Stepped-Care Telehealth for Distress in Cancer Survivors
Study Details
Study Description
Brief Summary
Mental health issues in post-treatment adult cancer survivors are associated with multiple adverse outcomes and may represent a cancer health disparity for rural survivors. The purpose of this study is to test a stepped-care approach tailored to symptom severity based on recent American Society of Clinical Oncology guidelines for reducing emotional distress (anxiety and/or depressive symptoms) and improving secondary outcomes (sleep disturbance, fatigue, fear of recurrence, quality of life) in rural, post-treatment cancer survivors in community oncology settings and to examine intervention costs. The resultant intervention will have great potential for widespread dissemination since it will be manualized, delivered by telephone, and comprised of modules to allow customized treatments for individuals with different cancer types.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Moderate Anxiety/depression: Low Intensity Stepped care participants with moderate symptoms (PHQ-9-14; GAD-7: 10-14) will be randomized to either low-intensity stepped care or enhanced usual care. Stepped care consist of a self-guided cognitive behavioral therapy (CBT) workbook to reduce anxiety and depressive symptoms and biweekly (every two weeks) check-in calls from research staff to assess changes in symptom severity/immediate need for psychiatric treatment and provide minimal support. |
Other: Moderate Anxiety/depression: Low Intensity Stepped care
The stepped care Telehealth low intensity intervention is tailored to participants with moderate anxiety and depression. Ppts randomized to this group will receive a self-guided CBT workbook and biweekly (every 2 weeks) check-in calls from a research staff person to assess changes in symptom severity and need for treatment/support.
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Experimental: Severe Anxiety/depression: High Intensity Stepped Care Participants with severe symptoms (PHQ-9: 15-27; GAD-7: 15-21) will be randomized to high intensity stepped care (consist of a CBT workbook with accompanying psychotherapy by a Master's-level therapist delivered by telephone) or EUC. EUC consist of information about referrals/resources locally and nationally. |
Other: Severe Anxiety/depression: High Intensity Stepped Care
The stepped-care Telehealth high intensity intervention is tailored to participants with severe anxiety and depression. Ppts randomized to this group will have 12 weekly psychotherapy sessions delivered by phone with a licensed therapist. Participants will also receive a CBT (cognitive behavioral therapy) workbook including daily exercises to supplement understanding.
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Active Comparator: Enhanced Usual Care Control (EUC) Participants randomized to EUC will receive information about local referrals/resources (support groups, mental health providers, etc.). They will also be provided "Facing Forward: Life after Cancer Treatment," a book developed by the NCI to assist with transition from active treatment to survivorship. Participants will receive information on self-help workbooks for anxiety & depressive symptoms. EUC control will receive a copy of the CBT workbook on completion of the study. |
Other: Enhanced Usual Care Control
Participants with moderate to severe anxiety/depression that are randomized to Enhanced Usual Care Control (EUC) will receive information about referrals/resources in their local area (support groups, mental health providers), NCI materials (Facing Forward: Life after Cancer Treatment", self-help workbooks, copy of the CBT (cognitive behavioral therapy) workbook on completion of the study.
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Outcome Measures
Primary Outcome Measures
- Feasibility of study intervention measured by recruitment rate [Screening through end of study at week 13]
Recruitment rate will be determined by the number of eligible participants who met all eligibility criteria and percent who agreed to participate.
- Feasibility of study intervention measured by accrual rate [Screening through end of study at week 13]
Accrual rates will be calculated by calculating the mean number of participants recruited per month.
- Feasibility of study intervention measured by adherence to intervention [Randomization through completion of study at week 13]
Intervention adherence will be estimated as the mean percentage of therapy (high-intensity intervention) or check-in (low-intensity intervention) sessions each participant completes.
