Revealing Information Genuinely & Honestly Across Time

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

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-16

Study Completion Date

2027-11-01

Brief Summary

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The purpose of this research study is to obtain insights and feedback from patients and parents about a new approach to support conversations about how cancer may affect one's future life and quality of life (i.e., prognostic communication). This study involves creating a personalized approach to discussing prognosis.

Primary Objectives

* To evaluate the feasibility of implementing the RIGHTimeCPV intervention among pediatric oncology patients, caregivers, and clinicians (referred to herein as "shareholders").
* To assess the acceptability of the intervention across the shareholder groups.

Secondary Objectives

* To explore the potential impact of the RIGHTimeCPV intervention on communication quality, concordance in prognostic understanding, and therapeutic alliance between patients/families and multidisciplinary clinicians.
* To explore whether the practice of eliciting, sharing, and honoring individualized communication preferences is sustained by clinicians after participation in the RIGHTimeCPV intervention.

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Detailed Description

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An estimated range of 52-85 total participants across all subject cohorts at St. Jude and participating affiliate sites, including 12-15 pediatric oncologists, 2-3 family units per participating oncologist (with an emphasis on dyadic recruitment within a given family unit, but also may include independent patients, independent caregivers, or a patient and multiple caregivers; estimated 15-25 patients and 15-25 parents), and 10-20 'communication preferences companions' (CPCs).

The RIGHTimeCPV intervention centers eliciting, sharing, and integrating individualized patient/parent preferences for prognostic communication into routine clinical practice through collaboration between multidisciplinary clinicians on the care team.

The intervention comprises five parts: 1) patient/parent identifies and selects a CPC; 2) CPC reviews intervention materials and conversation guide with the research team; 3) CPC and patient/parent meet for a CPV visit, and CPC documents patient/parent preferences in a templated form; 4) CPC and oncologist discuss the CPV form; 5) oncologist, patient/parent, and CPC attend next disease re-evaluation visit together.

Data will be collected at the following timepoints: 1) study enrollment (routine demographic information collected from each participant); 2) CPV 'conversation guide' training with CPC and research staff (audio-recorded encounter); 3) CPV with patient/parent and CPC (audio-recorded encounter); 4) during the period after a CPV and before the next disease re-evaluation encounter (brief survey and semi-structured interview for patients/parents and oncologists); 5) CPC-oncologist discussion to review the CPV form (email or audio-recorded encounter); 6) disease re-evaluation visit with patient/parent, oncologist, and CPC (audio-recorded encounter); 7) post-intervention interview (brief surveys for patients/parents and oncologists and semi-structured interviews for all participants); and 8) post-intervention interview six months after the final DRV (semi-structured interviews for all participants).

Conditions

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Cancer Communication

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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RIGHTimeCPV intervention: Patients and Caregivers (parents)

Pediatric patients aged 12-25 years with poor prognosis cancer who receive treatment at the study site or participating affiliate

Caregivers of patients of any age who receive treatment at the study site (referred to as 'parent')

Group Type OTHER

Prognostic Communication-Patient/parent

Intervention Type BEHAVIORAL

* Patient/parent identifies and selects a communication preferences companion (CPC)
* CPC and patient/parent meet for a Communication Preferences Visit (CPV)
* Oncologist, patient/parent, and CPC attend next disease re-evaluation visit together.

RIGHTimeCPV intervention: Psychosocial/nursing clinicians

Psychosocial/nursing clinicians who participate in the clinical care of participating patients/parents and serve as communication preferences companions (CPCs) under the auspices of this study

Group Type OTHER

Prognostic Communication-CPC

Intervention Type BEHAVIORAL

* CPC reviews intervention materials and conversation guide with the research team
* CPC and patient/parent meet for a CPV, and CPC documents patient/parent preferences in a templated form
* CPC and oncologist discuss the CPV form
* Oncologist, patient/parent, and CPC attend next disease re-evaluation visit together.

RIGHTimeCPV intervention: Pediatric oncologists

Pediatric oncologists who treat participating patients/parents

Group Type OTHER

Prognostic Communication-Oncologist

Intervention Type BEHAVIORAL

* CPC and oncologist discuss the CPV form
* Oncologist, patient/parent, and CPC attend next disease re-evaluation visit together

Interventions

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Prognostic Communication-Patient/parent

* Patient/parent identifies and selects a communication preferences companion (CPC)
* CPC and patient/parent meet for a Communication Preferences Visit (CPV)
* Oncologist, patient/parent, and CPC attend next disease re-evaluation visit together.

Intervention Type BEHAVIORAL

Prognostic Communication-CPC

* CPC reviews intervention materials and conversation guide with the research team
* CPC and patient/parent meet for a CPV, and CPC documents patient/parent preferences in a templated form
* CPC and oncologist discuss the CPV form
* Oncologist, patient/parent, and CPC attend next disease re-evaluation visit together.

Intervention Type BEHAVIORAL

Prognostic Communication-Oncologist

* CPC and oncologist discuss the CPV form
* Oncologist, patient/parent, and CPC attend next disease re-evaluation visit together

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Aged 12-25 years diagnosed with poor prognosis cancer (high risk or otherwise difficult to treat cancers), as defined by a pediatric oncologist estimating odds of overall survival as 50% or less
* Anticipated by a pediatric oncologist to have one or more disease re-evaluation timepoints over the next six months
* Not anticipated by a pediatric oncologist to approach end of life in the next three months

* Aged 18 years or older and/or legally emancipated
* Parent or other self-identified caregiver of a patient of any age with poor prognosis cancer (as defined above)

* Pediatric oncologists who treat eligible patients/caregivers at the study site, St. Jude Children's Research Hospital (SJCRH) or its included affiliates:

* Peoria, IL: The Jim and Trudy Maloof St. Jude Midwest Affiliate Clinic
* Charlotte, NC: Novant Health Hemby Children's Hospital
* Shreveport, LA: Ochsner LSU Health-Feist-Weiller Cancer Center

* Multidisciplinary clinicians from a participant's psychosocial or nursing care team, identified by that participant to serve as their 'communication preferences companion' (CPC) during the pilot
* Provides clinical care to pediatric cancer patients under the auspices of psychology, social work, spiritual care, child life, cultural navigation, quality of life/palliative care, or nursing

Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes