Cancer Prevention and Early Detection Among the Homeless Population: The Health Navigator Model

NCT ID: NCT05406687

Last Updated: 2024-01-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

654 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-08

Study Completion Date

2023-12-29

Brief Summary

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Prevention and early detection are key for the decrease of cancer-related mortality. However, socially deprived population groups don't have the privilege of unburdened access to the healthcare system. The EU-funded CANCERLESS project aims to develop an evidence-based, patient-centred innovation that reinforces patients through health education and social support and fosters timely access to primary and secondary prevention services. Based on the combination of the tested Patient Navigator Model and the Patient Empowerment Model, CANCERLESS will develop the Health Navigator Model for Europe, addressed to the underserved population.

Detailed Description

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Homeless individuals have higher prevalence of adverse health outcomes (infectious diseases, substance-related disorders, etc.) and premature mortality compared to the general population, with cancer being the second most common cause of death. In most cases, people experiencing homelessness experience significant barriers or do not have access to community health services, including access to primary and secondary prevention services and programs. Cancer prevention and early detection among the homeless population in Europe: Co-adapting and implementing the Health Navigator Model - The CANCERLESS project is a Horizon 2020 financed project aiming to adapt a novel, evidence based and person-centered model to address this underserved population and eliminate barriers to access primary and secondary preventive services.

The Health Navigator Model (HNM), a person-centered intervention co-designed during the first part of the project, will address the growing health and social disparities in the homeless population and promote timely access to cancer prevention and screening services. Therefore, the aim of this longitudinal, person-centered, and community-based intervention study is to pilot test the HNM by investigating a cohort of individuals experiencing homelessness in pilot-sites in Austria, Greece, Spain and the United Kingdom. Our study will assess whether the HNM intervention can improve the delivery of evidence of community-based primary and secondary cancer preventive care for the homeless population. The HNM will be conducted over a set time frame, with active participation being individually tailored to the needs of participants, within an overall period of 18 months. Evaluation will be performed at baseline and at three further evaluation points to assess the outcomes of the intervention. Adult individuals experiencing homelessness (as defined by the European Topology of Homelessness and Housing Exclusion) will be asked to participate during their visits to the pilot sites of cooperating facilities (non-governmental organizations offering free medical care, or social service institutions) after assessing eligibility criteria.

The study utilizes both a qualitative and quantitative methodology which will allow us to conduct both exploratory and confirmatory research and thus, gain a deeper comprehension of the impact of the HNM intervention on overall participation of homeless individuals in primary and secondary cancer preventive programs.

The project has been funded by the HORIZON 2020 program of the European Commission under the topic: "H2020-SC1-2020-Single-Stage-RTD - Call for proposals on the prevention and/or early diagnosis of cancer" and is coordinated by the Medical University of Vienna.

Conditions

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Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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People experiencing homelessness

All homeless adults, aged 18 years and over, who visit the CANCERLESS pilot sites will be asked to participate (convenience sampling). We define individuals as being homeless if they fall under one of the categories listed in the European typology of homelessness and housing exclusion.

Group Type OTHER

Health Navigator Model

Intervention Type OTHER

The Health Navigator Model will be a longitudinal, person-centered and community-based intervention focused on addressing both primary and secondary cancer prevention, as well as reducing wider barriers to healthcare. Health Navigators (HNs) will be professionals who have a background in social care and an understanding of the local user population, and will be embedded in settings familiar and accessible to people experiencing homelessness. The primary aspects of the HN role will be to identify the health needs and barriers of users, promote cancer awareness and education, facilitate timely access to healthcare services and cancer screening, provide practical assistance, delivered through regular in-person meetings, and utilize wider stakeholders, including healthcare professionals, to deliver the intervention. A comprehensive training package will be delivered to the HNs, covering population specific knowledge, interpersonal skills, cancer education and local resources.