- Feasibility of study intervention measured by retention [Randomization through completion of study at week 13]
Study retention will be estimated by the proportion of participants who complete the Week 7 and 13 visits
Secondary Outcome Measures
- Longitudinal changes in the Generalized Anxiety Disorder-7 (GAD-7) score for anxiety [Screening, baseline (if >30 days since screening), Week 7, Week 13]
The GAD-7 is a self-report measure of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms of Generalized Anxiety Disorder (GAD). Longitudinal changes in the GAD-7 will be measured in participants to evaluate the effectiveness of the intervention in reducing anxiety. Patients select 1 of 4 numbers with "0" indicating not all, to "3" indicating nearly everyday. GAD-7 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe anxiety, respectively.
- Longitudinal changes in the Patient Health Questionnaire (PHQ-9) score for depression [Screening, baseline (if >30 days since screening), Week 7, Week 13]
The PHQ-9 is a self-report measure of DSM-IV symptoms of Major Depressive Disorder where participants rate how often they experienced 9 symptoms over past 2 weeks. Patients select 1 of 4 numbers with "0" indicating not all, to "3" indicating nearly everyday. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Longitudinal changes in the PHQ-9 will be measured in participants to evaluate the effectiveness of the intervention in reducing depression.
- Combined analysis of PHQ-9 and GAD-7 [Screening, baseline (if >30 days since screening), Week 7, Week 13]
A combined variable will be created that indicates if a participant had moderate/severe depression or anxiety at mid- or post-intervention. Each stepped care group will be compared with EUC using a generalized estimating equation (GEE) approach with a logit link to determine if rates of the combined outcome differ at mid- or post-intervention.
- Longitudinal changes in the Insomnia Severity Index (ISI) [Baseline (Week 0), Week 13]
The Insomnia Severity Index is a 7-item self-reported measure of type and severity of insomnia symptoms. Patients select 1 of 5 numbers with "0" indicating no problem, to "4" indicating very severe problem. ISI scores of 0-7 = no clinically significant insomnia; 8-14 =subthreshold insomnia; 15-21 clinical insomnia of moderate severity; 21-28 =severe clinical insomnia. Longitudinal changes in the ISI will be measured in participants to evaluate the effectiveness of the intervention on problems with sleep.
- Longitudinal changes in the PROMIS Fatigue Scale [Baseline (Week 0), Week 13]
The Patient Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form is a measure of the experience of fatigue and the impact of fatigue on activities across multiple domains. Each questions has five response options ranging in value from one to five with one indicating the least amount of frequency/intensity and five indicating the highest frequency/intensity. Longitudinal changes in the PROMIS Fatigue Short Form will be measured in participants to evaluate the effectiveness of the intervention on problems with fatigue.
- Longitudinal changes in the Fear of Recurrence Inventory Severity Subscale [Baseline (Week 0), Week 13]
The Fear of Cancer Recurrence Inventory (FCRI; severity subscale) will be used to measure self-reported fear of recurrence of cancer. Items are rated on a 5-point scale, where 0 = never/not at all, 1 = rarely/a little, 2 = sometimes/somewhat, 3 = most of the time/a lot and 4 = all the time/a great deal. Longitudinal changes in the FCRI scores will be measured in participants to evaluate the effectiveness of the intervention on fear of cancer recurrence.
- Longitudinal changes in the Health Status Questionnaire (SF-36) [Baseline (Week 0), Week 13]
The Health Status Questionnaire (SF-36) is a self-report measure of quality of life. The 36 item questionnaire is divided into 8 subscales and 2 composite domains. Each of the 8 summed scores is linearly transformed onto a scale. The higher the score, the higher the quality of life. Longitudinal changes in the IES-R scores will be measured in participants to evaluate the effectiveness of the intervention on cancer-specific distress.
