Bilingual Houston area Latinos surveyed for 7 continuous days with objective and subjective assessments using accelerometer and smart phone.

36 questionnaires at the first visit (a total of 474 questions) and 25 questionnaires at the second visit (a total of 278 questions), taking about 60 to 90 minutes to complete each visit.

Questionnaires

Small device worn on the hip for 7 consecutive days that measures physical activity.

Accelerometer

Questions on smart phone up to 5 times a day for 7 days taking about 5-7 minutes to complete each time.

Smart Phone

Larkin L. Strong, PHD

The goal of this research study is to learn how cultural, environmental, and interpersonal experiences, as well as personal thoughts and feelings, influence cancer risk behaviors among Latino residents of Houston, Texas.

Study Participation:

If you are eligible and choose to take part in this study, you can choose to visit the clinic 2 times or have research staff visit you in your home or a community setting (such as a church or community center) 2 times.

At the first visit (this is the same visit where you complete the in-person screening test):

* You will have your height, weight, and waistline measured.
* You will be given a smart phone to take home with you. You will answer questions on the smart phone up to 5 times a day for 7 days. The phone will beep at random times (4 times per day) and set times (in the evening) to prompt you to answer questions about what you are doing and your current thoughts and feelings. These questions should take about 5-7 minutes to complete each time.
* You will be given an accelerometer (a movement meter). The accelerometer is a small device worn on your hip that measures the amount of physical activity you do. You will wear the accelerometer for 7 days in a row.
* You will receive training on how to use the smart phone and the accelerometer.

At the second visit, you will return the smart phone and the accelerometer.

At both study visits, you will be asked to complete questionnaires that ask about your feelings, moods, and behaviors. You will complete 36 questionnaires at the first visit (a total of 474 questions) and 25 questionnaires at the second visit (a total of 278 questions). These questionnaires should take about 60 to 90 minutes to complete.

Throughout the study, you will be contacted by mail, email, or telephone for reminders of visits. You will be reminded before each visit. You will be asked to provide the names and contact information for family and/or friends should the study staff have trouble reaching you.

Confidentiality:

Each time you complete a survey on the smart phone, your answers will be saved on the phone. When you return the phone, all of your answers will be downloaded from the phone to a secure server, where they will be stored. Then, all of your information will be deleted from the phone. Your name or other personal information will not be stored on the phone.

Your name and other identifying information will not be stored together in the same files as other information you provide during your participation in the study. The link between your identifying information and other data will be kept in a separate file and securely protected. The link between you and the study data will be destroyed 5 years after the study ends.

Length of Study:

You will be considered off study when you complete the second visit.

This is an investigational study.

Up to 225 participants will take part in this study. All will be enrolled at MD Anderson.

Determinants of Multiple Health Risk Behaviors Among Latinos

Outcomes assessed through daily diary ecological momentary assessment (EMA) data and coded as yes (engaged in activity) or no (did not engage in activity). EMA assessments done over 7 contiguous days in a questionnaire computer-administered self-interview format.

National Cancer Institute (NCI)

National Institutes of Health (NIH)

M.D. Anderson Cancer Center

Behaviors and Mental Disorders

All Conditions

Depressive Disorder

Depression

Behavioral Symptoms

Symptom information will be collected using an automated telephone system, approximately 5 minutes per week.

Telephone Intervention

3 questionnaires and one-on-one interviews during 3 regularly scheduled clinic visits.

Questionnaires & Interviews

Tito Mendoza, BS,MED,MS,PHD

The goal of this research study is to learn how well a telephone system works for improving the management of emotional distress, sadness, and/or depression in patients who are being treated for cancer.

Study Groups:

If you agree to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 2 groups: telephone intervention or standard care. You have an equal chance of being assigned to either group.

No matter which group you are assigned to, you will be asked to tell your doctor and/or nurse about all symptoms you may be experiencing during your regularly scheduled visits. You will also be asked to call your doctor and/or nurse right away when your symptoms are severe. The doctor and/or nurse will give you instructions about calling when your symptoms are severe.

You will receive educational material about emotional distress, sadness, and depression in people who are being treated for cancer. The material also will tell you about community resources that are available for people with cancer.

