Overview
cancer
CANCER
Briefly, the trial is being undertaken at multiple sites, with clusters defined at the level of the cancer care team; each cluster includes between 2 and 20 oncologists/hematologists and mid-level providers. The trial’s stepped wedge design (SWD) randomized the order of E2C2 implementation among 15 clusters, with 3 clusters randomized to each of 5 sequences. All clusters will be observed for 6 months under the control condition prior to the transition of clusters in the first sequence (step 1). Transitions from control to intervention occur 8 months apart.This SW-CRT design allows data to be sequentially collected from all clusters for a minimum of 6 months during pre-E2C2 usual care and a minimum of 8 months during the implementation phase. This design also allows us to compare outcomes both across intervention groups and with historical controls at the same clinic, supporting a rigorous assessment of the impact of E2C2 on controlling SPPADE symptoms among patients with cancer while also exploring factors relevant to its implementation across all sites.There is no transition period between control and intervention steps in a sequence, as it is anticipated that the impact of the intervention will be immediate. Due to the nature of the intervention, blinding was deemed infeasible.