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
AU - Bowie, Janice
AU - Elmi, Ahmed
AU - Slade, Jimmie L.
AU - Towson, Michele
AU - Dobs, Adrian S.
N1 - Funding Information:
This work was funded by the Community Networks Program Centers Grant (U54CA153710) of the Center to Reduce Cancer Health Disparities, National Cancer Institute. Ms. Mbah, Mr. Elmi, Mr. Slade, Ms. Towson and Drs. Ford, Wenzel, Bone, Bowie and Dobs were supported in part by the Community Networks Program Centers Grant (U54CA153710); Dr. Wenzel is supported by the American Cancer Society MRSGT-09-152-01-CPPB. Dr. Qiu was supported as an oncology fellow under the Johns Hopkins - Sun Yat-sen University Collaboration Program.
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 - CBPR
KW - Cancer screening
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
C2 - 26573809
AN - SCOPUS:84963600732
VL - 15
JO - BMC Cancer
JF - BMC Cancer
SN - 1471-2407
IS - 1
M1 - 907
ER -