- Determine costs associated with stepped care mental health and enhanced usual care [Cornell Services Index baseline and week 13, weekly sessions logs (weeks 1-12), tracking log (Baseline to Week 13), implementation cost interviews at study completion]
Includes costs of intervention implementation & health care costs for each participant. Implementation costs determined using data on time spent on intervention activities (tracking logs,staff interviews). Other costs (e.g., telephone, printed materials) valued using project records on expenses. All costs summed related to each intervention to obtain total cost of implementing. Total costs in each arm will be divided by # of patients served to obtain average cost/patient. Sensitivity analyses conducted to assess how implementation costs vary depending on inputs used, such as salaries. Health care cost determined using data from self-reported utilization of heath care services (Cornell Services Index). To calculate these costs, published data on avg costs of these events or data from sources (such as Medicare Fee Schedule, Medical Expenditure Panel Survey) will be used. Analyses conducted to examine impact of interventions on health care utilization and costs. Use of linear models with
- Analysis of differential effects of intervention measured by subgroup stratification [Screening, Baseline (Week 0), Mid week 7, Week 13]
Stratified subgroup analysis of secondary outcomes by gender, age, race/ethnicity, stratification arm(moderate/severe), expectancy and psychotropic medication use at baseline.
- Longitudinal changes in the Impact of Events Scale-Revised (IES-R) [Baseline (Week 0), Week 13]
The IES-R is a 22-item self-report measure of cancer-specific distress. Patients select numbers from 0 (not at all) to 4 (extremely) to indicate how frequently particular comments have been true during the past seven days. The total score, which ranges from 0 to 88 provides a measure of the severity of distress. Longitudinal changes in the IES-R scores will be measured in participants to evaluate the effectiveness of the intervention on cancer-specific distress.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age ≥18 years
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Score ≥10 on the GAD-7 and/or a score ≥8 on the PHQ-9, indicating clinically significant anxiety or depressive symptoms, respectively.
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Past history of treated Stage I, II, or III (newly diagnosed or recurrent) breast, colorectal, prostate, gynecologic (to include uterine and cervical) cancers and non-Hodgkin's lymphoma.
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6-60 months post-treatment (surgery, chemotherapy, and/or radiation therapy) for cancer. Time frame applies to most recent completion of treatment if participant had a cancer recurrence. It is acceptable to be on maintenance or hormonal therapies.
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Participant resides in California, Georgia, Illinois, Kansas, Michigan, Minnesota, Missouri, New Mexico, North Carolina, North Dakota, South Carolina, Virginia, Tennessee, or Wisconsin
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Study-trained therapist in the state where the participant resides.
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Must be able to speak and understand English.
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Must have access to a telephone
Exclusion Criteria:
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Current psychotherapy [regular appointment(s) with a psychologist, counselor, or therapist within the last 30 days prior to randomization].
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Self-reported active alcohol or substance abuse within the last 30 days.
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Past history of prostate cancer or non-Hodgkin's lymphoma with only active surveillance (i.e., no surgery, chemotherapy, or radiation therapy).
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Diagnosis of a second malignancy (except for non-melanoma skin cancers) after a previous diagnosis of breast, colorectal, gynecologic cancers and non-Hodgkin's lymphoma
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Progressive cancer (must be considered no evidence of disease or stable)
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Self -reported history of a diagnosis of dementia from a healthcare provider.
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Self -reported psychotic symptoms in the last 30 days prior to randomization
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Active suicidal ideation (currently reported suicidal plan and intent).
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Any change in psychotropic medications within the last 30 days.
