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“The Promise of Community-Based Advocacy and Education Efforts for Increasing Cancer Clinical Trials Accrual”

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Abstract

Only 3% of cancer patients participate in cancer clinical trials (CCTs). A number of barriers to participation, particularly for minority groups, can be addressed through community-focused education and advocacy efforts. Working with community partnerships, a pilot program sought to change knowledge, attitudes, and role behaviors among community leaders, primary care providers (PCPs), and clinical researchers about CCTs, to increase patient awareness of and participation in CCTs. A mixed method evaluation utilized quantitative analysis of surveys administered to participants during the program period (2006–2008) and qualitative data from interviews with key participants. Programmatic efforts were effective in increasing knowledge and training community leaders and PCPs to disseminate messages about clinical trials, and ultimately increasing patient inquiries about local trials. Training improved cultural competency skills among clinical researchers to recruit and retain CCT participants. Partnerships fostered new processes and structures to facilitate CCT participation in their communities. Clinical trials education and advocacy efforts through community partnerships have an important role in enhancing clinical trial access and in increasing clinical trial participation. Oncologists’ involvement in and leadership of such partnerships are critical to promoting CCT accrual, particularly for minority groups.

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References

  1. The American College of Surgeons Commission on Cancer Standards. Commission on Cancer, Cancer Program Standards. 2009, revised edition. Available from: http://www.facs.org/cancer/coc/cocprogramstandards.pdf. Accessed 1 December 2010

  2. National Cancer Institute. Digest Page: Boosting Cancer Trial Participation. Available from: http://www.cancer.gov/clinicaltrials/digestpage/boosting-trial-participation. Accessed 1 December 2010

  3. Murthy VH, Krumholz HM et al (2004) Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA 291(22):2720–2726

    Article  PubMed  CAS  Google Scholar 

  4. Nass SJ, Moses HL, Mendelsohn J. (eds) (2010) National Cancer Clinical Trials System for the 21st Century: reinvigorating the NCI Cooperative Group Program. Committee on Cancer Clinical Trials and the NCI Cooperative Group Program. Institute of Medicine of the National Academies

  5. Mills EJ, Seely D et al (2006) Barriers to participation in clinical trials of cancer: a meta-analysis and systematic review of patient-reported factors. Lancet Oncol 7(2):141–148

    Article  PubMed  Google Scholar 

  6. Markman M, Petersen J et al (2008) An examination of the influence of patient race and ethnicity on expressed interest in learning about cancer clinical trials. J Cancer Res Clin Oncol 134(1):115–118

    Article  PubMed  Google Scholar 

  7. Jones JM, Nyhof-Young J et al (2006) Identifying motivations and barriers to patient participation in clinical trials. J Cancer Educ 21(4):237–242

    Article  PubMed  Google Scholar 

  8. Corbie-Smith G, Thomas SB et al (2002) Distrust, race, and research. Arch Intern Med 162(21):2458–2463

    Article  PubMed  Google Scholar 

  9. Ford JG, Howerton MW et al (2008) Barriers to recruiting underrepresented populations to cancer clinical trials: a systematic review. Cancer 112(2):228–242

    Article  PubMed  Google Scholar 

  10. Comis RL, Miller JD et al (2009) Physician-related factors involved in patient decisions to enroll onto cancer clinical trials. J Oncol Pract 5(2):50–56

    Article  PubMed  Google Scholar 

  11. Ford JG, Howerton MW et al. (2005) Knowledge and access to information on recruitment of underrepresented populations to cancer clinical trials (evidence report/technology assessment no. 122). Baltimore (MD): Johns Hopkins University, Evidence-based Practice Center; AHRQ Publication No. 05-E019-2; Contract No. 290-02-0018

  12. Weinberg AD, Cooper HP et al (2004) Attitudes of primary care physicians and specialists about cancer clinical trials: a survey of Texas physicians. Tex Med 100(4):66–72

    PubMed  Google Scholar 

  13. Crosson K, Eisner E et al (2001) Primary care physicians’ attitudes, knowledge and practices related to cancer clinical trials. J Cancer Educ 16(4):188–192

    PubMed  CAS  Google Scholar 

  14. Sherwood PR, Given BA et al (2004) To refer or not to refer: factors that affect primary care provider referral of patients with cancer to clinical treatment trials. J Cancer Educ 19(1):58–65

