Characterization of Educational and Behavioral Intervention Trials in U.S. Oncology Specialties

Abstract

Disproportionate educational deficits in U.S. minority cancer populations have been linked to decreased therapy compliance, suboptimal disease outcomes and low clinical trial enrollment rates. Investigating strategies to improve patient education and health-promoting behaviors is therefore critical to mitigating disparities in oncology. In this study, we characterized for the first time all current educational and behavioral intervention (EBI) studies in U.S. cancer specialties.EBI clinical trials registered on clinicaltrials.gov with completed, active or planned enrollment of adult cancer patients were collated. Clinical trials that were terminated, withdrawn or suspended were excluded from the analysis. EBI trial records were individually appraised and assigned into one of four subtype categories: prevention/screening, treatment experience/compliance, survivorship or clinical trial receptiveness study. EBI trials were further binned based on cancer specialty and type of target demographic. EBI study subtypes were compared between specialties using Chi-squared tests of independence.A total of 654 trials were reviewed, 567 met inclusion criteria. Trial subtype composition is summarized in Table 1. EBI trial subtypes included: 1) 225 prevention/screening (39.7%), 210 treatment experience/compliance (37%), 118 survivorship (20.8%), and 14 clinical trial receptiveness (2.5%). EBI trials with a recruitment focus of racial/ethnic minorities and women were 79 (13.9%) and 128 (22.6%) respectively, most of which are within medical oncology (P < 0.0001). Radiation oncology had no minority focused, survivorship or clinical trial receptiveness studies.We provide the first report of U.S. EBI trials in adult oncology. Interventions targeted towards racial/ethnic minorities are lacking in oncology and are non-existent in radiation oncology. In addition to developing EBI efforts with racial/ethnic minority cancer populations, studies aimed at improving survivorship and clinical trial receptiveness and enrollment within radiation oncology are greatly needed.