The following is a summary of “Effect of a Community Health Worker–Led Intervention Among Low-Income and Minoritized Patients With Cancer: A Randomized Clinical Trial,” published in the February 2024 issue of Oncology by Patel, et al.
For a randomized clinical trial, researchers sought to assess whether a community health worker (CHW)–led intervention could enhance health-related quality of life (HRQoL) among low-income and racial and ethnic minoritized populations newly diagnosed with cancer, compared to usual care alone.
The study was conducted between November 1, 2018, and August 31, 2021, in outpatient cancer clinics in Atlantic City, NJ, and Chicago, IL. Hourly low-wage worker members of an employer union health fund, aged 18 years or older, with newly diagnosed solid tumors and hematologic malignancies, were eligible for participation. Participants were randomly assigned in a 1:1 ratio to either usual care (control group) or usual care supplemented with a trained CHW for 12 months (intervention group). The CHW assisted with advance care planning (ACP), actively screened for symptoms, and directed participants to community-based resources for identified health-related social needs. Usual care consisted of nurse case management and benefits redesign, including waived copayments and free transportation for any cancer care received at preferred oncology clinics in each city. The primary outcome measured was HRQoL, with secondary outcomes including patient activation, satisfaction with the decision, ACP documentation, healthcare utilization, total healthcare costs, and overall survival.
A total of 160 participants were enrolled in the study. Participants in the intervention group exhibited a greater increase in mean HRQoL scores at both the 4-month and 12-month follow-up assessments compared to baseline, in comparison to participants in the control group (expected mean difference, 11.25 [95% CI, 7.28 to 15.22]; 11.29 [95% CI, 6.96 to 15.62], respectively).
The randomized trial demonstrated that a CHW-led intervention significantly enhances HRQoL among low-income and racial and ethnic minoritized patients with cancer, surpassing the effects of usual care alone.
Reference: ascopubs.org/doi/10.1200/JCO.23.00309