Participation In Cancer Clinical Trials Research Articles

Abstract A20: Hispanic patient navigation: An intervention to increase clinical trial participation

Abstract Background: Hispanics are the fastest-growing population in North Carolina and have unique health care needs related to culture and language. To meet their needs and address the historically low participation in cancer clinical trials, we developed a bilingual Hispanic Clinical Trial Navigator (HCTN) position to support Hispanic adult and pediatric patients treated at Wake Forest Baptist Comprehensive Cancer Center (WFBCCC). The HCTN is a novel approach to integrate culturally and linguistically competent navigation with support around clinical trial decision making. The purpose of this analysis was to evaluate the services provided during the program's first year and its impact on clinical trial participation. Methods: Retrospective data from 11/1/2015 to 10/31/2016 were obtained from a navigation database, WFBCCC cancer registry, and clinical trial system. Data are reported in the aggregate, and clinical trial participation rates were compared to data prior to the hiring of the HCTN (11/1/2014-10/31/2015). Results: There were 108 pediatric and adult patients navigated during the first year; 55 breast screening/diagnostic and 53 cancer treatment. The majority of patients were female (87%) with a mean age of 45 years. The most common diagnoses among treatment patients were breast (47%), hematologic (34%), and gastrointestinal (6%) malignancies. Major patient barriers identified include treatment logistics/transportation (87%), financial/insurance (70%) information/education (55%), and continuity of care (53%). In addition to education and referrals, the HCTN was able to remove potential barriers to trial participation through transportation assistance (31%), meal vouchers (21%), and parking validation (40%). In the year prior to the HCTN there were 88 newly diagnosed Hispanic patients with a clinical trial participation rate of 20% in treatment/non-treatment intervention studies. With HCTN navigation, clinical trial participation among Hispanic patients navigated was 34%. Conclusions: Our data indicate an initial success in increasing Hispanic participation in cancer clinical trials utilizing an HCTN. Navigation is now available in a majority of community cancer centers and is used as an opportunity to provide culturally and linguistically appropriate patient support around cancer and clinical trials. Placing HCTNs in cancer treatment settings could be a cost-effective and efficient method of providing navigation, while also facilitating state-of-the-art care through clinical trials. Opportunities exist for additional studies of navigation to increase clinical trial participation in underserved populations. Citation Format: Carla Strom, Kathryn E. Weaver, Jimmy Ruiz, Karen M. Winkfield. Hispanic patient navigation: An intervention to increase clinical trial participation [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A20.

Abstract A25: Community research navigators: The bridge to increasing ethnic minority participation in clinical research

Abstract The participation of underserved ethnic minorities in clinical research is critical to achieving progress in cancer control. Ethnic minority patient accrual in clinical trials is a formidable challenge that requires patient trust, commitment, and overcoming of barriers. Racial and ethnic minorities make up about 40% of the United States population, yet are not well represented in research studies. Less than 10% of all patients with cancer enrolled in clinical trials are minorities. Diverse participation may lead to more generalizable results for under-represented groups, more best practices for prevention and treatment to specific minority groups, increase in knowledge and awareness of disparities about cancer, and a more accurate reflection of the United States' increasingly diverse population. Although there is a proliferation of patient navigation programs to increase health care among the underserved, there is little known on its potential effects as a strategy to enhance minority clinical trial and biospecimen accrual. City of Hope has built a functional and sustainable program for addressing health inequity, which includes training a network of community research navigators (CRN) to address gaps in knowledge, medical mistrust, and access, and navigate participation and engagement of under-represented groups in research. The research navigator program draws from the patient navigation and promotora model and is a novel and innovative application to this approach. This approach has utility and applicability to address research participation barriers, including trust and referrals. It promises sustainability and cost effectiveness as trained CRNs can deliver the program. The Community Research Navigator (CRN) project enhances community advocates' capacity by training community health leaders/promotoras as community research navigators (CRN) to widen the dissemination of the clinical trial and research participation enrollment for increased ethnic minority participation in clinical trials and health-related research. CRNs attended a 1-day training on clinical trials and research. The training included educating and encouraging individuals to proactively think about and discuss clinical trial participation with their family, friends, and health care providers; disseminating information about specific research studies, targeting the African and Latino communities; and referring individuals to specific biospecimen, clinical trials, and population studies. In total, we trained and mentored a team of 14 CRNs. Participants were 24-66 years old; most were female (86%), Latino (69%), and single (43%). After participating in the training, participants were more likely to correctly define HIPAA (p=.040) and the types of clinical trials (p=.038). In addition, CRNs were more likely to encourage clinical research participation among their family after the training (p=0.034). Further, we measured confidence in various domains, including: increase in confidence in describing the purpose and process of clinical research (p=0.006); educating minority communities about clinical trials (p=0.045); and providing informational workshops/forums on clinical research (p=0.046). Participants had an increase in overall confidence (p=.033). Our findings demonstrate that the CRN strategy holds promise in increasing minority participation in cancer clinical trials. It is an innovative application of the extensively studied patient navigation approach that warrants research. Future research should focus on the CRN project as a cost-effective tool for enrollment and retention of ethnic minorities in cancer clinical trials and the potential of enhancing clinical trial understanding outcomes among participants. Citation Format: Marisela Garcia, Mayra Serrano, Alejandro Fernandez, Katty Nerio, Kimlin Ashing. Community research navigators: The bridge to increasing ethnic minority participation in clinical research [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A25.

