A Randomized Controlled Interventional Trial of a Social Determinants of Health and Patient Navigation Program to Improve Treatment Utilization Among Low-income Patients With Hepatocellular Carcinoma
University of Southern California
Summary
The goal of this study is to test whether providing various social resources (transportation support through Lyft rides, housing support through Hyatt House LA, and meal support through Project Angel Food LA) will reduce treatment delays and increase treatment uptake for patients with liver cancer.
Description
Social determinants of health (SDOH) play a central role in drop-offs at each step of the cancer care cascade for patients living in poverty. Social barriers have been shown to result in delays in care, increased non-compliance, and poorer outcomes. Importantly, negative SDOH among patients with HCC may impact receipt of therapy, a critical contributor to improved survival. Studies have shown that even small delays in therapy (more than 3 months from diagnosis) can lead to worse survival. The treatment landscape for HCC is complex, ranging from surgical options to locoregional therapies to imm…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adults (18 years or older) * Diagnosis of HCC (BCLC Stage A-C) * Uninsured or underinsured (i.e., Medicaid as primary or secondary insurance) * Able to provide informed consent Exclusion Criteria: * Non-HCC liver tumors * BCLC Stage D and/or Child Pugh C cirrhosis (latter unable to receive treatment due to poor liver function) * No plans for cancer treatment for any reason including patient refusal (best supportive care only) * Only oral systemic therapy planned (i.e., tyrosine kinase inhibitors) * Incarcerated patients or pregnant patients * Unable to provide informed…
Interventions
- OtherSocial Determinants of Health Program
Social resources to be offered under our SDOH program will include 1) rideshares to treatment-related visits, 2) hotel stays for treatment-related visits, and/or 3) a 12-week meal delivery program.
- OtherPatient Navigation
Usual clinic-provided patient navigation to appointments, scheduling, social resources, financial challenges, etc.
Locations (3)
- Keck Hospital of USCLos Angeles, California
- LA General Medical CenterLos Angeles, California
- USC Norris Comprehensive Cancer CenterLos Angeles, California