Feedback Group:

If you are assigned to the feedback group, your symptom information will be collected using a telephone system. You will be asked to rate 13 symptoms, such as sadness, emotional distress, and fatigue, on a scale of 0 to 10 using the touch tone key pad of your telephone. The 0 means that you are not having the symptom at all, and the 10 means that the symptom is as bad as you can imagine.

If you rate either of the 2 symptoms of sadness and/or emotional distress as moderate or severe, then the telephone system will send a message to the research staff and your doctor or nurse right away. Only the symptoms of sadness and emotional distress will be reported right away to the doctor or nurse and the research staff. If you answer moderate to severe to any other questions, it will not be sent right away to the doctor, nurse or study staff. The telephone system usually works very well. But, if for any reason the telephone system is not working, the research staff will report any moderate or severe sadness or distress to your doctor or nurse. Your doctor or nurse also will receive a written summary of your symptom ratings before your next clinic visit.

Standard Care Group:

If you are assigned to the standard care group, your symptom information will not be collected using the telephone system. You will be asked to tell your doctor and/or nurse about all symptoms you may be experiencing.

Telephone System:

For patients in the feedback group, the research staff will teach you how to use a telephone system for measuring your symptoms. The research staff also will ask you to practice using the telephone system. The telephone system will call you 1 time a week for 16 weeks. You will be asked to rate your symptoms and how much the symptoms interfere with your life. You can set up a time to receive the phone calls that works best for you. Rating your symptoms using the telephone system will take about 5 minutes for each call.

If you do not answer the telephone system on the first call, then the system will try to reach you 3 more times. If you do not answer after the fourth try, then the research staff will call you to find out why you could not answer the telephone system. If you prefer, the research staff will change the day or time that the telephone system calls you.

Questionnaires and Interviews:

You will be asked to fill out 3 questionnaires during 3 regularly scheduled clinic visits. These questionnaires ask questions about pain, stress, sadness, quality of life, and other symptoms you may be experiencing. You will also compete an interview at the first and third visit. During the interview, you will be asked questions about your feelings and emotions. The questionnaires and interview will be completed at the following times:

* At the first visit when you enroll in the study, 8-10 weeks after the study begins, and 14-16 weeks after the study begins, you will complete the questionnaires. This will take about 45 minutes.
* At the first visit and 14-16 weeks after the study begins, you will complete a short interview. Completing the interview will take about 15 minutes.

Length of Study:

Your participation in this study will last up to 16 weeks.

This is an investigational study.

Up to 166 patients will take part in this study. All will be enrolled at MD Anderson.

Identification and Treatment of Depression

Identification and Treatment of Depression in Underserved African American and Latino Patients With Cancer

Robert Wood Johnson Foundation

Neoplasms

Digestive System Diseases

Symptoms and General Pathology

Diseases and Abnormalities at or Before Birth

Nutritional and Metabolic Diseases

Rare Diseases

Adenoma

Stomach Neoplasms

Colorectal Neoplasms

Syndrome

Colorectal Neoplasms, Hereditary Nonpolyposis

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Neoplastic Syndromes, Hereditary

Genetic Diseases, Inborn

DNA Repair-Deficiency Disorders

Metabolic Diseases

Stomach Cancer

Familial Colorectal Cancer

Marcia R. Cruz-Correa, MD, PhD

Jessica Hernandez, RN, BS, CON

Jessica Hernandez, RN, MS

Jessica Hernandez, RN, BS, MS

Reynold Lopez-Enriquez, MD

Rafael A. Mosquera-Fernandez, MD

Carlos G. Micames-Caceres, MD

Segundo Rodriguez-Quilichini, MD

Elba Caraballo, PhD

Maria Gonzalez Pons, PhD

Colorectal cancer (CRC) is the second leading cause of cancer in Puerto Rico (PR) accounting for approximately 1,500 individuals annually, which represent 12% of all cancer cases in the island. The genetic epidemiology of CRC among Hispanic populations is not well studied, hence studies focused on large, well defined ethnic groups such as Puerto Ricans, are clearly warranted. The first step towards evaluating the molecular, environmental, and genetic epidemiology of CRC in PR is to establish a population-based familial CRC registry. The following specific aims have been proposed:

Specific Aim 1: To prospectively identify and recruit approximately 300 CRC probands from two distinct geographical areas in PR (Metropolitan and Southern Region). From each proband the investigators will obtain a pedigree extended to second-degree relatives and cousins. Assuming 10% will be positive for a family history of CRC, the investigators will then recruit all 30 probands with a family history of CRC and a sample of 15 family-history negative probands and obtain: paraffin-embedded tumors blocks, blood samples, risk factor and food frequency questionnaires.