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Hearing loss that would preclude participating in telephone sessions (determined by brief hearing assessment administered by research staff)
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Failure/inability/unwillingness to provide names and contact information for two family members or friends to serve as emergency contacts during the course of the study.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Mercy Hospital Fort Smith | Fort Smith | Arkansas | United States | 72903 |
2 | Kaiser Permanente-Fresno | Fresno | California | United States | 93720 |
3 | Kaiser Permanente-Modesto | Modesto | California | United States | 95356 |
4 | Kaiser Permanente-South Sacramento | Sacramento | California | United States | 95823 |
5 | Pacific Central Coast Health Center-San Luis Obispo | San Luis Obispo | California | United States | 93401 |
6 | Kaiser San Rafael-Gallinas | San Rafael | California | United States | 94903 |
7 | Kaiser Permanente-Santa Rosa | Santa Rosa | California | United States | 95403 |
8 | Kaiser Permanente-Stockton | Stockton | California | United States | 95210 |
9 | Augusta University Medical Center | Augusta | Georgia | United States | 30912 |
10 | Lewis Cancer and Research Pavilion at Saint Joseph's/Candler | Savannah | Georgia | United States | 31405 |
11 | Low Country Cancer Care Associates PC | Savannah | Georgia | United States | 31405 |
12 | Summit Cancer Care-Candler | Savannah | Georgia | United States | 31405 |
13 | Rush - Copley Medical Center | Aurora | Illinois | United States | 60504 |
14 | Illinois CancerCare-Bloomington | Bloomington | Illinois | United States | 61704 |
15 | Illinois CancerCare-Canton | Canton | Illinois | United States | 61520 |
16 | Memorial Hospital of Carbondale | Carbondale | Illinois | United States | 62902 |
17 | SIH Cancer Institute | Carterville | Illinois | United States | 62918 |
18 | Illinois CancerCare-Carthage | Carthage | Illinois | United States | 62321 |
19 | Centralia Oncology Clinic | Centralia | Illinois | United States | 62801 |
20 | Carle on Vermilion | Danville | Illinois | United States | 61832 |
21 | Cancer Care Specialists of Illinois - Decatur | Decatur | Illinois | United States | 62526 |
22 | Decatur Memorial Hospital | Decatur | Illinois | United States | 62526 |
23 | Illinois CancerCare-Dixon | Dixon | Illinois | United States | 61021 |
24 | Carle Physician Group-Effingham | Effingham | Illinois | United States | 62401 |
25 | Crossroads Cancer Center | Effingham | Illinois | United States | 62401 |
26 | Illinois CancerCare-Eureka | Eureka | Illinois | United States | 61530 |
27 | Illinois CancerCare-Galesburg | Galesburg | Illinois | United States | 61401 |
28 | Western Illinois Cancer Treatment Center | Galesburg | Illinois | United States | 61401 |
29 | Illinois CancerCare-Kewanee Clinic | Kewanee | Illinois | United States | 61443 |
30 | Illinois CancerCare-Macomb | Macomb | Illinois | United States | 61455 |
31 | Carle Physician Group-Mattoon/Charleston | Mattoon | Illinois | United States | 61938 |
32 | Good Samaritan Regional Health Center | Mount Vernon | Illinois | United States | 62864 |
33 | Cancer Care Center of O'Fallon | O'Fallon | Illinois | United States | 62269 |
34 | Illinois CancerCare-Ottawa Clinic | Ottawa | Illinois | United States | 61350 |
35 | Illinois CancerCare-Pekin | Pekin | Illinois | United States | 61554 |
36 | Illinois CancerCare-Peoria | Peoria | Illinois | United States | 61615 |
37 | Methodist Medical Center of Illinois | Peoria | Illinois | United States | 61636 |
38 | Illinois CancerCare-Peru | Peru | Illinois | United States | 61354 |
39 | Valley Radiation Oncology | Peru | Illinois | United States | 61354 |
40 | Illinois CancerCare-Princeton | Princeton | Illinois | United States | 61356 |
41 | Southern Illinois University School of Medicine | Springfield | Illinois | United States | 62702 |
