KanSurvive: Testing a Model for Improving Cancer Survivorship Care in Rural Practice

NCT04763824 | Completed Results

• 2 other identifiers: STUDY001443145R01CA240103-02
• Study Type: interventional
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

Approximately, 20 rural primary care practices to participate in a delayed intervention-controlled trial. Phase I: Formal and structured work flow evaluations to better identify specific gaps in processes of care while assessing what on-going training is needed for adoption of high-quality cancer survivorship care in rural practice. These will be incorporated into the ECHO sessions (Aim 1). Phase II: Conduct and test the effectiveness of the novel KanSurvive-ECHO intervention (Aim 2) and finally identify barriers and facilitators to implementation of KanSurvive-ECHO (Aim 3).

Conditions

Breast Cancer; Colorectal Cancer; Lung Cancer; Prostate Cancer

Keywords

Cancer Survivorship; Rural Primary Care Practices

Outcome Measures

Primary Outcomes (12)

• Tumor Surveillance Completion (Pre-Intervention)

  This outcome reflects whether recommended tumor surveillance was completed and documented in the EHR. Tumor surveillance includes cancer-specific follow-up imaging consistent with evidence-based survivorship guidelines (e.g., NCCN, ASCO). Charts were coded as "Completed" if the recommended surveillance test was documented within the appropriate interval and "Not Completed" if documentation was absent, outdated, or incomplete. The outcome reports the proportion of EHR charts meeting tumor surveillance recommendations at baseline (pre-intervention) and again 24 months after the intervention.

  Baseline (Pre-Intervention) Chart Audit

• Tumor Surveillance Completion (Post-Intervention)

  This outcome reflects whether recommended tumor surveillance was completed and documented in the EHR. Tumor surveillance includes cancer-specific follow-up imaging consistent with evidence-based survivorship guidelines (e.g., NCCN, ASCO). Charts were coded as "Completed" if the recommended surveillance test was documented within the appropriate interval and "Not Completed" if documentation was absent, outdated, or incomplete. The outcome reports the proportion of EHR charts meeting tumor surveillance recommendations at baseline (pre-intervention) and again 24 months after the intervention.

  24-Month Follow-Up (Post-Intervention) Chart Audit

• Distress Screening Completion (Pre-Intervention)

  This outcome reflects whether recommended Distress Screening was completed and documented in the EHR. Distress Screening was defined as documentation of using a standardized distress assessment tool consistent with survivorship best practices. Charts were coded as "Completed" when a distress screening result was documented during the chart abstraction interval. "Not Complete" indicated missing or incomplete documentation.

  Baseline (Pre-intervention) Chart Review

• Distress Screening Completion (Post-Intervention)

  This outcome reflects whether recommended Distress Screening was completed and documented in the EHR. Distress Screening was defined as documentation of using a standardized distress assessment tool consistent with survivorship best practices. Charts were coded as "Completed" when a distress screening result was documented during the chart abstraction interval. "Not Complete" indicated missing or incomplete documentation.

  24-Month Follow-Up (Post-Intervention) Chart Audit

• Body Mass Index (BMI) Assessment Completion (Pre-Intervention)

  BMI assessment was defined as documentation of a height and weight measurement sufficient to calculate body mass index (BMI) in the electronic health record (EHR). Charts were coded as "Completed" when BMI or its components were documented within the recommended timeframe.

  Baseline (Pre-intervention) Chart Review

• Body Mass Index (BMI) Assessment Completion (Post-Intervention)

  BMI assessment was defined as documentation of a height and weight measurement sufficient to calculate body mass index (BMI) in the electronic health record (EHR). Charts were coded as "Completed" when BMI or its components were documented within the recommended timeframe.

  24-Month Follow-Up (Post-Intervention) Chart Audit

• Tobacco Use Screening Completion (Pre-Intervention)

  Tobacco use screening was defined as documentation of current tobacco use status in the electronic health record (EHR). Charts were coded as "Completed" when a screening result was documented within the recommended timeframe.

  Baseline (Pre-Intervention) Chart Audit

• Tobacco Use Screening Completion (Post-Intervention)

  Tobacco use screening was defined as documentation of current tobacco use status in the electronic health record (EHR). Charts were coded as "Completed" when a screening result was documented within the recommended timeframe.

