What question did this study set out to answer?

To assess whether a multilevel intervention including community health workers enhances patient knowledge and receipt of precision cancer care compared to standard interventions.

April 16, 2026Open Access

Community Health Workers and Precision Medicine: Results of A Randomized Clinical Trial on Patient Knowledge, Healthcare Use, and Evidence-Based Care

Key Points

To assess whether a multilevel intervention including community health workers enhances patient knowledge and receipt of precision cancer care compared to standard interventions.
Conducted a randomized clinical trial in a community oncology clinic.
Participants included low-income and racial and ethnic minority adults with newly diagnosed or relapsed cancer.
Compared two-level (usual care plus clinician training) and three-level (with patient education by community health workers) interventions.
Evaluated outcomes such as precision medicine knowledge, health-related quality of life, patient activation, and healthcare utilization.
The three-level intervention led to a significant increase in precision medicine knowledge (mean difference of 4.17, p < 0.001).
Participants reported higher patient activation and satisfaction with care.
Fewer emergency department visits and hospitalizations were observed in the intervention group.
There was a greater receipt of molecular testing and targeted therapies in the intervention group.

Abstract

Background/Objectives: Molecular testing and targeted therapeutics remain inequitably delivered among patients with cancer. In response, we refined a multilevel intervention directed at clinicians, payers, and patients to determine whether it could improve patient knowledge and receipt of precision cancer care more than an intervention directed at clinicians and payers alone. Methods: This patient-level randomized trial was conducted in a community oncology clinic among low income and racial and ethnic minority adults who were newly diagnosed with cancer or relapsed disease. We compared a two-level enhanced usual care intervention, in which patients received usual care, clinicians received annual precision medicine training, and payers eliminated prior authorization for molecular testing and targeted therapeutics (control group), with a three-level intervention, in which patients received enhanced usual care along with a patient-level 12 month precision medicine education component led by community health workers (intervention group). The primary outcome was precision medicine knowledge. Secondary outcomes were health-related quality of life (HRQOL), patient activation, satisfaction, acute care use, molecular testing, and targeted treatment. Results: Among 110 participants, the three-level intervention resulted in greater improvement in knowledge of precision medicine compared with the two-level control group (mean difference of 4.17, 95% CI of 2.33–7.48; p < 0.001). Intervention participants also had greater patient activation and satisfaction with care, fewer emergency department visits and hospitalizations, and greater receipt of molecular testing and targeted therapy compared with patients in the control group. Conclusions: Multilevel interventions that include patient-level education can improve care delivery gaps. Trial Registration: clinicaltrials.gov, NCT04843332.

Community Health Workers and Precision Medicine: Results of A Randomized Clinical Trial on Patient Knowledge, Healthcare Use, and Evidence-Based Care

Key Points

Abstract

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