A Culturally Informed Patient Navigation Program (CFPN) to Reduce Delays Between Diagnosis and Treatment in American Indian and Alaska Native Cancer Patients Living in Rural California

NCT ID: NCT07332312

Last Updated: 2026-01-12

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

71 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-30

Study Completion Date

2028-11-13

Brief Summary

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This clinical trial develops and tests whether a culturally informed patient navigation program, Community-Focused Patient Navigation (CFPN), works to reduce delays between diagnosis and treatment in American Indian and Alaska Native (AIAN) cancer patients living in rural California. AIAN communities face some of the most severe cancer disparities in the United States, including higher death rates, later-stage diagnoses, and limited access to timely, culturally responsive care. This may be due to barriers such as rural isolation, divided referral systems, or a lack of trust in mainstream healthcare systems. Patient navigation is a care delivery model designed to guide a patient through the healthcare system and address the barriers that prevent patients from accessing timely and effective care. The CFPN program is culturally tailored and designed with AIAN communities in mind. The program provides the patient with a treatment plan based on the patient's unique needs, goals, and barriers. This may be an effective way to reduce delays between diagnosis and treatment in AIAN cancer patients living in rural California.

Detailed Description

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PRIMARY OBJECTIVES:

I. Conduct a comprehensive community-informed planning process to co-design the Community-Focused Patient Navigation (CFPN) program.

II. Develop and implement an evidence and practice-informed, culturally responsive, CFPN program.

III. Evaluate the implementation and impact of the CFPN program using Practical, Robust Implementation and Sustainability Model (PRISM) and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) frameworks, along with Indigenous evaluation practices.

OUTLINE: Participants are assigned to 1 of 2 objectives.

OBJECTIVE 1: Participants are assigned to 1 of 3 groups.

GROUP I: Participants serve on a Community Advisory Board (CAB) to guide the co-design process of the CFPN program on study.

GROUP II: Participants complete a focus group over 1-2 hours in support of the co-design process of the CFPN program on study.

GROUP III: Participants complete a key informant interview (KII) over 30 minutes in support of the co-design process of the CFPN program on study.

OBJECTIVE 2:

Patients engage with the CFPN program navigator as needed and receive a treatment plan based on the patient's needs, goals, and barriers on study. Patients also receive opioid misuse education and care coordination on study.

Conditions

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Hematopoietic and Lymphatic System Neoplasm Malignant Solid Neoplasm

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Objective 1 group I (CAB)

Participants serve on a CAB to guide the co-design process of the CFPN program on study.

Group Type OTHER

Discussion

Intervention Type OTHER

Serve on CAB

Objective 1 group II (focus group)

Participants complete a focus group over 1-2 hours in support of the co-design process of the CFPN program on study.

Group Type OTHER

Discussion

Intervention Type OTHER

Complete focus group

Objective 1 group III (KII)

Participants complete a KII over 30 minutes in support of the co-design process of the CFPN program on study.

Group Type OTHER

Interview

Intervention Type OTHER

Complete KII

Objective 2 (CFPN program)

Patients engage with the CFPN program navigator as needed and receive a treatment plan based on the patient's needs, goals, and barriers on study. Patients also receive opioid misuse education and care coordination on study.

Group Type EXPERIMENTAL

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Interview

Intervention Type OTHER

Ancillary studies

Patient Navigation

Intervention Type BEHAVIORAL

Engage with CFPN program navigator

Survey Administration

Intervention Type OTHER

Ancillary studies

Tailored Intervention

Intervention Type PROCEDURE

Receive treatment plan

Educational Intervention

Intervention Type OTHER

Receive opioid misuse education and care coordination

Interventions

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Electronic Health Record Review

Ancillary studies

Intervention Type OTHER

Interview

Complete KII

Intervention Type OTHER

Interview

Ancillary studies

Intervention Type OTHER

Patient Navigation

Engage with CFPN program navigator

Intervention Type BEHAVIORAL

Survey Administration

Ancillary studies

Intervention Type OTHER

Tailored Intervention

Receive treatment plan

Intervention Type PROCEDURE

Discussion

Serve on CAB

Intervention Type OTHER

Discussion

Complete focus group

Intervention Type OTHER

Educational Intervention

Receive opioid misuse education and care coordination

Intervention Type OTHER

Other Intervention Names

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Discuss Discuss Education for Intervention Intervention by Education Intervention through Education Intervention, Educational Patient Navigator Program

Eligibility Criteria

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Inclusion Criteria

* CAB: Self-identify as AIAN or have experience working with the AIAN community
* CAB: Are 18 years or older
* CAB: Live within Toiyabe Indian Health Program (TIHP) catchment area(s)
* CAB: Are either a cancer patient/survivor/caregiver and/or a family member of an individual(s) affected by cancer, OR a Board member (ex: Tribal Health Board or Elders Board)
* FOCUS GROUP: Self-identify as AIAN or a family member of an AIAN individual affected by cancer
* FOCUS GROUP: Are 18 years or older
* FOCUS GROUP: Live within TIHP catchment area(s)
* FOCUS GROUP: Are either a cancer patient/survivor/caregiver and/or a family member of an individual(s) affected by cancer, OR a Board member (ex: Tribal Health Board or Elders Board)
* KII: Be a TIHP healthcare staff member
* KII: Be 18 years or older
* KII: Work with AIAN cancer patients in TIHP catchment area
* CFPN PROGRAM IMPLEMENTATION: Have any type of cancer, are in any treatment stage along the cancer continuum
* CFPN PROGRAM IMPLEMENTATION: Self-identify as AIAN or be a TIHP patient
* CFPN PROGRAM IMPLEMENTATION: Live in the TIHP service area
* CFPN PROGRAM IMPLEMENTATION: Receive cancer-related services from TIHP

Exclusion Criteria

* FOCUS GROUP: Individual with no experience with cancer either as a patient or know someone who is/was a cancer patient at TIHP
* CFPN PROGRAM IMPLEMENTATION: Not a TIHP patient
* CFPN PROGRAM IMPLEMENTATION: Does not currently have cancer or has not previously had cancer
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

American Cancer Society, Inc.

OTHER

Sponsor Role collaborator

Pfizer

INDUSTRY

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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Claradina Soto

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Locations

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Toiyabe Indian Health Project

Bishop, California, United States

Site Status

USC / Norris Comprehensive Cancer Center

Los Angeles, California, United States

Site Status

Countries

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United States

Facility Contacts

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Tina Cassar

Role: primary

760-872-2622

Claradina Soto

Role: primary

323-442-8219

Other Identifiers

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NCI-2025-08365

Identifier Type: REGISTRY

Identifier Source: secondary_id

UP-25-00814

Identifier Type: -

Identifier Source: secondary_id

19PS-25-8

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA014089

Identifier Type: NIH

Identifier Source: secondary_id

View Link

19PS-25-8

Identifier Type: -

Identifier Source: org_study_id

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