A lay navigator‐led, early palliative care intervention for African American and rural family caregivers of individuals with advanced cancer (Project Cornerstone): Results of a pilot randomized trial

• DOI: 10.1002/cncr.34044
• Publication Date: 2021-12-07T10:00:48Z
• Authors: J. Nicholas Dionn...; Andres Azuero; Richard A. Taylor; Chinara Dosse; Avery C. Bechthold; Erin Currie; Rhiannon D. Reed; Erin R. Harrell; Sally Engler; Deborah B. Ejem; Nataliya V. Ivankova; Michelle Y. Martin; Gabrielle B. Rocque; Grant R. Williams; Marie A. Bakitas
• Keywords: Telehealth; Advance Care Planning

Background The objective of this study was to assess the feasibility, acceptability, and potential efficacy ENABLE (Educate, Nurture, Advise, Before Life Ends) Cornerstone—a lay navigator‐led, early palliative care telehealth intervention for African American/Black and/or rural‐dwelling family caregivers individuals with advanced cancer (ClinicalTrials.gov identifier NCT03464188). Methods This a pilot randomized trial (November 2019 March 2021). Family patients newly diagnosed, stage III/IV, solid‐tumor cancers were receive either an or usual care. Intervention paired specially trained navigator who delivered 6 weekly, 20‐minute 60‐minute coaching sessions plus monthly follow‐up 24 weeks, reviewing skills in stress management, self‐care, getting help, staying organized, future planning. Feasibility assessed according completion questionnaires (predefined as rate ≥80%). Acceptability determined through participants' ratings their likelihood recommending intervention. Measures caregiver distress quality life collected at 8 weeks. Results Sixty‐three (usual care, n = 32; intervention, 31). Caregivers completed 65% 87% questionnaires. Average program 9.4, from 1 (not all likely) 10 (extremely likely). Over mean ± SE Hospital Anxiety Depression Scale score improved by 0.30 1.44 points group worsened 1.99 1.39 (difference, −2.29; Cohen d, −0.32). between‐group difference scores −1.56 − intervention; −0.07). Similar outcome results observed patient participants. Conclusions authors piloted Cornerstone, American caregivers. acceptability data collection rates high, preliminary promising. Lay Summary To date, very few programs have been developed support under‐resourced address need, successfully tested program, called Educate, Ends (ENABLE) rural cancer. Cornerstone is led people involves series weekly phone focused on manage provide effective are now testing larger trial. If demonstrates benefit, it may yield model that could be widely implemented.