Specific Aim 2: To prospectively identify and recruit selected relatives (parents, grandparents, and same generation relatives - cousins and siblings) from the 45 probands identified in Specific Aim 1. In addition, for siblings and cousins of probands (i.e. relatives in the same generation as the proband), the investigators will obtain risk factor and food frequency questionnaires, and for colorectal cancer cases, tumor blocks and pathology reports of their cancers.

Specific Aim 3: To estimate from this pilot study the following parameters: (a) response rate of probands and their selected relatives; (b) response rate of participants for each data item; (c) family history of CRC and other cancers; (d) number of living first- and second-degree relatives and cousins of probands; (e) number of these relatives who live in the same household and region/municipality; (f) prevalence/distribution of selected risk factors from the administered questionnaires.

Data obtained from this study will serve as the foundation for our large, island-wide, population-based, genetic-epidemiologic study of familial colorectal cancer in Puerto Rico. Through this feasibility study, we will assess the feasibility: (1) of recruiting colorectal cancer patients using the PR Central Cancer Registry, (2) of evaluating family pedigrees and recruiting the relatives of probands (3) obtaining tumor, blood, medical and exposure information from both probands and their relatives. Providing important data on Hispanic populations that would enable family-based case-control studies of risk factors for CRC, with an emphasis on candidate genes in selected carcinogenic pathways, genetic and epigenetic modifications. Furthermore, information obtained from this proposal may serve to identify families that would be informative for linkage studies to potentially map new genes, evaluate genotype-phenotype correlations, gene-gene and gene-environmental interactions.

Tumor blocks (colorectal tumors) and blood samples

Familial Colorectal Cancer Registry in Hispanics

Familial Colorectal Cancer In Puerto Rico: A Feasibility Study

University of Puerto Rico

Associate Professor of Medicine, Biochemistry and Surgery at University of Puerto Rico School of Medicine, Director of Gastrointestinal Oncology at the University of Puerto Rico (UPR) Comprehensive Cancer Center

Best clinical practices plus culturally print materials

Best clinical practices plus standard print materials

Best clinical practices alone: This intervention arm includes best clinical practices (or standard/usual care at MSSM) and no additional print materials.

This intervention arm includes best clinical practices (or usual care at MSSM) and the culturally relevant print materials developed for this study.

Best clinical practices plus culturally targeted print materials

This intervention arm includes best clinical practices (or usual care at MSSM) and the standard CRC screening print materials developed by the Centers for Disease Control (CDC).

This intervention arm includes best clinical practices (or standard/usual care at MSSM) and no additional print materials.

Best clinical practices alone

Katherine DuHamel, PhD

Lina Jandorf, MA

The proposed study seeks to investigate the impact of a culturally targeted print educational intervention on rates of colorectal cancer (CRC) screening via colonoscopy among Hispanics. If, as expected, the addition of culturally targeted materials to best clinical practices as compared to a) best clinical practices plus standard materials or b) best clinical practices alone leads to higher rates of CRC screening via colonoscopy then the culturally targeted print educational materials can be easily disseminated among this rapidly growing minority group who have low rates of CRC screening and whose disease is detected at later, less curable stages.

