Extended Cancer Education for Longer-Term Survivors in Primary Care for Patients With Stage I-II Breast or Prostate Cancer or Stage I-III Colorectal Cancer

Extended Cancer Education for Longer-Term Survivors in Primary Care for Patients With Stage I-II Breast or Prostate Cancer or Stage I-III Colorectal Cancer

This study tests four different methods of educating patients about follow-up care (NCI facing forward, brochure, EXCELS website alone, EXCELS health coaching alone and EXCELS website & health coaching combination) after cancer treatment ends. While it is known that patients need information to guide follow-up it remains unknown how to best provide this in primary care.

PRIMARY OBJECTIVES: I. Develop the EXCELS intervention to facilitate engaged self-management of cancer follow-up for cancer survivors. II. Evaluate the efficacy of EXCELS intervention in a small randomized controlled trial. III. Assess/refine intervention usability and acceptability for primary care patients. OUTLINE: PHASE I: EXCELS intervention is developed and assessed. PHASE II: Participants are randomized into 1 of 4 arms. ARM I: Participants receive National Cancer Institute's Facing Forward brochure. ARM II: Participants have untimed access to the EXCELS mobile web application. ARM III: Participants also receive 4 calls of 15-20 minutes each over 3 months focusing on assisting survivors with addressing challenges to receiving preventive service and health care. ARM IV: Participants have access to EXCELS website as in Arm II. Participants also receive 4 health coaching calls as in Arm III. Patients are followed up at 6 months, 12 months and 18 months post randomization.

Stage I Breast Cancer, Stage I Colorectal Cancer AJCC v6 and v7, Stage I Prostate Cancer, Stage IA Breast Cancer, Stage IB Breast Cancer, Stage II Breast Cancer, Stage II Colorectal Cancer AJCC v7, Stage II Prostate Cancer, Stage IIA Breast Cancer, Stage IIA Colorectal Cancer AJCC v7, Stage IIA Prostate Cancer, Stage IIB Breast Cancer, Stage IIB Colorectal Cancer AJCC v7, Stage IIB Prostate Cancer, Stage IIC Colorectal Cancer AJCC v7, Stage III Colorectal Cancer AJCC v7, Stage IIIA Colorectal Cancer AJCC v7, Stage IIIB Colorectal Cancer AJCC v7, Stage IIIC Colorectal Cancer AJCC v7

Participants also receive 4 quarterly calls of 15-20 minutes each over 3 months. These calls focus on checking if patients have received preventive and cancer related follow-up care.

Preventative services will be measured using adherence to evidence based guideline care which will be computed as a percentage of the eligible guideline related services provided to each patient.

Inclusion Criteria: Have been diagnosed with localized breast or prostate (stages 1-2) or colorectal cancer (stage 1-3) Have completed active treatment for their cancer diagnosis (excluding hormonal therapy) Have access to a phone for contact with health coach Be able to communicate in English; and be competent to consent Usability Testing and the randomized control trial (RCT): have access to a computer, a smartphone or an i-Pad/tablet equivalent with internet access Exclusion Criteria: Patients who are required because of their disease to see primarily oncologists for follow-up will be excluded (i.e., those diagnosed with lymph node or distant metastasis, those with a new primary cancer)

Davis SN, O'Malley DM, Bator A, Ohman-Strickland P, Clemow L, Ferrante JM, Crabtree BF, Miller SM, Findley P, Hudson SV. Rationale and design of extended cancer education for longer term survivors (EXCELS): a randomized control trial of 'high touch' vs. 'high tech' cancer survivorship self-management tools in primary care. BMC Cancer. 2019 Apr 11;19(1):340. doi: 10.1186/s12885-019-5531-6.