    Article  PubMed  Google Scholar 

  15. Chen DT, Miller FG, Rosenstein DL (2003) Clinical research and the physician-patient relationship. Ann Intern Med 138(8):669–672

    PubMed  Google Scholar 

  16. Howerton MW, Gibbons MC et al (2007) Provider roles in the recruitment of underrepresented populations to cancer clinical trials. Cancer 109(3):465–476

    Article  PubMed  Google Scholar 

  17. Sateren WB et al (2002) How sociodemographics, presence of oncology specialists, and hospital cancer programs affect accrual to cancer treatment trials. J Clin Oncol 20(8):2109–2117

    Google Scholar 

  18. Brown RF, Butow PN et al (2007) Seeking informed consent to cancer clinical trials; evaluating the efficacy of doctor communication skills training. Psychooncology 16(6):507–516

    Article  PubMed  CAS  Google Scholar 

  19. Albrecht TL, Blanchard C et al (2008) Influence of clinical communication on patients’ decision making on participation in clinical trials. J Clin Oncol 26(16):2666–2673

    Article  PubMed  Google Scholar 

  20. Joseph G, Dohan D (2009) Diversity of participants in clinical trials in an academic medical center: the role of the ‘good study patient?’. Cancer 115(3):608–615, 1

    Article  PubMed  Google Scholar 

  21. Jenkins V, Fallowfield L et al (2005) Discussing randomized clinical trials of cancer therapy: evaluation of a Cancer Research UK training programme. BMJ 330(7488):400

    Article  PubMed  CAS  Google Scholar 

  22. Paskett ED, Cooper MR et al (2002) Clinical trial enrollment of rural patients with cancer. Cancer Pract 10(1):28–35

    Google Scholar 

  23. Wendler D, Kington R et al (2006) Are racial and ethnic minorities less willing to participate in health research? PLoS Med 3(2):e19, Epub 2005

    Article  PubMed  Google Scholar 

  24. Rogers EM (2003) Diffusion of innovations, 5th edn. Free Press, New York

    Google Scholar 

  25. Kelly JA, St Lawrence JS et al (1991) HIV risk behavior reduction following intervention with key opinion leaders of a population: an experimental analysis. Am J Public Health 81(2):168–171

    Article  PubMed  CAS  Google Scholar 

  26. Kelly JA, St Lawrence JS et al (1992) Community AIDS/HIV risk reduction: the effects of endorsements by popular people in three cities. Am J Public Health 82(11):1483–1489

    Article  PubMed  CAS  Google Scholar 

  27. Sanson-Fisher RW (2004) Diffusion of innovation theory for clinical change. Med J Aust 180(6 Suppl):S55–S56

    PubMed  Google Scholar 

  28. Lasker RD, Weiss ES (2003) Creating partnership synergy: the critical role of community stakeholders. J Health Hum Serv Adm 26(1):119–139

    PubMed  Google Scholar 

  29. Solomon FM, Eberl-Lefko AC, Michaels M et al (2005) Development of a linguistically and culturally appropriate booklet for Latino cancer survivors: lessons learned. Health Promot Pract 6(4):405–413

    Article  PubMed  Google Scholar 

  30. National Standards for Culturally and Linguistically Appropriate Services in Health Care (2001) U.S. Department of Health and Human Services Office of Minority Health

  31. Office of Human Research Protections Policy and Guidance (1995) Obtaining and documenting informed consent of subjects who do not speak English. Available from: http://www.hhs.gov/ohrp/policy/ic-non-e.html. Accessed 1 December 2010

  32. Pande PS, Neuman RP et al (2002) The Six Sigma way team fieldbook: an implementation guide for process improvement teams. McGraw-Hill, Columbus

    Google Scholar 

  33. Seifer SD, Michaels M et al (2010) Applying community-based participatory research principles and approaches in clinical trials: forging a new model for cancer clinical research. Prog Community Health Partnersh 4(1):37–46, Spring

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful for the funding and support of LIVESTRONG and the in-kind contribution of EmergingMed.

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Correspondence to Margo Michaels.

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Michaels, M., Weiss, E.S., Guidry, J.A. et al. “The Promise of Community-Based Advocacy and Education Efforts for Increasing Cancer Clinical Trials Accrual”. J Canc Educ 27, 67–74 (2012). https://doi.org/10.1007/s13187-011-0271-6

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  • DOI: https://doi.org/10.1007/s13187-011-0271-6

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