CRC is the 2nd leading cause of cancer death among Hispanic women and men. Hispanics are more likely to be diagnosed at more advanced disease stages compared to non-Hispanic whites and have a lower probability of survival. A key way to decrease mortality from CRC among Hispanics is to increase rates of CRC screening and thereby early detection of CRC. To address low screening rates, thereby increasing the prevention and early detection of CRC, the proposed research seeks to increase CRC colonoscopy screening among Hispanics. The primary aim is to investigate the impact of a culturally targeted print educational intervention designed to increase CRC screening via colonoscopy in a diverse group of Hispanics 50 years of age and older. Our long standing (since 1999) research platform has included significant community input through ongoing meetings with our Community Advisory Board (CAB) soliciting their viewpoints and concerns. In addition, we consult with key community members on an ongoing basis for additional input. A Randomized Clinical Trial (RCT) will be conducted with 400 Hispanics within the context of the best clinical practices currently provided at Mount Sinai. There are three study arms: 1) best clinical practices plus culturally relevant print materials, 2) best clinical practices plus standard print materials and 3) best clinical practices alone. These three arms will allow the investigation of the addition of print materials and the comparison of culturally relevant to standard print materials to assess the differential impact of each print format. This comparison controls for the possible benefit of adding standard print materials to best clinical practices and allows for investigation of the additional benefit of culturally targeted relevant materials over and above that of standard materials. Further, by including feedback from the community, we will be able to clearly understand the benefits of, and be able to disseminate culturally targeted materials among this rapidly growing minority group. If, as hypothesized, the addition of the culturally targeted print materials leads to higher rates of colonoscopy, they can then be easily disseminated among health care settings treating Hispanics.

Improving Colorectal Cancer Screening for Diverse Hispanics in Urban Primary Care

Improving Colorectal Cancer (CRC) Screening for Diverse Hispanics in an Urban Primary Care Setting

Comparison of physician recommended colonoscopy (post intervention) obtained at approximately 3 months and 6 months (via self report) and at 12 months (as per chart review), to that of colonoscopy obtained at baseline.

Memorial Sloan Kettering Cancer Center

Icahn School of Medicine at Mount Sinai

Cancer Clinical Trials Education Program is offered to English- and Spanish-speaking Hispanics in the experimental arm. This program was designed to promote increased clinical trials literacy among Hispanic Americans. Increased clinical trials knowledge and a better understanding of clinical trials is anticipated to create more positive attitudes, and perceptions about clinical trials among Hispanic Americans.

The Neighborhood Watch Program created by the Bureau of Justice Assistance and the National Crime Prevention Council was selected for inclusion in the control arm of this study. It provided participants with a program of equivalent length and format, as well as an equivalent focus on improving the well-being of Hispanic Americans. It also provided an opportunity to evaluate the impact of the Neighborhood Watch Program.

Hispanic Americans are underrepresented in cancer clinical trials. The purpose of this study is to develop and test programs designed to reduce barriers and increase facilitators associated with cancer clinical trials participation for Hispanic Americans.

Cancer Clinical Trials Education Program

Georgia R Sadler, PhD

Vanessa L Malcarne, PhD

Hispanic Americans are underrepresented in cancer clinical trials. The purpose of this study is to develop and test education programs designed to reduce barriers and Increase facilitators associated with cancer clinical trials participation for Hispanic Americans. Focus groups were conducted with Hispanic American men and women to obtain culturally-linked attitudes related to clinical trials participation. This information was used to create a prototypic educational program anticipated to increase participation in clinical trials. It was then vetted and honed via additional focus groups.

Simultaneously, a validation study was conducted with Hispanic Americans for a packet of psychosocial instruments that could be used for a subsequent randomized controlled trial to evaluate the impact of the clinical trials education program.

The finalized clinical trials education program was tested via a randomized controlled trial. Participants assigned to the experimental group received the clinical trials education program, while participants in the control arm were administered a comparable, but non-relevant education program. Recruitment to this study has been completed.

Clinical Trials Education Program for Hispanic Americans

Randomized Controlled Clinical Trials Education Program for Hispanic Americans

To assess the impact of the intervention arm on participants' knowledge, attitudes, and perceptions related to clinical trials, they were asked to complete the same surveys given at baseline during post-intervention immediately after intervention.

At the three-month follow-up, participants were mailed the final packet of survey instruments to complete and return in a stamped, self-addressed envelope.

Two weeks after receiving the intervention, participants were mailed an invitation to participate in a different research study by a researcher not previously known to them, to assess whether the intervention influenced behavior related to clinical trials invitations.

