Evaluating Coaches of Older Adults for Cancer Care and Health Behaviors
| Status: | Completed |
|---|---|
| Conditions: | Breast Cancer, Colorectal Cancer, Cervical Cancer, Cervical Cancer, Cancer, Cancer, Cancer, Women's Studies |
| Therapuetic Areas: | Oncology, Reproductive |
| Healthy: | No |
| Age Range: | 50 - 74 |
| Updated: | 4/28/2018 |
| Start Date: | June 2012 |
| End Date: | September 2016 |
Evaluating Coaches of Older Adults for Cancer Care and Health Behaviors (COACH)
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. 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.
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. 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 50 coaches; and (Aim 3)
a full-size randomized trial involving recruitment of total 550 study participants and 550
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
50 participant-designated coaches: Using convenience sampling, we will recruit and enroll
African American residents of Baltimore City and Prince George's County who are aged 50-74
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 and other sampling methods, we will recruit and
enroll African American residents of Baltimore City and Prince George's County who are aged
50-74 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 40-minute in-person
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.
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 50 coaches; and (Aim 3)
a full-size randomized trial involving recruitment of total 550 study participants and 550
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
50 participant-designated coaches: Using convenience sampling, we will recruit and enroll
African American residents of Baltimore City and Prince George's County who are aged 50-74
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 and other sampling methods, we will recruit and
enroll African American residents of Baltimore City and Prince George's County who are aged
50-74 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 40-minute in-person
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.
Inclusion Criteria:
- Resident in Baltimore City, MD or Prince George's County, MD
- African American
- 50-74 years of age
- Eligible for breast, cervical and/or colorectal cancer screenings at time of study
enrollment
- Has a support person who is willing to participate in the study
Exclusion Criteria:
- Diagnosis of colon, cervix or breast cancer within the past 5 years
- A current diagnosis of another cancer
- Residence in a chronic care facility, being otherwise institutionalized
- Inability or unwillingness to give informed consent
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