42 | Springfield Clinic | Springfield | Illinois | United States | 62702 |
43 | Memorial Medical Center | Springfield | Illinois | United States | 62781 |
44 | Carle Cancer Center | Urbana | Illinois | United States | 61801 |
45 | The Carle Foundation Hospital | Urbana | Illinois | United States | 61801 |
46 | Rush-Copley Healthcare Center | Yorkville | Illinois | United States | 60560 |
47 | HaysMed University of Kansas Health System | Hays | Kansas | United States | 67601 |
48 | Lawrence Memorial Hospital | Lawrence | Kansas | United States | 66044 |
49 | Olathe Health Cancer Center | Olathe | Kansas | United States | 66061 |
50 | Ascension Via Christi - Pittsburg | Pittsburg | Kansas | United States | 66762 |
51 | Salina Regional Health Center | Salina | Kansas | United States | 67401 |
52 | University of Kansas Health System Saint Francis Campus | Topeka | Kansas | United States | 66606 |
53 | Spectrum Health Reed City Hospital | Reed City | Michigan | United States | 49677 |
54 | Sanford Joe Lueken Cancer Center | Bemidji | Minnesota | United States | 56601 |
55 | Fairview Ridges Hospital | Burnsville | Minnesota | United States | 55337 |
56 | Cambridge Medical Center | Cambridge | Minnesota | United States | 55008 |
57 | Mercy Hospital | Coon Rapids | Minnesota | United States | 55433 |
58 | Fairview Southdale Hospital | Edina | Minnesota | United States | 55435 |
59 | Unity Hospital | Fridley | Minnesota | United States | 55432 |
60 | Fairview Clinics and Surgery Center Maple Grove | Maple Grove | Minnesota | United States | 55369 |
61 | Minnesota Oncology Hematology PA-Maplewood | Maplewood | Minnesota | United States | 55109 |
62 | Saint John's Hospital - Healtheast | Maplewood | Minnesota | United States | 55109 |
63 | Abbott-Northwestern Hospital | Minneapolis | Minnesota | United States | 55407 |
64 | Hennepin County Medical Center | Minneapolis | Minnesota | United States | 55415 |
65 | Health Partners Inc | Minneapolis | Minnesota | United States | 55454 |
66 | Monticello Cancer Center | Monticello | Minnesota | United States | 55362 |
67 | New Ulm Medical Center | New Ulm | Minnesota | United States | 56073 |
68 | Fairview Northland Medical Center | Princeton | Minnesota | United States | 55371 |
69 | North Memorial Medical Health Center | Robbinsdale | Minnesota | United States | 55422 |
70 | Park Nicollet Clinic - Saint Louis Park | Saint Louis Park | Minnesota | United States | 55416 |
71 | United Hospital | Saint Paul | Minnesota | United States | 55102 |
72 | Saint Francis Regional Medical Center | Shakopee | Minnesota | United States | 55379 |
73 | Lakeview Hospital | Stillwater | Minnesota | United States | 55082 |
74 | Sanford Thief River Falls Medical Center | Thief River Falls | Minnesota | United States | 56701 |
75 | Ridgeview Medical Center | Waconia | Minnesota | United States | 55387 |
76 | Rice Memorial Hospital | Willmar | Minnesota | United States | 56201 |
77 | Minnesota Oncology Hematology PA-Woodbury | Woodbury | Minnesota | United States | 55125 |
78 | Sanford Cancer Center Worthington | Worthington | Minnesota | United States | 56187 |
79 | Fairview Lakes Medical Center | Wyoming | Minnesota | United States | 55092 |
80 | Saint Louis Cancer and Breast Institute-Ballwin | Ballwin | Missouri | United States | 63011 |
81 | Central Care Cancer Center - Bolivar | Bolivar | Missouri | United States | 65613 |
82 | Parkland Health Center-Bonne Terre | Bonne Terre | Missouri | United States | 63628 |
83 | Cox Cancer Center Branson | Branson | Missouri | United States | 65616 |
84 | Saint Francis Medical Center | Cape Girardeau | Missouri | United States | 63703 |
85 | Southeast Cancer Center | Cape Girardeau | Missouri | United States | 63703 |
86 | Parkland Health Center - Farmington | Farmington | Missouri | United States | 63640 |
87 | Capital Region Southwest Campus | Jefferson City | Missouri | United States | 65109 |
