Abstract IA031: Equitable access to clinical trials: The role of community healthcare systems

Abstract

Abstract Approximately 85% of US cancer care is delivered in community healthcare systems, most of which have no formal affiliation with academic programs and do not identify the research mission as a core responsibility. Therefore, most community-based cancer programs are research deserts. Yet there is strong evidence to support the oft-cited statement: 'the best treatment is a clinical trial.' In this age of rapid-fire discovery and clinical trials driven by deep knowledge of cancer biology and drug chemistry, coupled with close regulatory oversight, clinical trials carry much smaller risk for participants than ever before. In the end, clinical trials provide access to tomorrow's treatment, today. The socio-ecological model of healthcare recognizes that most problems and solutions reside at the levels of the individual, clinician, organization and social policy. As the number of actors sequentially diminishes from the individual to the social policy levels, the potential enduring impact of interventions sequentially rises. Interventions directly targeting the individual level are least efficient, those that target key social policies have the greatest enduring impact. So with the wicked challenge of inequitable clinical trials access. We will focus on the institutional level in my solutions-oriented discussion of equitable access to clinical trials. Using the NCI's Minority-Underserved NCORP progam and the Baptist Memorial Health Care Corporation as living examples, we will review intervention frameworks, objectively analyze the barriers to clinical trials access, and provide a pragmatic discussion of stakeholder-centered approaches to building clincial trials infrastructure in the places where people routinely seek care. We propose approaches to integrate clincal research as a core component of cancer care delivery in community healthcare systems and make the case that key external stakeholders, including patient advocacy groups, sponsors of research and healthcare policymakers must meet the target population where they reside. That connection can only happen by building clinical trials infrastructure and manpower within community healthcare systems. Citation Format: Ray U. Osarogiagbon. Equitable access to clinical trials: The role of community healthcare systems [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr IA031.