San Diego State University

University of California, San Diego

Professor

Antiemetics

Gastrointestinal Agents

All Drugs and Chemicals

Emetics

Participants randomized to this arm will receive Spanish-Language Self-Administered Training + Usual Care.

Patients will be given the Spanish-language version of "Chemotherapy and You: Support for People with Cancer" ("La quimioterapia y usted: Apoyo para las personas con cancer") published by NCI. The intervention associate will review how it provides answers to common questions about chemotherapy, describes common side effects and their management, and identifies ways to obtain additional information. Patients will also be provided with a list of local support groups for cancer patients and informed that a social worker is available to meet with them without charge to discuss personal concerns or practical problems. At the first infusion, oncology nurses will provide all patients with standard education about the chemotherapy agents and anti-emetic agents to be administered, possible adverse reactions to these agents, and recommended precautions for avoiding illness and maintaining health.

Patients will receive usual care. In addition, a Spanish-speaking intervention associate will spend an extra 10 minutes on the day usual care is initiated reviewing the self-administered training materials in Spanish titled "Cómo tratar el estrés durante la quimioterapia." Materials consist of an 18-minute DVD (also available as a videocassette (VC)), a 28-minute CD (also available as an audiocassette (AC)), a 16-page booklet, and a workbook to record practice and use of stress management techniques. Participants are instructed to first view the DVD/VC and then follow directions in the booklet and on the CD/AC about training, practice, and use of stress management techniques.

Spanish-Language Self-Administered Training Plus Usual Care (SL-SAT)

Usual Care Only

Brian D Gonzalez, Ph.D

Cancer patients receiving chemotherapy experience a number of aversive symptoms that are accompanied by declines in physical and mental well-being. Although the benefits of stress management training interventions on quality of life are well documented, there are no published studies examining the efficacy of these interventions among Hispanic women and Latinas (hereafter referred to as Latinas) receiving chemotherapy. This dearth of research reflects the general lack of stress management interventions for cancer patients whose preferred language is Spanish. Simply translating existing English-language interventions into Spanish may seem to be a solution for the lack of Spanish-language stress management interventions. This approach, however, does not take into account cultural values, beliefs and situational realities that are likely to contribute to patients' uptake of health promoting behaviors. The proposed research seeks to address this gap by evaluating a stress management training intervention developed specifically for Latinas beginning chemotherapy for cancer.

In response to the identified need, the investigators created a Spanish-Language Self-Administered Stress Management Training (SL-SAT) intervention "Cómo tratar el estrés durante la quimioterapia" ("How to manage stress during chemotherapy"). The intervention is based on an English-language self-administered stress management training intervention the investigators previously developed and showed to be efficacious in a randomized controlled trial. Development of the Spanish-language intervention was the result of extensive use of ethnographic and learner verification methods, guided by a community-based participatory research approach. Similar to the English-language version, the SL-SAT intervention consists of a digital video disc(DVD), booklet, and audio compact disc (CD), and provides instruction in three well-established stress management techniques: deep breathing; progressive muscle relaxation and guided imagery; and use of coping self-statements. The proposed study will evaluate the efficacy of this transcreated intervention in a randomized controlled trial involving Spanish-speaking Latinas about to begin chemotherapy for cancer. Following a baseline assessment, participants will receive usual care or usual care plus the SL-SAT intervention. Participants will be reassessed on study measures approximately 7 and 13 weeks after the baseline assessment.

Specific aims of the project are:

1. To evaluate the impact of Cómo tratar el estrés durante la quimioterapia on quality of life during chemotherapy relative to usual care only. Consistent with prior research, the investigators hypothesize that the intervention will result in better psychological and spiritual well-being and less anxiety, depression, and cancer-related distress.
2. To investigate the mechanism by which Cómo tratar el estrés durante la quimioterapia improves quality of life during chemotherapy. Based on relevant theory and prior research, the investigators hypothesize that improvement in perceived self-efficacy in managing stress will explain beneficial effects of the intervention on quality of life outcomes.
3. To examine whether communication and sociocultural factors associated with the acculturation process moderate the impact of Cómo tratar el estrés durante la quimioterapia on quality of life. Based on relevant theory and prior research, the investigators hypothesize that, among women who receive the intervention, those who have a stronger preference for communicating and receiving information in Spanish will benefit more.