88 | Freeman Health System | Joplin | Missouri | United States | 64804 |
89 | Mercy Hospital Joplin | Joplin | Missouri | United States | 64804 |
90 | Truman Medical Centers | Kansas City | Missouri | United States | 64108 |
91 | Delbert Day Cancer Institute at PCRMC | Rolla | Missouri | United States | 65401 |
92 | Mercy Clinic-Rolla-Cancer and Hematology | Rolla | Missouri | United States | 65401 |
93 | Heartland Regional Medical Center | Saint Joseph | Missouri | United States | 64506 |
94 | Saint Louis Cancer and Breast Institute-South City | Saint Louis | Missouri | United States | 63109 |
95 | Mercy Hospital South | Saint Louis | Missouri | United States | 63128 |
96 | Missouri Baptist Medical Center | Saint Louis | Missouri | United States | 63131 |
97 | Mercy Hospital Saint Louis | Saint Louis | Missouri | United States | 63141 |
98 | Sainte Genevieve County Memorial Hospital | Sainte Genevieve | Missouri | United States | 63670 |
99 | Mercy Hospital Springfield | Springfield | Missouri | United States | 65804 |
100 | CoxHealth South Hospital | Springfield | Missouri | United States | 65807 |
101 | Missouri Baptist Sullivan Hospital | Sullivan | Missouri | United States | 63080 |
102 | Missouri Baptist Outpatient Center-Sunset Hills | Sunset Hills | Missouri | United States | 63127 |
103 | Mercy Hospital Washington | Washington | Missouri | United States | 63090 |
104 | University of New Mexico Cancer Center | Albuquerque | New Mexico | United States | 87102 |
105 | AdventHealth Infusion Center Asheville | Asheville | North Carolina | United States | 28803 |
106 | AdventHealth Infusion Center Haywood | Clyde | North Carolina | United States | 28721 |
107 | AdventHealth Hendersonville | Hendersonville | North Carolina | United States | 28792 |
108 | AdventHealth Infusion Center Weaverville | Weaverville | North Carolina | United States | 28787 |
109 | Sanford Bismarck Medical Center | Bismarck | North Dakota | United States | 58501 |
110 | Sanford South University Medical Center | Fargo | North Dakota | United States | 58103 |
111 | Sanford Broadway Medical Center | Fargo | North Dakota | United States | 58122 |
112 | Sanford Roger Maris Cancer Center | Fargo | North Dakota | United States | 58122 |
113 | Mercy Hospital Oklahoma City | Oklahoma City | Oklahoma | United States | 73120 |
114 | Prisma Health Cancer Institute - Spartanburg | Boiling Springs | South Carolina | United States | 29316 |
115 | Prisma Health Cancer Institute - Laurens | Clinton | South Carolina | United States | 29325 |
116 | Prisma Health Cancer Institute - Easley | Easley | South Carolina | United States | 29640 |
117 | McLeod Regional Medical Center | Florence | South Carolina | United States | 29506 |
118 | Gibbs Cancer Center-Gaffney | Gaffney | South Carolina | United States | 29341 |
119 | Tidelands Georgetown Memorial Hospital | Georgetown | South Carolina | United States | 29440 |
120 | Prisma Health Cancer Institute - Butternut | Greenville | South Carolina | United States | 29605 |
121 | Prisma Health Cancer Institute - Faris | Greenville | South Carolina | United States | 29605 |
122 | Prisma Health Greenville Memorial Hospital | Greenville | South Carolina | United States | 29605 |
123 | Prisma Health Cancer Institute - Eastside | Greenville | South Carolina | United States | 29615 |
124 | Self Regional Healthcare | Greenwood | South Carolina | United States | 29646 |
125 | Prisma Health Cancer Institute - Greer | Greer | South Carolina | United States | 29650 |
126 | Gibbs Cancer Center-Pelham | Greer | South Carolina | United States | 29651 |
127 | Prisma Health Cancer Institute - Seneca | Seneca | South Carolina | United States | 29672 |
128 | Spartanburg Medical Center | Spartanburg | South Carolina | United States | 29303 |
129 | Spartanburg Medical Center - Mary Black Campus | Spartanburg | South Carolina | United States | 29307 |
