A Multilevel Intervention to Improve Timely Cancer Detection and Treatment Initiation

Overview

This study evaluates whether the Potlako+ intervention of community education, clinical provider support, and patient navigation can improve access to cancer case for patients presenting with symptoms of cancer. Half of communities will receive the Potlako+ intervention, while the other communities will continue to receive standard programs.

Description

The Potlako+ trial is a pair-matched, community-randomized study involving 20 rural and peri-urban communities in Botswana (population ~190,100 with ~100,000 30 years or older). Communities will be randomized 1:1 to the Potlako+ intervention versus standard care. The goal of the intervention is to identify individuals with symptoms/signs suggestive of cancer and expedite diagnosis (and treatment).

The trial includes a community education component focused on cancer awareness and importance of early diagnosis and a patient navigation component that aims to expedite the diagnostic evaluation. Community education will be directed at approximately 50,000 community residents (30 years and older). We anticipate approximately 1500 cancer suspects will be identified by their clinic providers.

Eligibility

1. Community members
   1. Inclusion Criteria:
      • Botswana citizen
      • Age 30 years or older
      • engaged in longitudinal care for chronic health problem
      • resident of study community
   2. Exclusion Criteria:
      • Involuntary incarceration
      • Educational messaging could interfere with clinical management or increase distress in the opinion or clinic or research staff 2. Cancer suspects
   3. Inclusion Criteria:
      • Botswana citizen
      • Age 30 years or older
      • resident of study community
      • Recorded as a cancer suspect by clinic staff
   4. Exclusion Criteria
      • Involuntary incarceration
      • Unable or unwilling to provide confirmation of informed consent
      • Already engaged in oncology care