Stress Management Training for Latinas Receiving Chemotherapy

This 14-item measure has been used widely in behavioral oncology research because it does not assess somatic symptoms of anxiety and depression (e.g., fatigue) that may be confounded with disease- or treatment-related symptoms. The validated Spanish version will be used in the current study. Analyses will focus on the total score as a primary outcome.

The 8-item Intrusion Subscale from the IES-R measures intrusive thoughts, such as dreams, images, and reminders of a stressful event. In the present study, as in other research, it will be keyed to "your cancer and cancer diagnosis" in order to provide a measure of cancer-related distress. The IES-R has been validated in numerous populations and is widely used in cancer research. The validated Spanish version will be used in the current study.

This 27-item measure has been used to assess health-related quality of life in patients with many different types of cancer. The validated Spanish version will be used in the current study.The FACT-G yields scores for physical, social/family, emotional, and functional well-being. Analyses will focus on emotional well-being scores as a primary outcome; other scales will be examined as secondary outcomes.

This 12-item scale is a valid and reliable measure of spiritual well-being in cancer patients. The validated Spanish version will be used in the current study. The FACIT-Sp yields scores for meaning/peace and faith as well as a total score. Analyses will focus on total FACIT-Sp scores as a primary outcome.

This scale is a valid and reliable measure of the severity of 32 symptoms commonly experienced by cancer patients (e.g., nausea, vomiting, and lack of appetite). The Spanish version produced by the original scale developers will be used in the current study. Responses yield measures of the severity of individual symptoms that can also be combined to yield indices of total, physical, and psychological symptom severity. MSAS-SF summary scale scores will be examined as secondary outcomes in the current study.

This 17-item measure assesses perceived self-efficacy in managing stress. Items closely mirror stress management strategies that comprise the SL-SAT intervention. Based on our conceptual model and previous research with cancer patients, the investigators will examine whether perceived self-efficacy, as measured by the MOCS, mediates the expected positive effects of the SL-SAT intervention on the primary outcomes

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Determinants of Multiple Health Risk Behaviors Among Latinos	NCT01479257	Cancer Risk Factors in...	Questionnaires Accelerometer Smart Phone	18 Years - 65 Years	M.D. Anderson Cancer Center
Identification and Treatment of Depression	NCT00863200	Cancer	Telephone Inter... Questionnaires ...	18 Years -	M.D. Anderson Cancer Center
Familial Colorectal Cancer Registry in Hispanics	NCT00927680	Colorectal Canc... Gastric Cancer Colorectal Neop... Colorectal Aden... Lynch Syndrome		15 Years -	University of Puerto Rico
Improving Colorectal Cancer Screening for Diverse Hispanics in Urban Primary Care	NCT01569620	Colorectal Canc...	Best clinical p... Best clinical p... Best clinical p...	50 Years - 85 Years	Icahn School of Medicine at Mount Sinai
Clinical Trials Education Program for Hispanic Americans	NCT02083770	Cancer	Cancer Clinical...	21 Years -	University of California, San Diego
Clinical Trials Education Program for Hispanic Americans	NCT02083770	Cancer	Cancer Clinical...	21 Years -	University of California, San Diego
Improving Colorectal Cancer Screening for Diverse Hispanics in Urban Primary Care	NCT01569620	Colorectal Canc...	Best clinical p... Best clinical p... Best clinical p...	50 Years - 85 Years	Icahn School of Medicine at Mount Sinai
Stress Management Training for Latinas Receiving Chemotherapy	NCT01599520	Cancer Stress	Spanish-Languag... Usual Care Only	18 Years -	H. Lee Moffitt Cancer Center and Research Institute
Stress Management Training for Latinas Receiving Chemotherapy	NCT01599520	Cancer Stress	Spanish-Languag... Usual Care Only	18 Years -	H. Lee Moffitt Cancer Center and Research Institute

Spots Global Cancer Trial Database for hispanics

Every month we try and update this database with for hispanics cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for hispanics

Every month we try and update this database with for hispanics cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for hispanics cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.