Access to Genetic Testing in Underserved Patients With Cancer

NCT ID: NCT06422455

Last Updated: 2025-06-04

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

RECRUITING

Clinical Phase

NA

Total Enrollment

800 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-24

Study Completion Date

2028-10-24

Brief Summary

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This study compares the experiences of people who receive information about genetic testing from a computer-generated character to patients who receive information from a human genetics healthcare provider. Patients with cancer are increasingly recommended for genetic testing as standard of care. Multiple factors contribute to low usage of genetic testing but for many patients the lack of access to genetic counseling and testing is an important and flexible factor. Lack of access is especially relevant to racial/ethnic minority patients and those living in non-metropolitan rural settings who are frequently cared for at safety-net hospitals with limited genetics services. Alternative delivery models are necessary to improve rates of access to genetic testing in patients with cancer. Health information technology is under used by genetics providers. A patient-facing relational agent (PERLA) will provide pre-test genetics education in both English and Spanish across two clinical settings to facilitate more timely access to genetic testing. Using the PERLA intervention may help researchers learn different ways to provide education about genetic testing to patients with cancer compared to usual care.

Detailed Description

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PRIMARY OBJECTIVES:

I. To obtain patient and provider input on the optimal content and format of a new relational agent (RA) intervention ("PERLA") for automated pre-test genetics education.

II. To obtain patient feedback on the usability of the English- and Spanish-language PERLAs.

III. To determine the acceptability of the newly designed English- and Spanish-language PERLAs among patients with cancer.

IV. To evaluate the impact of the English- and Spanish-language PERLAs on the proportion of patients who meet cancer-based genetic testing guidelines who receive genetic test results within 3 months of initiating cancer care.

V. To evaluate the potential barriers and facilitators to implementation of PERLA in the clinical setting.

OUTLINE:

DEVELOPMENT PHASE: Participants attend focus groups and provide feedback on the content, format, and usability of the PERLAs to enable to tailor the design of the intervention.

USABILITY PHASE: Participants attend usability testing and provide feedback through cognitive interviews.

PILOT TESTING PHASE: Participants evaluate the newly developed PERLAs and provide feedback through focused interviews and structured assessment.

INTERVENTION PHASE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive access to PERLA comprising pre-test genetics education and standard post-test provider-based genetic counseling over 20-60 minutes.

ARM B: Patients receive access to usual care pre- and post-test provider-based genetic counseling.

IMPLEMENTATION PHASE: Participants complete qualitative interviews to evaluate potential barriers and facilitators to implementation of PERLA in the clinic.

After completion of study intervention, patients are followed up at 1, 3, and 6 months.

Conditions

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Breast Carcinoma Male Breast Carcinoma Malignant Solid Neoplasm Metastatic Prostate Carcinoma Ovarian Carcinoma Pancreatic Exocrine Neoplasm Stage IVB Prostate Cancer American Joint Committee on Cancer v8 Triple-Negative Breast Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Intervention Phase Arm A (PERLA)

Patients receive access to PERLA comprising pre-test genetics education and standard post-test provider-based genetic counseling over 20-60 minutes. .

Group Type EXPERIMENTAL

Educational Intervention

Intervention Type OTHER

Receive genetics education

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Genetic Counseling

Intervention Type OTHER

Receive provider-based genetic counseling

Interview

Intervention Type OTHER

Ancillary studies

Survey Administration

Intervention Type OTHER

Ancillary studies

Intervention Phase Arm B (usual care)

Patients receive access to usual care pre- and post-test provider-based genetic counseling.

Group Type ACTIVE_COMPARATOR

Best Practice

Intervention Type OTHER

Receive provider-based genetic counseling

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Survey Administration

Intervention Type OTHER

Ancillary studies

Interventions

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Best Practice

Receive provider-based genetic counseling

Intervention Type OTHER

Educational Intervention

Receive genetics education

Intervention Type OTHER

Electronic Health Record Review

Ancillary studies

Intervention Type OTHER

Genetic Counseling

Receive provider-based genetic counseling

Intervention Type OTHER

Interview

Ancillary studies

Intervention Type OTHER

Survey Administration

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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standard of care standard therapy Education for Intervention Intervention by Education Intervention through Education Intervention, Educational

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years old
* Diagnosed with least one of the following:

* Epithelial ovarian cancer
* Exocrine pancreatic cancer
* Metastatic or high or very high-risk prostate cancer
* Breast cancer at or before age 50
* Bilateral breast cancer
* Triple negative breast cancer
* Male breast cancer OR
* Healthcare provider who treats patients with any of the above types of cancer
* Able to read and write in English or Spanish
* Able to provide informed consent

* Patients with none of the listed cancer diagnoses and clinical characteristics
* Healthcare provider who do not treats cancer patients

Exclusion Criteria

* Patients who cannot provide informed consent
* Patients who cannot see, read, or write
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Northeastern University

OTHER

Sponsor Role collaborator

Dana-Farber Cancer Institute

OTHER

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Charite Ricker, MS

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Locations

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USC / Norris Comprehensive Cancer Center

Los Angeles, California, United States

Site Status RECRUITING

University of Rochester

Rochester, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Charite Ricker, MS

Role: CONTACT

323-409-7710

Facility Contacts

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Charite Ricker

Role: primary

323-409-7710

Meghan L. Underhill

Role: primary

Other Identifiers

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NCI-2024-02187

Identifier Type: REGISTRY

Identifier Source: secondary_id

19PS-24-3

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA014089

Identifier Type: NIH

Identifier Source: secondary_id

View Link

R01CA263532

Identifier Type: NIH

Identifier Source: secondary_id

View Link

19PS-24-3

Identifier Type: -

Identifier Source: org_study_id

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