Access to Care Pilot for ED-Presenting Head and Neck Cancer Patients (ENRICH-HNC)

Starting soon · Not applicable

Conditions studied: Head and Neck Neoplasms, Emergency Department Presentation, Head and Neck Cancer (H&N)

In brief

Patients diagnosed with head and neck cancer (HNC) after presenting to an emergency department (ED) often face significant delays in diagnosis and treatment. These patients are frequently younger, underinsured, and experience multiple socioeconomic and systems-level barriers to accessing timely cancer care. Delays of more than 30 days have been associated with worse outcomes, including higher recurrence rates and reduced survival. This pilot study will evaluate the feasibility and early impact of a community-based navigation program designed to improve access to timely care for ED-presenting HNC patients. The study embeds trained Community Health Support Specialists (CHSS) from the Engaging Navigators to Reduce Inequities in Cancer Health (ENRICH) program into the ED-to-treatment pathway. After ED discharge, CHSS staff will contact participants by telephone or text message to identify barriers to care-such as transportation, insurance, housing, or communication challenges-and connect them with appropriate community or institutional resources. All participants will receive the CHSS navigation intervention. Outcomes will be compared with a historical cohort of similar ED-presenting HNC patients treated prior to program implementation. The primary outcomes are time from ED discharge to diagnostic biopsy and time from ED discharge to initiation of definitive treatment. Secondary outcomes include feasibility, measured as the proportion of participants who complete CHSS navigation, and exploratory analyses of the types of barriers identified and resolved. Findings from this pilot will generate preliminary data to inform larger studies aimed at improving access, reducing disparities, and accelerating treatment for head and neck cancer patients who first present in the emergency setting.

Key facts

Study ID

NCT07225725

Run by

University of Tennessee

People needed

24

Starts

2026-02-01

Expected to finish

2027-01-31

Last updated by the study team

2026-01-22

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age 18 years or older
• Presentation to the emergency department (ED) with a new or suspected head and neck cancer (including oral cavity, oropharynx, hypopharynx, larynx, salivary gland, cutaneous, sinonasal, nasopharyngeal, thyroid, or metastatic disease with unknown primary)
• Residence within the regional catchment area of participating UTHSC-affiliated hospitals (Methodist University Hospital or Regional One Health)
• Ability to provide informed consent electronically using REDCap eConsent after ED discharge
• Has a valid telephone number for post-discharge contact

You may not qualify if…

• Prior or ongoing established head and neck oncology care at the time of ED presentation
• Currently receiving hospice or palliative-only care
• Incarcerated individuals
• Inability to complete electronic informed consent (e.g., lack of decisional capacity or inability to complete consent even with staff assistance)
• Lacks reliable telephone access or is unable to be reached after three documented contact attempts by study staff
• Non-English or non-Spanish speaking when interpreter services are unavailable
• Expected survival less than four weeks, as determined by the treating clinical team

Where it is running

• Methodist University Hospital — Orlando, Florida, United States
• Regional One Health — Memphis, Tennessee, United States

Full record on ClinicalTrials.gov

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