Communicating health information and improving coordination with primary care (CHIIP): Rationale and design of a randomized cardiovascular health promotion trial for adult survivors of childhood cancer

被引:10
作者
Chow, Eric J. [1 ,2 ,3 ]
Baldwin, Laura-Mae [4 ]
Hagen, Anna M. [1 ]
Hudson, Melissa M. [5 ,6 ]
Gibson, Todd M. [6 ]
Kochar, Komal [6 ]
McDonald, Aaron [6 ]
Nathan, Paul C. [7 ]
Syrjala, Karen L. [1 ,2 ]
Taylor, Sarah L. [1 ]
Tonorezos, Emily S. [8 ]
Yasui, Yutaka [6 ]
Armstrong, Gregory T. [6 ]
Oeffinger, Kevin C. [9 ]
机构
[1] Fred Hutchinson Canc Res Ctr, Publ Hlth Sci Div, Seattle, WA 98109 USA
[2] Fred Hutchinson Canc Res Ctr, Clin Res Div, Seattle, WA 98109 USA
[3] Univ Washington, Dept Pediat, Seattle, WA 98195 USA
[4] Univ Washington, Dept Family Med, Seattle, WA 98195 USA
[5] St Jude Childrens Res Hosp, Dept Oncol, 332 N Lauderdale St, Memphis, TN 38105 USA
[6] St Jude Childrens Res Hosp, Dept Epidemiol & Canc Control, 332 N Lauderdale St, Memphis, TN 38105 USA
[7] Univ Toronto, Hosp Sick Children, Dept Pediat, Toronto, ON, Canada
[8] Mem Sloan Kettering Canc Ctr, Dept Med, 1275 York Ave, New York, NY 10021 USA
[9] Duke Univ, Dept Med, Durham, NC USA
基金
美国国家卫生研究院;
关键词
Cancer survivor; Childhood cancer; Cardiovascular disease; Randomized clinical trial; Survivorship care plan; RISK-FACTORS; SCIENTIFIC STATEMENT; SELF-MANAGEMENT; MEDICAL-CARE; LIFE-STYLE; PARTICIPATION; PREVENTION; DISEASE; YOUNG; PREFERENCES;
D O I
10.1016/j.cct.2019.105915
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Long-term survival for children diagnosed with cancer exceeds 80%. Notably, premature cardiovascular disease has become the leading non-cancer cause of late mortality among these survivors. Methods/design: This randomized controlled trial (RCT; NCT03104543) focuses on adult participants in the Childhood Cancer Survivor Study identified as high risk for ischemic heart disease or heart failure due to their cancer treatment. Participants undergo a home-based evaluation of blood pressure and laboratory tests to determine the prevalence of undiagnosed and/or undertreated hypertension, dyslipidemia, and diabetes. Those with abnormal values are then enrolled in an RCT to test the efficacy of a 12-month personalized, remotely delivered survivorship care plan (SCP) intervention designed to reduce undertreatment of these three target conditions. The intervention approximates a clinical encounter and is based on chronic disease self-management strategies. Results: With a goal of 750, currently 342 out of 742 eligible participants approached have enrolled (46.1%). Initially, we randomized participants to different recruitment strategies, including shorter approach packets and a tiered consent, but did not find significant differences in participation rates (40.7% to 42.9%; p = .95). Subsequently, slightly greater participation was seen with larger upfront unconditional incentive checks ($50 vs. $25: 50.7% vs. 44.1%; p = .10). Overall, the financial impact of the $50 upfront incentive was cost neutral, and possibly cost-saving, vs. a $25 upfront incentive. Conclusion: The overall study will determine if a National Academy of Medicine-recommended SCP intervention can improve cardiovascular outcomes among long-term survivors of childhood cancer. Modifications to the recruitment strategy may improve participation rates over time.
引用
收藏
页数:8
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