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The SEA CHANGE Study: A Self Management Intervention for Head and Neck Cancer Survivors (SEA-CHANGE)

Primary Purpose

Head and Neck Cancer

Status
Unknown status
Phase
Not Applicable
Locations
Ireland
Study Type
Interventional
Intervention
SEA CHANGE intervention
Sponsored by
Dublin City University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Head and Neck Cancer focused on measuring Head and Neck Cancer, Self-management, Intervention, Pilot Randomised Control Trial, Behavioural intervention, Quality of Life

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • had a pathologically confirmed diagnosis of an invasive primary tumour in the head and neck (oral cavity, salivary glands, nasal cavity, sinuses, middle ear, pharynx and larynx);
  • have undergone and completed treatment by surgery, chemotherapy, radiotherapy or a combination thereof;
  • are aged 18 or older at the time of their HNC diagnosis;
  • are within 12 months of having completed their primary treatment; and
  • have provided written informed, consent.

Exclusion Criteria:

  • are unable to read or speak English;
  • had a second invasive primary cancer other than non-melanoma skin cancer diagnosed after the HNC (as these patients are likely to be more focused on the treatment of their second cancer rather than self-management of their HNC);
  • are unable to provide informed consent (e.g., if they have dementia/Alzheimer's disease); or
  • have other known medical condition or other reason why they would be unable to take part.

Sites / Locations

  • Royal Victoria Eye and Ear Hospital, IrelandRecruiting
  • St James Hospital, IrelandRecruiting
  • St Lukes Hospital, IrelandRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Usual Care arm

Intervention arm

Arm Description

Participants allocated to the control group will receive their usual care. Healthcare professionals within the designated sites will deliver aftercare treatment as usual, with no changes to the patient's clinical care. Participants in this arm do not receive the self-management intervention (SEA CHANGE).

Participants in the intervention group will receive usual care and will be offered access to the self-management intervention (SEA CHANGE). Healthcare professionals within the designated sites will deliver aftercare treatment as usual, with no changes to the patient's clinical care.

Outcomes

Primary Outcome Measures

Change in the Functional Assessment of the Cancer Therapy scale (FACT-G and Head and Neck Cancer Subscale (FACT H&N)) from baseline up to 12 months
FACT-G consists of 4 domains and 27 statements, asking participants to consider the previous week and rate their Quality of life (QoL) across physical, social/family, emotional, and functional domains on a five point likert scale (0-4). FACT H&N comprises 12 statements about HNC specific challenges and can be used independently of the FACT-G to indicate HNC specific QoL. Higher domain scores indicate higher QoL (Maximum domain scores: Physical 28; Social/Family 28; Emotional 24; Functional 28; FACT H&N subscale 48). The FACT-G and FACT H&N subscale have been widely used and validated and are commonly used to assess the QoL of HNC survivors.

Secondary Outcome Measures

Changes in The Distress Thermometer scale from baseline up to 12 months
The distress thermometer measures an individuals level of distress during the past week and is scored on a 0 to 10 point Likert scale with 0 indicating "No distress" and 10 indicating "Extreme distress". Scores of 4 or more indicate moderate to extreme distress.
Changes in the Social Role Participation Questionnaire (SRPQ) from baseline up to 12 months
The SRPQ assesses an individual's perceptions of: 1) the importance of participation in diverse roles; 2) restrictions in role participation; and 3) satisfaction with performance in social roles. Mean scores are calculated separately for each of the 3 social role dimensions on Likert scales: 1) salience or role importance (scores; 1 "Not at all important" to 5 "Extremely important"); 2) physical difficulty with each role (i.e., role limitations) (scoring; 1 "No difficulty" to 4 "Unable to do") and 3) satisfaction with role performance (scoring; 1 "Not satisfied" to 5 "Extremely satisfied"). Because individuals may not engage in all roles, mean role satisfaction scores are calculated if participants respond to at least 9 of 12 role domains.
Changes in the Fear of Recurrence/Relapse Scale from baseline up to 12 months
The Fear of Recurrence/Relapse Scale is a five-item scale measuring patients' beliefs about recurrence of their cancer using 5-point Likert scales from 1 (Strongly agree) to 5 (Strongly disagree). Scores range from 5-25 and higher scores reflect a greater fear of cancer relapse.
Changes in the UK Cancer Costs Questionnaire (UKCC) from baseline up to 12 months
The UKCC is a modular questionnaire designed to capture the resources used by people with a current or previous diagnosis of cancer. Each question can be used in isolation. Captured activity includes primary care usage, community care usage, medications and personal social services. Societal costs are also captured including patient out-of-pocket costs, costs incurred by carers and time taken off work. The questionnaire has been appropriately modified for the Irish context.