130 | MGC Hematology Oncology-Union | Union | South Carolina | United States | 29379 |
131 | Sanford Cancer Center Oncology Clinic | Sioux Falls | South Dakota | United States | 57104 |
132 | Sanford USD Medical Center - Sioux Falls | Sioux Falls | South Dakota | United States | 57117-5134 |
133 | Wellmont Bristol Regional Medical Center | Bristol | Tennessee | United States | 37620 |
134 | Wellmont Medical Associates Oncology and Hematology-Johnson City | Johnson City | Tennessee | United States | 37604 |
135 | Regional Cancer Center at Indian Path Community Hospital | Kingsport | Tennessee | United States | 37660 |
136 | Wellmont Holston Valley Hospital and Medical Center | Kingsport | Tennessee | United States | 37660 |
137 | Wellmont Medical Associates-Bristol | Bristol | Virginia | United States | 24201 |
138 | Sovah Health Martinsville | Martinsville | Virginia | United States | 24115 |
139 | Southwest VA Regional Cancer Center | Norton | Virginia | United States | 24273 |
140 | Virginia Cancer Institute | Richmond | Virginia | United States | 23230 |
141 | VCU Massey Cancer Center at Stony Point | Richmond | Virginia | United States | 23235 |
142 | Virginia Commonwealth University/Massey Cancer Center | Richmond | Virginia | United States | 23298 |
143 | VCU Community Memorial Health Center | South Hill | Virginia | United States | 23970 |
144 | Langlade Hospital and Cancer Center | Antigo | Wisconsin | United States | 54409 |
145 | Marshfield Clinic-Chippewa Center | Chippewa Falls | Wisconsin | United States | 54729 |
146 | Marshfield Medical Center-EC Cancer Center | Eau Claire | Wisconsin | United States | 54701 |
147 | Saint Vincent Hospital Cancer Center Green Bay | Green Bay | Wisconsin | United States | 54301 |
148 | Saint Vincent Hospital Cancer Center at Saint Mary's | Green Bay | Wisconsin | United States | 54303 |
149 | Gundersen Lutheran Medical Center | La Crosse | Wisconsin | United States | 54601 |
150 | Marshfield Clinic - Ladysmith Center | Ladysmith | Wisconsin | United States | 54848 |
151 | Holy Family Memorial Hospital | Manitowoc | Wisconsin | United States | 54221 |
152 | Saint Vincent Hospital Cancer Center at Marinette | Marinette | Wisconsin | United States | 54143 |
153 | Marshfield Medical Center-Marshfield | Marshfield | Wisconsin | United States | 54449 |
154 | Aspirus Medford Hospital | Medford | Wisconsin | United States | 54451 |
155 | Marshfield Clinic-Minocqua Center | Minocqua | Wisconsin | United States | 54548 |
156 | Cancer Center of Western Wisconsin | New Richmond | Wisconsin | United States | 54017 |
157 | Saint Vincent Hospital Cancer Center at Oconto Falls | Oconto Falls | Wisconsin | United States | 54154 |
158 | Marshfield Medical Center-Rice Lake | Rice Lake | Wisconsin | United States | 54868 |
159 | HSHS Saint Nicholas Hospital | Sheboygan | Wisconsin | United States | 53081 |
160 | Marshfield Clinic Stevens Point Center | Stevens Point | Wisconsin | United States | 54482 |
161 | Saint Vincent Hospital Cancer Center at Sturgeon Bay | Sturgeon Bay | Wisconsin | United States | 54235-1495 |
162 | Aspirus Regional Cancer Center | Wausau | Wisconsin | United States | 54401 |
163 | Marshfield Clinic-Wausau Center | Wausau | Wisconsin | United States | 54401 |
164 | Marshfield Medical Center - Weston | Weston | Wisconsin | United States | 54476 |
165 | Aspirus Cancer Care - Wisconsin Rapids | Wisconsin Rapids | Wisconsin | United States | 54494 |
166 | Marshfield Clinic - Wisconsin Rapids Center | Wisconsin Rapids | Wisconsin | United States | 54494 |
Sponsors and Collaborators
- Wake Forest University Health Sciences
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: Suzanne Danhauer, PhD, Wake Forest Baptist Medical Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IRB00047561
- 1R21CA198237
- 5R21CA198237-02
- 3UG1CA189824-04S1
- WF-30917CD
- NCI-2017-01840
- NCT03190291