Building CAPACITI for Community-Based Palliative Care

NCT05120154 | Completed

• 1 other identifier: 13867
• Study Type: interventional
• Target: 566
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this cluster randomized controlled trial is to assess the efficacy of a quality improvement intervention called CAPACITI intended to increase competency among primary care teams to deliver early palliative care. CAPACITI is palliative care training and coaching program for primary care teams, comprised of three, two-month (4 session) modules, each addressing a critical component of implementing a palliative care approach into primary care practice.

Conditions

Palliative Care

Keywords

Palliative care; CAPACITI; End of life; Primary care; Early identification

Outcome Measures

Primary Outcomes (3)

• Proportion of case load identified as requiring a palliative care approach

  Measured based on self-reported i) Number of patients in caseload and number (calculated %) reported as identified as requiring a palliative care approach, ii) Typical timing of when to initiate a palliative care approach for cancer and non-cancer patients respectively.

  Up to one month post module

• End-of-Life Professional Caregiver Survey (EPCS)

  The EPCS is a 28-item scale developed to assess palliative care-specific educational needs within an interprofessional team related to three main subdomains: Effective Care Delivery (ECD 8-items); Patient and Family-Centered Communication (PFCC 12-items); and Cultural and Ethical Values (CEV 8-items) (Lazenby, 2012). Each item is scored on a 5-point Likert scale ranging from 1 (lowest level of skill) to 5 (greatest level of skill). Items represent care-provider comfort with a variety of situations related to palliative and EOL care. The EPCS covers all eight domains of the national palliative care guidelines and core lessons of physician-specific and nurse-specific end of life education curricula in the USA. The EPCS exhibits strong internal consistency (alpha = 0.96). For the purposes of this study we will exclude the CEV sub-domain items from the EPCS.

  Up to one month post module

• Assignment Completion & Change Survey

  This survey is a two-part, study created questionnaire based on the CAPACITI module activities. Part A is unique to each module, asking participants to indicate the extent to which they were able to complete each of the session assignments for the module. Response options are: Have not started (1), Started but not completed (2), Completed (3). Part B contains four items assessing changes in thinking, behaviour, processes, and patient/family experience, respectively. Each item is scored on a 5-point Likert scale, rating the strength of agreement with each element of change, from 1 (strongly disagree) to 5 (strongly agree).

  Up to one month post module

Secondary Outcomes (3)

• CAPACITI Competencies Survey

  Up to one month post module

• Assessment of Interprofessional Team Collaboration Scale II (AITCS II)

  Up to one month post module

• Module Session Evaluation

  Up to one month post module

Study Arms (2)

Intervention

EXPERIMENTAL

Access to all the CAPACITI module materials, provided on a learning management system. The intervention group will also receive the CAPACITI program with module facilitation, namely high-facilitation and expert coaching in the coverage of module materials in four live webinars (bimonthly for the 2 month duration of the module = 4 webinars).

Other: Online educational materials; Behavioral: Facilitated online webinars

Control

ACTIVE COMPARATOR

Access to all the CAPACITI module materials, provided on a learning management system. The control group will not receive module facilitation (i.e., will entail self-directed learning).

Other: Online educational materials

Interventions

Online educational materials OTHER

The CAPACITI program is comprised of three independent modules, taken separately (each constituting an intervention): (1) Identify and Assess; (2) Enhance Communication Skills; (3) Enhance Skills for Ongoing Care (including involvement of family and specialists). Each module addresses a critical component of implementing a palliative care approach into primary care practice. The CAPACITI program emphasizes practice supports in each module, integrating two components: 1) clinical education in the form of expert advice and tips, and 2) evidence-based tools with action steps.

Control; Intervention

Facilitated online webinars BEHAVIORAL

Intervention participants will be invited to participate in facilitated online discussions. These discussions review the online materials and share strategies for problem-solving.

Intervention

Eligibility Criteria

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

You may qualify if:

• Each team must be comprised of primary care providers, defined as having a minimum of at least 1 of the following: family physician, nurse practitioner, or nurse and practice coordinator (including manager or administrator) that provides primary care. Teams can be a single provider. Teams can also have other team members (e.g. social worker, pharmacist, etc.).
• Each team must be community-based and willing to provide palliative care, defined as managing symptoms, addressing psychosocial needs, educating patients and families, and coordinating care.

You may not qualify if:

• Not community-based
• Not willing to provide palliative care
• Outside of Canada

Sponsors & Collaborators

• McMaster University: lead

Study Sites (1)

Juravinski Cancer Centre - Hamilton Health Sciences

Hamilton, Ontario, L8V 5C2, Canada

Location

Related Publications (2)

• Matthew M, Bainbridge D, Myers J, Levine O, Steinberg L, Incardona N, Winemaker S, Kortes-Miller K, Stajduhar K, Kilbertus F, Pereira J, Seow H. Facilitated Versus Self-Directed Educational Modalities in Palliative Care Training: A Randomized Controlled Trial of the CAPACITI Intervention. Palliat Med Rep. 2025 Jun 17;6(1):365-373. doi: 10.1089/pmr.2025.0010. eCollection 2025.

  PMID: 40919547 DERIVED

• Seow H, Bainbridge D, Winemaker S, Stajduhar K, Pond G, Kortes-Miller K, Marshall D, Kilbertus F, Myers J, Steinberg L, Incardona N, Levine O, Pereira J. Increasing palliative care capacity in primary care: study protocol of a cluster randomized controlled trial of the CAPACITI training program. BMC Palliat Care. 2023 Jan 5;22(1):2. doi: 10.1186/s12904-022-01124-x.

  PMID: 36604714 DERIVED

MeSH Terms

Conditions

Death

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Hsien Seow, PhD

  Department of Oncology, McMaster University and Juravinski Cancer Centre

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 15, 2021
• First Posted: November 15, 2021
• Study Start: November 15, 2021
• Primary Completion: December 1, 2023
• Study Completion: March 1, 2024
• Last Updated: May 3, 2024

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)