Full Information

First Posted
July 22, 2019
Last Updated
August 7, 2019
Sponsor
Dublin City University
Collaborators
National University of Ireland, Maynooth, Newcastle University, St. James's Hospital, Ireland, St. Luke's Hospital, Royal Victoria Eye and Ear Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04051697
Brief Title
The SEA CHANGE Study: A Self Management Intervention for Head and Neck Cancer Survivors
Acronym
SEA-CHANGE
Official Title
The SEA-CHANGE Study: a Pilot Randomized Controlled Trial of the SElf-management After Cancer of the Head and Neck Group intErvention
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Unknown status
Study Start Date
September 10, 2018 (Actual)
Primary Completion Date
December 30, 2020 (Anticipated)
Study Completion Date
December 30, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dublin City University
Collaborators
National University of Ireland, Maynooth, Newcastle University, St. James's Hospital, Ireland, St. Luke's Hospital, Royal Victoria Eye and Ear Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study aims to test the feasibility of implementing the Self-Management after Cancer of the Head and Neck Group Intervention (SEA-CHANGE), designed to promote quality of life and participation in life activities and reduce distress in people who have completed primary treatment for head and neck cancer as compared to usual care.
Detailed Description
Head and neck cancer (HNC) and its treatment are associated with specific challenges such as facial disfigurement and impairments in speech, breathing and swallowing, and can have a negative impact on well-being. Self-management interventions can provide people with skills to deal with health-related problems, maintain life roles, and manage negative emotions, and have been found to increase confidence, improve quality of life, and reduce health service use across a range of chronic conditions. The aim of this study is to pilot a self-management intervention (SEA-CHANGE) designed to promote quality of life and participation in life activities, and reduce distress in people who have completed primary treatment for HNC as compared to usual care. The study includes: (1) a pilot randomised study to assess the feasibility and acceptability of the intervention and its related procedures; (2) a qualitative process evaluation of the intervention; and (3) a systematic decision-making process regarding progression to a definitive trial. The expected outcome is a self-management intervention that is feasible and acceptable to HNC survivors and has the potential to realise both health benefits and economic gains.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Cancer
Keywords
Head and Neck Cancer, Self-management, Intervention, Pilot Randomised Control Trial, Behavioural intervention, Quality of Life

