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Feasibility of delivering survivorship care via lay health educators: A pilot randomized controlled trial among rural cancer survivors


Abstract We tested the feasibility of survivorship care plan (SCP) delivery with/without a lay health educator (LHE) telephone-delivered information session among rural cancer survivors, and their effects on health-related self-efficacy and knowledge of cancer history.Randomized trial of cancer survivors from 3 rural oncology clinics featuring either SCP alone (control) or SCP plus LHE-delivered information session (intervention). Participants completed a questionnaire on health-related self-efficacy and knowledge of cancer-specific medical history. Responses were compared to medical records for accuracy. SCPs were then mailed to participants. Approximately 5 months later, participants completed a follow-up questionnaire. A subset of participants took part in subsequent qualitative interviews about their study experience.Of 301 survivors approached, 72 (23.9%) were randomized (mean age 66.4 years; 3.1 years from diagnosis; 62.5% female), and 65 (90.3%) completed the study. Global mental and physical health or self-efficacy scores did not change significantly from baseline to follow-up for either group. In exploratory analyses, self-efficacy increased in participants with inadequate/marginal health literacy in the intervention arm (+0.7, 95% CI = 0.1-1.2; P = .01). Accuracy of knowledge did not improve but was high at baseline (mean 76.0±14.5%). 60.1% and 48.4% of control and intervention participants, respectively, found SCPs definitely/somewhat useful. Qualitative data (n = 20) suggested that SCPs were helpful to patients when primary and oncology care were less integrated.An LHE-delivered informational session was feasible but had limited benefit to rural cancer survivors versus delivery of SCP alone but may be of benefit to patients with low health literacy or with less integrated care.
Authors Catherine Duggan ORCID , Kara L. Cushing‐Haugen ORCID , Allison Cole ORCID , Jeffrey W. Allen , Ryan Gilles , Jaime Hornecker University of Wyoming , Adrianna I. Gutierrez , Jude Warner , K. Scott Baker ORCID , Rachel M. Ceballos ORCID , Eric J. Chow ORCID
Journal Info Wiley-Blackwell | The Journal of Rural Health , vol: 39 , iss: 3 , pages: 666 - 675
Publication Date 1/2/2023
ISSN 0890-765X
TypeKeyword Image article
Open Access closed Closed Access
DOI https://doi.org/10.1111/jrh.12736
KeywordsKeyword Image Cancer Survivorship (Score: 0.582769) , Cancer Communication (Score: 0.546496)