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Pediatric CancerNCT06680687

Survivorship Intervention Program in Western Kenya: Study Protocol

A study testing Educational Program (video, information booklet, Survivorship Card) and Follow-Up Program (form and healthcare provider training) in people with Pediatric Cancer and Survivorship, run by Moi University at 1 site in Kenya.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

In this study protocol, the investigators described a survivorship intervention program that will be performed at a referral hospital in Western Kenya. This will be a non-randomized prospective cohort study with a sequential hybrid effectiveness - implementation design. Read more about this study

Who is it for?
Any age
Conditions the study is for
Pediatric Cancer, Survivorship
What is being tested?
Educational Program (video, information booklet, Survivorship Card) and Follow-Up Program (form and healthcare provider training)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
130 participants
Where
1 siteKenya
Study dates
Nov 2024to Nov 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Caregivers of children diagnosed with cancer (primary or secondary malignancy) below fifteen years old.
  • Children will soon be finalizing childhood cancer treatment (enrolled during the last 2 months of treatment).
  • Healthcare providers (the pediatric oncology workforce comprises of an estimated 30 staff members) working in the Pediatric Oncology department at MTRH will be recruited.
  • Any cadre involved in patient care or patient education (e.g. pediatric oncologists, fellows, registrars, medical officers, clinical officers, nurses, patient navigators, child life specialists) will be allowed to participate.

Who cannot join

  • Childhood cancer patients should have no treatment failure (abandonment, relapsed disease, progressive disease).
  • Caregivers of children with a relapsed malignancy in remission will be excluded.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Susan Mageto, MPharm contact

+254 715823203

susanmageto.mageto@gmail.com

Jesse Lemmen, MSc contact

+31 649892448

jpm.lemmen@gmail.com

Kenya1 site
  • Moi Teaching and Referral Hospital

    Eldoret, Rift Valley, P.O. Box 3-30100

    Susan Mageto, MPharm, +254 715823203, susanmageto.mageto@gmail.com

    Festus Njuguna, MD, PhD, +254 787723677, muigaifes2000@yahoo.com

Other trials in Kenya

About this study

Official title: A Non-randomized Prospective Cohort Study to Improve Follow-up Adherence, Survivorship Knowledge and Late Effects Documentation at a Childhood Cancer Clinic in Western Kenya: A Study Protocol

In this study protocol, the investigators described a survivorship intervention program that will be performed at a referral hospital in Western Kenya. This will be a non-randomized prospective cohort study with a sequential hybrid effectiveness - implementation design. The study comprises of an educational component for caregivers of childhood cancer survivors and a follow-up component targeting healthcare providers with survivorship training and implementation of a late effects documentation tool.

Through these interventions the investigators aim to:

  1. increase follow-up adherence of childhood cancer survivors;
  2. increase caregivers' and healthcare providers' knowledge about childhood cancer diagnoses, treatment and the corresponding late effects risks;
  3. document late effects at a childhood cancer outpatient clinic;
  4. evaluate program implementation and satisfaction among recipients and providers.
Read the detailed description

This non-randomized prospective cohort study will be performed at a referral hospital in Western Kenya. Hundred caregivers of children diagnosed with cancer, who will complete treatment within two months, will be enrolled and followed for 24 months after completion of treatment. A caregiver control group receiving usual care will be recruited and sequentially, caregivers will be included in an intervention group to attend an educational group session and receive educational materials (video, booklet and Survivorship Card). Primary study outcome will be survivors' follow-up adherence. Survivors will be considered lost to follow-up after missing a scheduled appointment and subsequently do not revisit the clinic for more than six months. Mixed models regression analyses will be performed to determine intervention effects on follow-up adherence and secondly on caregiver survivorship knowledge uptake. Additionally, healthcare providers will be trained on follow-up care, whereafter a form will be introduced at the outpatient clinic to document late effects in pediatric survivors attending the clinic for the period of a year. Secondary outcomes will be late effects prevalence as documented in the Follow-Up Form and healthcare provider survivorship knowledge uptake. Implementation measures (reach, potential effectiveness, adoption, satisfaction and maintenance) will be evaluated for both programs.

Being tested
Educational Program (video, information booklet, Survivorship Card), Follow-Up Program (form and healthcare provider training)
Keywords
Aftercare, Health Education, Patient Compliance, Surveillance
Medical subject headings
Neoplasms, Health Education, Patient Compliance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Educational Program (video, information booklet, Survivorship Card)Behavioural

    Caregivers will be invited to attend an educational group session. Each session will be organized weekly to monthly. A maximum of ten caregivers can be present at a session.