Interventions

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Health Navigator Model

The Health Navigator Model will be a longitudinal, person-centered and community-based intervention focused on addressing both primary and secondary cancer prevention, as well as reducing wider barriers to healthcare. Health Navigators (HNs) will be professionals who have a background in social care and an understanding of the local user population, and will be embedded in settings familiar and accessible to people experiencing homelessness. The primary aspects of the HN role will be to identify the health needs and barriers of users, promote cancer awareness and education, facilitate timely access to healthcare services and cancer screening, provide practical assistance, delivered through regular in-person meetings, and utilize wider stakeholders, including healthcare professionals, to deliver the intervention. A comprehensive training package will be delivered to the HNs, covering population specific knowledge, interpersonal skills, cancer education and local resources.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older
* No diagnosed cancer
* Any category of the European Typology of Homelessness and housing exclusion applies
* Sufficient knowledge of language

Exclusion Criteria

* Persons who cannot give consent due to diminished capacity
* Persons who do not provide informed consent
* Known cancer diagnosis
* Cancer survivorship
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Valencia

OTHER

Sponsor Role collaborator

Senior Europa Sociedad Limitada

UNKNOWN

Sponsor Role collaborator

Ministry of Social Policies and Family, Spain

UNKNOWN

Sponsor Role collaborator

Servicio Madrileño de Salud, Madrid, Spain

OTHER

Sponsor Role collaborator

International Foundation for Integrated Care

UNKNOWN

Sponsor Role collaborator

Programs of Development, Social Support and Medical Cooperation Association

UNKNOWN

Sponsor Role collaborator

European Federation of National Organisations working with the Homeless

UNKNOWN

Sponsor Role collaborator

Prolepsis Institute for Preventive, Environmental and Occupational Medicine

OTHER

Sponsor Role collaborator

Anglia Ruskin University

OTHER

Sponsor Role collaborator

Universitat Politècnica de València

OTHER

Sponsor Role collaborator

Medical University of Vienna

OTHER

Sponsor Role lead

Responsible Party

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Igor Grabovac

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Igor Grabovac, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Medical University of Vienna

Locations

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AmberMed

Vienna, , Austria

Site Status

PRAKSIS Open Day Center for Homeless Athens

Athens, Attica, Greece

Site Status

PRAKSIS Open Day Center for Homeless Piraeus

Piraeus, Attica, Greece

Site Status

PRAKSIS Community Center

Sepolia, Attica, Greece

Site Status

Centro de Salud Segre

Madrid, , Spain

Site Status

Centro de Salud Segovia

Madrid, , Spain

Site Status

Samur Social

Madrid, , Spain

Site Status

Centro de Salud Casa de Campo

Madrid, , Spain

Site Status

Centro de Salud Cortes

Madrid, , Spain

Site Status

Centro de Salud Justicia

Madrid, , Spain

Site Status

Centro de Salud Benita de Ávila

Madrid, , Spain

Site Status

Centro de Salud Las Águilas

Madrid, , Spain

Site Status

Shelter el Pinar

Madrid, , Spain

Site Status

Shelter San Isidro

Madrid, , Spain

Site Status

Shelter San Juan de Dios

Madrid, , Spain

Site Status

Women's centre Beatriz Galindo

Madrid, , Spain

Site Status

The Purfleet Trust - Pathway House

Kings Lynn, Norfolk, United Kingdom

Site Status

Dibden Road Hostel (Part of St Martins Housing Trust)

Norwich, Norfolk, United Kingdom

Site Status

Countries

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Austria Greece Spain United Kingdom

References

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Carmichael C, Schiffler T, Smith L, Moudatsou M, Tabaki I, Donate-Martinez A, Alhambra-Borras T, Kouvari M, Karnaki P, Gil-Salmeron A, Grabovac I. Barriers and facilitators to health care access for people experiencing homelessness in four European countries: an exploratory qualitative study. Int J Equity Health. 2023 Oct 6;22(1):206. doi: 10.1186/s12939-023-02011-4.

Reference Type DERIVED
PMID: 37803317 (View on PubMed)

Related Links

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Other Identifiers

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965351

Identifier Type: -

Identifier Source: org_study_id

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