  24-Month Follow-Up (Post-Intervention) Chart Audit

• Cancer Diagnosis on Problem List (Pre-Intervention)

  This outcome reflects whether a cancer diagnosis was documented on the patient's EHR problem list, consistent with survivorship care documentation standards. Charts were coded as "Completed" when the cancer diagnosis appeared in the structured problem list.

  Baseline (Pre-Intervention) Chart Audit

• Cancer Diagnosis on Problem List (Post-Intervention)

  This outcome reflects whether a cancer diagnosis was documented on the patient's EHR problem list, consistent with survivorship care documentation standards. Charts were coded as "Completed" when the cancer diagnosis appeared in the structured problem list.

  24-Month Follow-Up (Post-Intervention) Chart Audit

• Family History of Cancer Documentation (Pre-Intervention)

  Family history of cancer documentation was defined as the presence of cancer-related family history information in the EHR. Charts were coded as "Completed" when documentation included a family history of cancer assessment entry.

  Baseline (Pre-intervention) Chart Audit

• Family History of Cancer Documentation (Post-Intervention)

  Family history of cancer documentation was defined as the presence of cancer-related family history information in the EHR. Charts were coded as "Completed" when documentation included a family history of cancer assessment entry.

  24-Month Follow-Up (Post-Intervention) Chart Audit

Study Arms (1)

KanSurvive Telementoring with Practice Facilitation

OTHER

This study does not involve a therapeutic intervention. The KanSurvive project includes Project ECHO telementoring and education with practice facilitation to improve the delivery of cancer survivorship care in primary care practice.

Other: KanSurvive ECHO and Practice Facilitation

Interventions

KanSurvive ECHO and Practice Facilitation OTHER

Four, 1-hour, virtual, case-based education sessions covering the evidence-based practice guidelines for breast, colorectal, lung, and prostate cancer survivorship care. Practice facilitation also provided to support participating primary care practices with quality improvement in the delivery of cancer survivorship care.

KanSurvive Telementoring with Practice Facilitation

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Primary care practice (PCP) caring for rural cancer survivors
• Willing to participate in four ECHO sessions
• Capable and willing to complete pre- and post- data collection under a data use agreement
• Cancer survivor data is eligible for extraction if the patient is a breast, prostate, lung, and/or colorectal cancer survivor and considered to have a "reasonable likelihood" of 24-month survival by a practice provider.

You may not qualify if:

• PCPs unwilling to engage in project activities
• PCPs with no rural-dwelling patients on their patient panel
• Cancer survivor data is ineligible for extraction if the patient is \<18 years of age or \>75 years of age, is currently receiving hospice services, or has a history of cancer other than breast, prostate, lung, or colorectal.

Sponsors & Collaborators

• University of Kansas Medical Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

University of Kansas Cancer Center

Westwood, Kansas, 66206, United States

Location

MeSH Terms

Conditions

Breast Neoplasms; Colorectal Neoplasms; Lung Neoplasms; Prostatic Neoplasms

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Diseases; Respiratory Tract Diseases; Genital Neoplasms, Male; Urogenital Neoplasms; Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Prostatic Diseases; Male Urogenital Diseases

Limitations and Caveats

This study relied on retrospective EHR abstraction in rural primary care practices, and documentation variability may not fully reflect all care delivered. Differences in baseline and post-intervention sample sizes reflect routine variation in chart availability and completeness. Data collection occurred during and following the COVID-19 pandemic, which affected project implementation, staffing and workflows.

Results Point of Contact

• Title: Jennifer Klemp, PhD, Principal Investigator
• Organization: The University of Kansas Medical Center

jklemp@kumc.edu

9135887750

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Single-arm feasibility study aimed at evaluating the effectiveness of the KanSurvive ECHO intervention combined with practice facilitation to promote the adoption of evidence-based practice survivorship care guidelines.

Study Record Dates

• First Submitted: November 25, 2020
• First Posted: February 21, 2021
• Study Start: November 18, 2020
• Primary Completion: December 18, 2023
• Study Completion: December 18, 2023
• Last Updated: January 14, 2026
• Results First Posted: January 14, 2026

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)