    First a video will be displayed in which healthcare providers explain medical aspects of survivorship. Caregivers of survivors and young adult survivors discuss experiences after completing cancer treatment in the video.

    Secondly, the present healthcare provider will hand over an information booklet 'Life after childhood cancer' to the caregivers. The booklet covers similar topics as presented in the video.

    Lastly, a Survivorship Card will be shared with the caregivers. The card contains a record of the patient's cancer and treatment history and the expected follow-up appointment schedule. The survivor and family take one card home and a duplicate copy of the card remains in the medical file.

  • Follow-Up Program (form and healthcare provider training)Behavioural

    Healthcare providers will attend a training session of approximately 90 minutes, in which investigators will discuss the same topics as covered in the educational group session supported by PowerPoint slides.

    A Follow-Up Form will be introduced to be used by healthcare providers in the outpatient follow-up clinic. The form will include questions referring to symptoms specific for certain late effects. Specific questions will be included per subcategory: hematological malignancies, solid tumors or central nervous system (CNS) tumors.

Study groups in NCT06680687
Study groupRoleWhat they receive
"Usual Care"No interventionParticipants receiving "Usual Care" group (A), will be recruited during the last two months of treatment (T-2). At the end of treatment (T0), participants will complete a knowledge questionnaire and will be followed for another 24 months. At six months after treatment completion (T6), a final follow-up knowledge assessment will be conducted. Participants will be enrolled into group A until the intended sample size of 50 participants is reached. Investigators estimated to have reached this number within four to six months based on recent survival rates.
"Educational Intervention"ExperimentalA similar procedure will apply to the "Educational Intervention" group (B). Participants will complete a knowledge assessment before receiving an educational intervention between T-2 and T0. To evaluate early and late knowledge uptake, participants will complete a post-education knowledge assessment at T0 and a follow-up knowledge assessment at T6. Follow-up adherence will be evaluated at every three months for the first year and at every six months during the second year after treatment completion for both groups. Implementation measures will be captured starting at T3 until T24, together with a satisfaction questionnaire that will be administered at T6.
Receives: Behavioral: Educational Program (video, information booklet, Survivorship Card)
"Follow-Up Forms implementation"OtherHealthcare provider training on survivorship will start at the same timepoint as recruitment of the "Educational Intervention" group (A) at T-2. Follow-Up Forms will be introduced at the outpatient clinic once an estimated 30 healthcare providers have done the training (anticipated at T0). Healthcare providers will fill in a knowledge assessment directly pre- and post-training (T-2) and at six months post-training (T4). Documentation of late effect symptoms will be monitored for twelve months, starting at T0. Implementation measures will be collected weekly starting from T0 and healthcare providers will be assigned to a satisfaction questionnaire at T6.
Receives: Behavioral: Follow-Up Program (form and healthcare provider training)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of non-adherent study participants

    When survivors do not appear at a scheduled visit within four weeks before or after the scheduled date.

    Measured: 24 months: at 3, 6, 9, 12, 18 and 24 months.

  2. Percentage of participants lost to follow-up

    When survivors miss a scheduled appointment and do not revisit the follow-up clinic after a missed appointment for more than six months.

    Measured: 24 months: at 3, 6, 9, 12, 18 and 24 months.

  3. Reasons for non-adherence (questionnaire)

    Reasons for non-adherence (death, relapse, other logistic issues) will be explored through a phone call.

    Measured: 24 months: at 3, 6, 9, 12, 18 and 24 months.

  4. Intentions to revisit the follow-up clinic (questionnaire)

    Intentions to revisit the follow-up clinic (yes/no, what can hospital do to support participant in adhering to follow-up visit) will be explored through a phone call.

    Measured: 24 months: at 3, 6, 9, 12, 18 and 24 months.

Secondary outcomes (11)
  1. Caregiver knowledge (questionnaire)

    Caregivers' knowledge about disease history, treatment exposure, associations between treatment and late effects, follow-up care, late effects risk and risk perception.

    Levels of knowledge (number of accurate/inaccurate/unknown responses), and knowledge uptake (changes in number of accurate responses) progression will be followed over time.

    Measured: Two months prior to survivor's treatment completion, assessed up to six months after completion of treatment

  2. Healthcare provider knowledge (questionnaire)

    Caregivers' and healthcare providers' knowledge about disease history, treatment exposure, associations between treatment and late effects, follow-up care, late effects risk and risk perception according

    Levels of knowledge (number of accurate/inaccurate/unknown responses), and knowledge uptake (changes in number of accurate responses) progression will be followed over time.

