu, Miaozhen

AU - Wenzel, Jennifer

AU - Bone, Lee R

AU - Bowie, Janice

AU - Elmi, Ahmed

AU - Slade, Jimmie L.

AU - Towson, Michele

AU - Dobs, Adrian S

PY - 2015

Y1 - 2015

N2 - Background: Disadvantaged populations face many barriers to cancer care, including limited support in navigating through the complexities of the healthcare system. Family members play an integral role in caring for patients and provide valuable care coordination; however, the effect of family navigators on adherence to cancer screening has not previously been evaluated. Training and evaluating trusted family members and other support persons may improve cancer outcomes for vulnerable patients. Methods: Guided by principles of community based participatory research (CBPR), "Evaluating Coaches of Older Adults for Cancer Care and Healthy Behaviors (COACH)" is a community-based randomized controlled trial to assess the effectiveness of a trained participant-designated coach (support person or care giver) in navigating cancerscreening for older African American adults, 50-74 years old. Participants are randomly assigned as dyads (participant + coach pair) to receiving either printed educational materials only (PEM-control group) or educational materials plus coach training (COACH-intervention group). We defined a coach as family member, friend, or other lay support person designated by the older adult. The coach training is designed as a one-time, 35- to 40-minute training consisting of: 1) a didactic session that covers the role of the coach, basic facts about colorectal, breast and cervical cancers (including risk factors, signs and symptoms and screening modalities), engaging the healthcare provider in cancer screening, insurance coverage for screening, and related healthcare issues, 2) three video skits addressing misconceptions about and planning for cancer screening, and 3) an interactive role-play session with the trainer to reinforce and practice strategies for encouraging the participant to get screened. The primary study outcome is the difference in the proportion of participants completing at least one of the recommended screenings (for breast, cervix or colorectal cancer) between the control and intervention groups. Discussion: Building on trusted patient contacts to encourage cancer screening, COACH is a highly sustainable intervention in a high-risk population. It has the potential to minimize the effect of mistrust of the medical establishment on screening behaviors by mobilizing participants' existing support networks. If effective, the intervention could have a high impact on health care disparities research across multiple diseases.

AB - Background: Disadvantaged populations face many barriers to cancer care, including limited support in navigating through the complexities of the healthcare system. Family members play an integral role in caring for patients and provide valuable care coordination; however, the effect of family navigators on adherence to cancer screening has not previously been evaluated. Training and evaluating trusted family members and other support persons may improve cancer outcomes for vulnerable patients. Methods: Guided by principles of community based participatory research (CBPR), "Evaluating Coaches of Older Adults for Cancer Care and Healthy Behaviors (COACH)" is a community-based randomized controlled trial to assess the effectiveness of a trained participant-designated coach (support person or care giver) in navigating cancerscreening for older African American adults, 50-74 years old. Participants are randomly assigned as dyads (participant + coach pair) to receiving either printed educational materials only (PEM-control group) or educational materials plus coach training (COACH-intervention group). We defined a coach as family member, friend, or other lay support person designated by the older adult. The coach training is designed as a one-time, 35- to 40-minute training consisting of: 1) a didactic session that covers the role of the coach, basic facts about colorectal, breast and cervical cancers (including risk factors, signs and symptoms and screening modalities), engaging the healthcare provider in cancer screening, insurance coverage for screening, and related healthcare issues, 2) three video skits addressing misconceptions about and planning for cancer screening, and 3) an interactive role-play session with the trainer to reinforce and practice strategies for encouraging the participant to get screened. The primary study outcome is the difference in the proportion of participants completing at least one of the recommended screenings (for breast, cervix or colorectal cancer) between the control and intervention groups. Discussion: Building on trusted patient contacts to encourage cancer screening, COACH is a highly sustainable intervention in a high-risk population. It has the potential to minimize the effect of mistrust of the medical establishment on screening behaviors by mobilizing participants' existing support networks. If effective, the intervention could have a high impact on health care disparities research across multiple diseases.

KW - African Americans

KW - Cancer screening

KW - CBPR

KW - Family patient navigators

KW - Older adults

UR - http://www.scopus.com/inward/record.url?scp=84963600732&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84963600732&partnerID=8YFLogxK

U2 - 10.1186/s12885-015-1920-7

DO - 10.1186/s12885-015-1920-7

M3 - Article

VL - 15

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 907

ER -