A Multilevel Intervention to Improve Adherence to Childhood Cancer Survivorship

More than 80% of childhood cancer survivors develop serious or life-threatening late effects after cancer therapy, but \<20% receive recommended survivorship care offered at cancer center survivorship clinics. In a shared care model, the investigators propose to investigate an innovative multi-level intervention consisting of: 1) patient survivorship education via telehealth with the cancer center, 2) ongoing patient-tailored education program within the electronic health record patient portal, 3) a structured interactive phone communication between the cancer center and the primary care clinic, and 4) an in-person visit with the primary care clinic for survivorship care with the goal of achieving high rates of adherence to recommended surveillance for late effects, as well as improving patient and physician knowledge and self-efficacy. If this scalable intervention demonstrates patient completion of recommended care comparable to cancer center survivorship clinics, this innovative study has the enormous potential to deliver recommended care to a larger proportion of childhood cancer survivors and reduce survivorship care disparities, while engaging p to integrate survivorship care as part of overall, lifelong health maintenance.

Sex

All

Minimum age

2 Years

Inclusion Criteria:

1. Diagnosed with any cancer at age \<21 years
2. Treated with chemotherapy and/or radiation
3. 2.0-4.0 years status post-completion of all cancer-related therapy
4. Cancer-free with a life expectancy of ≥2 years
5. English- or Spanish-speaking (also applies to parent/guardian if patient age \<18 years)
6. No previous attendance at a specialty survivorship clinic
7. Followed at one of the 4 participating sites: Hackensack, University of North Carolina- Chapel Hill (UNC), University of Colorado Denver (CU), Miller's Children's and Women's Hospital Long Beach (MCWH)

Exclusion Criteria:

* Active medical problems severe enough to not be eligible for receiving survivorship care with primary care provider at the time of recruitment

• DERIVEDRoss WL, Santiago-Rivera Y, Tan MT, Roy MM, Bryant S, Appel BE, Casillas J, Demedis J, Smitherman AB, Horwitz LI, Hurtado-de-Mendoza A, Mendoza JA, Santacroce SJ, Kadan-Lottick NS. Design and methods of a multi-level intervention to improve adherence to childhood cancer survivorship care by partnering with primary care providers: The BRIDGES randomized controlled trial. Contemp Clin Trials. 2025 May;152:107859. doi: 10.1016/j.cct.2025.107859. Epub 2025 Feb 21. PMID 39987960