    Measured: From start healthcare provider training up to six months after the completion of the training session

  3. Follow-Up Form documented late effects prevalence

    The prevalence of late effects will be described as the percentage of individual survivors visiting the outpatient clinic for the duration of one year that reported a symptom (yes/no) as documented in the follow-up forms.

    Late effects are categorized into physical outcomes (e.g. relapsed disease, heart failure), physical aspects of quality of life (e.g. fatigue, challenges exercising), psychosocial aspects of quality of life (e.g. anxiety, exclusion), neurocognitive aspects of quality of life (memory, educational problems) according to the International Childhood Cancer Outcome Project.

    Measured: 12 months: weekly.

  4. Reach caregivers (Implementation measures data collection tool)

    Percentage eligible caregivers having received the booklet, video and Survivorship Card, characteristics of caregivers included in the study

    Measured: 24 months: weekly

  5. Reach healthcare providers (Implementation measures data collection tool)

    Percentage eligible healthcare providers trained, Characteristics of healthcare providers included in the study

    Measured: 12 months: weekly.

  6. Adoption caregivers (Implementation measures data collection tool)

    Percentage study participants taking the Survivorship Card to clinic appointment

    Measured: 24 months: at 3, 6, 9, 12, 18 and 24 months

  7. Adoption healthcare providers (Implementation measures data collection tool)

    Percentage eligible survivors having received the follow-up form in clinic; Percentage follow-up forms completely filled by clinician; Investigations and referrals done; Actions adhering to form instructions

    Measured: 12 months: weekly.

  8. Caregiver satisfaction (questionnaire)

    Satisfaction questionnaire rating satisfaction on a 3-point Likert scale (highest score indicating maximum satisfaction, and lowest score indicating maximum satisfaction for inverse questions). Values can range from minimum 1 (Disagree) to maximum 3 (Agree).

    Measured: At 6 months after receiving the educational intervention

  9. Healthcare provider satisfaction (questionnaire)

    Satisfaction questionnaire rating satisfaction on a 5-point Likert scale (highest score indicating maximum satisfaction, and lowest score indicating maximum satisfaction for inverse questions). Values can range from minimum 1 (Strongly Disagree) to maximum 5 (Strongly Agree).

    Measured: At 6 months after receiving the healthcare provider training

  10. Caregiver recommendations

    Open question exploring recommendations to improve educational intervention

    Measured: At 6 months after receiving the educational intervention

  11. Healthcare provider recommendations

    Open question exploring recommendations to improve the Follow-Up Form

    Measured: At 6 months after receiving the healthcare provider training

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Nov 2024
  2. Study startNov 2024 (estimated)
  3. Primary completionNov 2027 (estimated)
  4. Study completionNov 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Non-randomised
Intervention model
Sequential
Model description
A caregiver control group of 50 participants receiving usual care will be recruited and sequentially, 50 caregivers will be included in the intervention group. Because follow-up adherence is also time-dependent (the risk of non-adherence increases with time), the investigators reasoned that the Educational Program should be delivered before completion of treatment, to prevent survivors getting lost to follow-up before receiving the intervention. Healthcare provider training will be provided to at least 75 percent of the healthcare providers that match the inclusion criteria and timing of the training will be determined by availability. The Follow-Up Form will be used to document late effects in all survivors that attend the outpatient clinic, regardless enrollment in the Educational Program.
Masking
None (open label)
Enrolment
130 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06680687
Sponsor's protocol ID
0004807
Status last verified
Nov 2024
First submitted
30 Oct 2024
Last updated
12 Nov 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The data that support the findings of this study will be available from the corresponding authors upon reasonable request after publication of all results reporting on the the Primary and Secondary Outcomes of the study.

Publications

  • Lemmen J, Mageto S, Vik T, Olbara G, Kaspers G, Njuguna F. Non-randomised prospective clinical trial to improve follow-up adherence, survivorship knowledge and late effects documentation at a childhood cancer clinic in Western Kenya: a study protocol. BMJ Open. 2025 Jun 10;15(6):e096741. doi: 10.1136/bmjopen-2024-096741.

    PubMed 40499965

Questions about this trial

What is this clinical trial studying?

A study testing Educational Program (video, information booklet, Survivorship Card) and Follow-Up Program (form and healthcare provider training) in people with Pediatric Cancer and Survivorship, run by Moi University at 1 site in Kenya.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 12 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Kenya. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Susan Mageto, MPharm (+254 715823203, susanmageto.mageto@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of non-adherent study participants (time frame: 24 months: at 3, 6, 9, 12, 18 and 24 months.). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06680687, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Nov 2024.

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