Hybrid Type I Effectiveness-implementation Cluster Randomized Controlled Trial of CARES

NCT ID: NCT07183527

Last Updated: 2025-09-19

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

1750 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-08

Study Completion Date

2030-01-31

Brief Summary

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The trial will examine the effectiveness and facilitators and barriers of implementation of CARES, an integrated screening and stepped collaborative care intervention

Detailed Description

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Over 18 million Americans are living with cancer. Half of them report clinically significant levels of depression, pain, and/or fatigue. According to the NIH consensus statement, these are the three most common and distressing cancer-related symptoms. These symptoms lead to poorer health-related quality of life (HRQoL) and cancer-related treatment adherence, higher unplanned health care utilization and costs, and reduced life expectancy.

Investigators observed in a trial of CARES, an integrated screening and stepped collaborative care intervention, that 75% versus 4% of participants initiated treatment when compared to standard of care. Improvements in HRQoL and reductions in pain, depression, fatigue, emergency room visits, readmissions to the hospital, and length of stay in the hospital were observed. The cost savings to the health care system was $17,085 per patient per year when compared to standard of care.

The overarching objective of the proposed study is to move CARES from research to routine clinical care. Investigators plans to test the effectiveness of CARES in a pragmatic trial or "real world" setting. An implementation-focused process evaluation of participant and clinician engagement with CARES guided by the RE-AIM framework will also be performed. Finally, to prepare to disseminate the intervention, a full cost-effectiveness analysis of CARES will be conducted.

Conditions

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CARES Standard of Care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Cluster Randomized Controlled Trial
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

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CARES

Integrated Screening and Stepped Collaborative Care Intervention

Group Type EXPERIMENTAL

CARES

Intervention Type BEHAVIORAL

Integrated screening and stepped collaborative care

Standard of Care (SOC)

Integrated screening and referred to treatment in the community and/or at the cancer center

Group Type ACTIVE_COMPARATOR

Standard of Care (SOC)

Intervention Type BEHAVIORAL

Screening and referral of patient to provider in the community or cancer center

Interventions

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CARES

Integrated screening and stepped collaborative care

Intervention Type BEHAVIORAL

Standard of Care (SOC)

Screening and referral of patient to provider in the community or cancer center

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of Cancer
* Age 18 years or older
* Read and write in English

Exclusion Criteria

* Evidence of thought disorder
* Evidence of delusions
* Evidence of hallucinations
* Evidence of suicidal ideation with a plan
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Pittsburgh

OTHER

Sponsor Role lead

Responsible Party

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Jennifer Steel

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jennifer L Steel, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Locations

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University of Pittsburgh Medical Center (UPMC) Cancer Center

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jennifer L Steel, PhD

Role: CONTACT

14126922041

Jennifer L Steel

Role: CONTACT

4126922041

Facility Contacts

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Jennifer L Steel, PhD

Role: primary

4126922041

Other Identifiers

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1R01CA296402

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY24070065

Identifier Type: -

Identifier Source: org_study_id

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