An interventional study of Receive technology-based supportive cancer care and Receive redesigned team-based supportive cancer care in End of Life and Cancer, sponsored by Stanford University. Recruiting at 17 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-30.
Sponsored by Stanford University · Not applicable, Interventional, and Health services research
This cluster-randomized comparative effectiveness trial compares a technology-based supportive cancer care (SCC) approach with a redesigned team-based supportive cancer care (SCC) approach.
PRIMARY OBJECTIVES:
I. Greater intervention effects on health-related quality of life
SECONDARY OBJECTIVES:
I. Greater intervention effects on patient activation II. Greater satisfaction with care and decision-making III. Greater documentation of goals of care and symptoms IV. To lower acute care V. Greater palliative care and hospice
OUTLINE: Sites are randomized to 1 of 2 arms.
ARM A: Patients receive educational materials to assist with advance care planning and symptom management through a technology-based supportive cancer care weekly during months 1-4 and every other week during months 5-12.
ARM B: Patients are paired with a lay health worker who will discuss the same educational materials from ARM A either in person or by telephone discussions weekly during months 1-4 and every other week during months 5-12.
All participants complete a baseline interview upon enrollment during the initial consent phone contact and then a survey at 3-, 6-and 12-months post enrollment.
Exclusion Criteria:
Patients receive educational materials to assist with advance care planning and symptom management through a technology-based supportive cancer care weekly during months 1-4 and every other week during months 5-12.
Other: Receive technology-based supportive cancer care
Patients are paired with a health educator who will discuss the same educational materials from ARM A either in person or by telephone discussions weekly during months 1-4 and every other week during months 5-12.
Behavioral: Receive redesigned team-based supportive cancer care
All participants will receive an electronic health record message or email with standardized information provided regarding advance care planning and symptom management.
Also known as: Technology-based SCC approach
Lay Health Workers will meet with 1:1 with participants over 12 months to discuss advance care planning, surrogate decision-makers, advance directives and physician orders for life sustaining treatment.
Also known as: Patients Activated in Cancer care through Teams (PACT), Redesigned SCC team-based approach
Change in health-related quality of life as assessed by the Functional Assessment of Cancer Therapy (FACT-G).
Each patient will receive a health-related quality of life survey (FACT-G) at baseline, 3 months, 6 months, and 12 months.
Time frame: Change in health-related quality of life from baseline to 3 months
Change in health-related quality of life as assessed by the Functional Assessment of Cancer Therapy (FACT-G).
Each patient will receive a health-related quality of life survey (FACT-G) at baseline, 3 months, 6 months, and 12 months.
Time frame: Change in health-related quality of life from baseline to 6, and 12 months
Change in patient activation using the Patient Activation Measure (PAM-13).
Each patient will receive a validated patient activation survey (PAM-13) to assess their activation at baseline, 3 months, 6 months, and 12 months.
Time frame: Change in patient activation from baseline to 3, 6, and 12 months
Change in satisfaction with care using the Consumer Assessment of Health Care (Providers and Systems (CAHPS) Cancer Care Survey Questions #39 and #42.
Each patient will receive a validated satisfaction with care survey at baseline, 3 months, 6 months, and 12 months.
Time frame: Change in satisfaction with care from baseline to 3, 6, and 12 months
Change in satisfaction with decision using the Satisfaction with Decision Scale (SWD)
Each patient will receive a validated satisfaction with decision survey at baseline, 3 months, 6 months and 12 months.
Time frame: Change in satisfaction with decision from baseline to 3, 6, and 12 months
Palliative Care Use (Self-reported and Chart Review)
Palliative care use will be self-reported by each patient or abstracted by electronic medical record at 3, 6 and 12 months after patient enrollment.
Time frame: 3, 6, and 12 months after patient enrollment
Hospice Care Use (Self-reported and Chart Review)
Hospice care use will be self-reported by each patient or abstracted by electronic medical record at 3, 6, and 12 months after patient enrollment.
Time frame: 3, 6, and 12 months after patient enrollment
Emergency Department Visits (Self-reported and Chart Review)
Emergency Department use will be self-reported by each patient or abstracted by electronic medical record at 3, 6, and 12 months after enrollment.
Time frame: 3, 6, and 12 months after patient enrollment
Hospitalization Visits (Self-reported and Chart Review)
Hospital use for each patient will be self-reported by each patient or abstracted by electronic medical record at 3, 6, and 12 months after enrollment.
Time frame: 3, 6, and 12 months after patient enrollment
Documentation of goals of care discussions (Chart Review)
Documentation of goals of care discussions will be abstracted by electronic medical record chart review for each patient at 3, 6, and 12 months after enrollment.
Time frame: 3, 6, and 12 months after patient enrollment
Documentation of symptom discussions (Chart Review)
Documentation of symptom discussions will be abstracted by electronic medical record chart review for each patient at 3, 6, and 12 months after enrollment.
Time frame: 3, 6, and 12 months after patient enrollment
Time Toxicity
Each patient will receive a time toxicity survey at baseline, 3 months, 6 months and 12 months.
Time frame: 3, 6, and 12 months after patient enrollment
Financial Toxicity
Each patient will receive the validated COmprehensive Score for financial Toxicity (COST)-Functional Assessment of Chronic Illness Therapy (COST-FACIT) questionnaire at baseline, 3 months, 6 months, and 12 months.
Time frame: 3, 6, and 12 months after patient enrollment
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