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Two-armed (intervention vs usual care) non-blinded pilot randomised control trial
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Usual Care arm
Arm Type
No Intervention
Arm Description
Participants allocated to the control group will receive their usual care. Healthcare professionals within the designated sites will deliver aftercare treatment as usual, with no changes to the patient's clinical care. Participants in this arm do not receive the self-management intervention (SEA CHANGE).
Arm Title
Intervention arm
Arm Type
Experimental
Arm Description
Participants in the intervention group will receive usual care and will be offered access to the self-management intervention (SEA CHANGE). Healthcare professionals within the designated sites will deliver aftercare treatment as usual, with no changes to the patient's clinical care.
Intervention Type
Behavioral
Intervention Name(s)
SEA CHANGE intervention
Intervention Description
The SEA CHANGE intervention consists of six 2.5 hour facilitated group workshop sessions. The sessions run over six consecutive weeks and are delivered face-to-face by a leader and peer facilitator (HNC survivor). Each session focuses on a specific self-management topic and the development/enhancement of a particular set of skills. There are opportunities for peer learning, skills practice and take-home exercises to consolidate skills development. In delivering the intervention, leaders/facilitators use a standardised approach following a leader's/facilitators' manual and participant toolkit.
Primary Outcome Measure Information:
Title
Change in the Functional Assessment of the Cancer Therapy scale (FACT-G and Head and Neck Cancer Subscale (FACT H&N)) from baseline up to 12 months
Description
FACT-G consists of 4 domains and 27 statements, asking participants to consider the previous week and rate their Quality of life (QoL) across physical, social/family, emotional, and functional domains on a five point likert scale (0-4). FACT H&N comprises 12 statements about HNC specific challenges and can be used independently of the FACT-G to indicate HNC specific QoL. Higher domain scores indicate higher QoL (Maximum domain scores: Physical 28; Social/Family 28; Emotional 24; Functional 28; FACT H&N subscale 48). The FACT-G and FACT H&N subscale have been widely used and validated and are commonly used to assess the QoL of HNC survivors.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Secondary Outcome Measure Information:
Title
Changes in The Distress Thermometer scale from baseline up to 12 months
Description
The distress thermometer measures an individuals level of distress during the past week and is scored on a 0 to 10 point Likert scale with 0 indicating "No distress" and 10 indicating "Extreme distress". Scores of 4 or more indicate moderate to extreme distress.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in the Social Role Participation Questionnaire (SRPQ) from baseline up to 12 months
Description
The SRPQ assesses an individual's perceptions of: 1) the importance of participation in diverse roles; 2) restrictions in role participation; and 3) satisfaction with performance in social roles. Mean scores are calculated separately for each of the 3 social role dimensions on Likert scales: 1) salience or role importance (scores; 1 "Not at all important" to 5 "Extremely important"); 2) physical difficulty with each role (i.e., role limitations) (scoring; 1 "No difficulty" to 4 "Unable to do") and 3) satisfaction with role performance (scoring; 1 "Not satisfied" to 5 "Extremely satisfied"). Because individuals may not engage in all roles, mean role satisfaction scores are calculated if participants respond to at least 9 of 12 role domains.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in the Fear of Recurrence/Relapse Scale from baseline up to 12 months
Description
The Fear of Recurrence/Relapse Scale is a five-item scale measuring patients' beliefs about recurrence of their cancer using 5-point Likert scales from 1 (Strongly agree) to 5 (Strongly disagree). Scores range from 5-25 and higher scores reflect a greater fear of cancer relapse.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in the UK Cancer Costs Questionnaire (UKCC) from baseline up to 12 months
Description
The UKCC is a modular questionnaire designed to capture the resources used by people with a current or previous diagnosis of cancer. Each question can be used in isolation. Captured activity includes primary care usage, community care usage, medications and personal social services. Societal costs are also captured including patient out-of-pocket costs, costs incurred by carers and time taken off work. The questionnaire has been appropriately modified for the Irish context.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Other Pre-specified Outcome Measures:
Title
Changes in the Cancer Survivors' Self-efficacy Scale (CS-SES) from baseline up to 12 months
Description
The CS-SES measures self-efficacy in cancer survivors' by assessing confidence in performing various disease-related activities. The scale consists of 11 items scored on a 10 point scale with 1 being "not at all confident" to 10 being "totally confident". An overall score is determined using the mean of the 11 items.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in the Cognitive Emotional Regulation Questionnaire (CERQ) from baseline up to 12 months
Description
The CERQ measures what an individual thinks after experiencing threatening or stressful life events using a 36 item questionnaire focused on 9 domains; self-blame, blaming others, rumination, catastrophizing, putting into perspective, positive refocusing, positive reappraisal, acceptance and planning. Each item is scored on a Likert scale ranging from 1 (Almost never) to 5 (Almost always). Individual sub-scales are calculated by summing the scores from individual sub-scales with a range from 4 to 20.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in the Health Education Impact Questionnaire (HEIQ) from baseline up to 12 months
Description
The HEIQ is used as a measure of health education/ self-management behaviors in eight domains; Health Directed Behavior, Positive and Active Engagement in Life, Emotional Well-being, Self-monitoring and Insight, Constructive Attitudes and Approaches, Skills and Technique Acquisition, Social Integration and Support, and Health Service Navigation. Individuals are asked to indicate their level of agreement with 42 statements across the eight domains on four point Likert scales (1 "strongly disagree" to 4 "Strongly agree"). Higher scores indicate greater performance of specific self-management behaviors. Higher scores on the emotional well-being domain denote higher levels of negative affect. Each domain is used individually by calculating the mean score.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in the Patient Activation Measure (PAM) from baseline up to 12 months
Description
PAM assesses an individual's knowledge, skills and confidence for self-management. The measure contains 13 items measured on 4 point Likert scales (1 "Strongly disagree" to 4 "Strongly agree"). A total score is derived by dividing the raw score by the number of items answered and multiplying by 13. Calibration tables are used to apply a range of 1-100 with higher scores indicating higher patient activation.
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months
Title
Changes in lifestyle behaviours from baseline up to 12 months
Description
Alcohol and tobacco use
Time Frame
12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: had a pathologically confirmed diagnosis of an invasive primary tumour in the head and neck (oral cavity, salivary glands, nasal cavity, sinuses, middle ear, pharynx and larynx); have undergone and completed treatment by surgery, chemotherapy, radiotherapy or a combination thereof; are aged 18 or older at the time of their HNC diagnosis; are within 12 months of having completed their primary treatment; and have provided written informed, consent. Exclusion Criteria: are unable to read or speak English; had a second invasive primary cancer other than non-melanoma skin cancer diagnosed after the HNC (as these patients are likely to be more focused on the treatment of their second cancer rather than self-management of their HNC); are unable to provide informed consent (e.g., if they have dementia/Alzheimer's disease); or have other known medical condition or other reason why they would be unable to take part.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Pamela Gallagher, PhD
Phone
+353170058958
Email
pamela.gallagher@dcu.ie
First Name & Middle Initial & Last Name or Official Title & Degree
Nicholas Clarke, PhD
Phone
+35317005317
Email
nicholas.clarke@dcu.ie
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pamela Gallagher, PhD
Organizational Affiliation
Dublin City University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Royal Victoria Eye and Ear Hospital, Ireland
City
Dublin
Country
Ireland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Timon, MD
Phone
+35314162677
Email
timonsec@stjames.ie
Facility Name
St James Hospital, Ireland
City
Dublin
Country
Ireland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Timon, MD
Phone
+35314162677
Email
timonsec@stjames.ie
Facility Name
St Lukes Hospital, Ireland
City
Dublin
Country
Ireland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sinead Brennan, MD
Phone
+35314065000
Email
Sinead.Brennan@slh.ie

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The SEA CHANGE Study: A Self Management Intervention for Head and Neck Cancer Survivors

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