Incorporating cultural values and use of technology platforms may help outreach Asian Americans in cancer clinical trial participation

Asian Americans are the fastest growing ethnic group in U.S. However, they represent only 1.7% of U.S. cancer clinical trial participants. This pilot study describes findings on barriers, promoters and recommendations related to cancer clinical trial participation from Asian Americans. The research team conducted 3 focus groups comprised of 21 community members and 4 key informant interviews with healthcare providers. Qualitative methodology was used to identify themes about cancer clinical trial participation. Barriers and promoters were categorized based on themes identified and previous study findings. Eight major themes and 5 recommendations were identified from the focus group data. Five major themes and 7 recommendations were identified from the key informant data. Asian Americans’ decision to participate in cancer clinical trials is largely influenced by their cultural values and practices such as altruism and family-based decision making process. Technology platforms provide promising venues to reach Asian Americans. Family-based decision making process, altruism, and the use of technology platforms may need to be considered when outreaching to Asian Americans on cancer clinical trial participation.

2433 Community forums as a channel for communicating with the public and to influence perceptions of cancer clinical trials

OBJECTIVES/SPECIFIC AIMS: Cancer clinical trials (CCTs) are vital tools in the advancement of cancer prevention and treatment. Yet, only 3%–5% of eligible patients enroll in CCTs. Low participation can be attributed, in part, to poor communication as well as a lack of awareness and understanding about CCTs. In order to increase participation in trials, interventions should foster meaningful communication about cancer prevention and CCTs, especially between medical professionals and members of the community. Community forums provide a channel to communicate about cancer with members public and to educate prospective participants about CCTs. Thus, our goal was to evaluate the efficacy of hosting community forums about cancer in order to educate the public and influence perceptions of CCT participation. METHODS/STUDY POPULATION: During the Spring of 2016, participants (n=51) who attended a community forum about CCTs completed a pretest and post-test survey assessing their understanding and perceptions of CCTs. RESULTS/ANTICIPATED RESULTS: Results from the pretest to post-test survey revealed a significant positive increase (p=0.01) in participants’ attitudes toward cancer clinical research as well as marginally significant increases in participants’ perceived subjective norms (p=0.06) about participating in CCTs and the perceived personal relevance (p=0.06) of clinical research participation pretest and post-test. DISCUSSION/SIGNIFICANCE OF IMPACT: Findings suggest that community forums about cancer and CCTs could lead to an increased awareness and understanding of CCTs among members of the population and could be useful channels for cancer interventions.

Patient comorbid conditions and cancer clinical trial participation.

6540Background: The American Society of Clinical Oncology (ASCO) recently recommended modernizing criteria related to comorbid conditions routinely used to exclude patients from clinical trials. We...

Addressing financial concerns of cancer clinical trial participants: Longitudinal outcomes of an equity intervention.

6566Background: Cancer patients’ (pts) financial concerns (FCs) represent a barrier to clinical trial (CT) participation and interventions targeting pts’ FCs are needed. We sought to assess the imp...

Development and Preliminary Testing of the Perceived Benefit and Burden Scales for Cancer Clinical Trial Participation.

We developed measures of benefits and burdens of research participation in cancer clinical trials using a sequential mixed methods design with a qualitative ( n = 32) and quantitative sample ( n = 110) of cancer clinical trial participants. Benefit-burden items (22 for benefits, 23 for burdens) were subsequently developed and assessed through cognitive interviewing for content, clarity, and meaning. Preliminary psychometric analyses support the internal consistency reliability and construct validity of Benefit (α = .90) and Burden (α = .87) research participation scales. Item response theory models supported the discrimination ability of the items on the scales. Participants who had thoughts of dropping out had lower Benefit scale scores ( p < .001) and higher Burden scores ( p < .001) than those who had no thoughts of dropping out, supporting construct validity. With further psychometric testing, the scale can be used to develop appropriate interventions to address recruitment and retention of human participants in clinical research.

Recruitment practices for U.S. minority and underserved populations in NRG oncology: Results of an online survey

IntroductionCancer clinical trials (CCT) provide much of the evidence for clinical guidelines and standards of care. But low levels of CCT participation are well documented, especially for minorities.Methods and materialsWe conducted an online survey of 556 recruitment practices across the NRG Oncology network. Survey aims were 1) to learn how sites recruit minority/underserved populations; 2) to better understand the catchment areas of the NRG institutions; and 3) to aid in planning education programs for accrual of minority/underserved populations.ResultsThe survey response rate was 34.9%. The most effective methods reported for recruiting minority/underserved participants were patient navigators (44.4%) and translators (38.9%). All institutions reported using a mechanism for eligibility screening and 71% of institutions reported using a screening/enrollment tracking system. CCT training was required at 78.1% and cultural competency training was required at 47.5% of responding institutions. Only 19.9% of sites used community partners to assist with minority recruitment and just 37.1% of respondents reported a defined catchment area. Sites reported very little race and ethnicity data.ConclusionThis NRG Oncology online survey provides useful data for improvements in trial enrollment and training to recruit minority/underserved populations to CCT. Areas for further investigation include web-based methods for recruitment and tracking, cultural competency training, definition of catchment areas, use of patient navigators, and community partnerships. The survey results will guide recruitment training programs.

Increased access for and enhancement of cancer (ca) patients (pts) participation (par) in clinical trials (cts) by alleviation of financial toxicity.

24 Background: Prognosis for pts is increasing as a result of advances in cts. However, the degree to which cancer caused financial problems may influence ca pts par in cts and negatively impact quality of life. Excess financial burden of cts par, may include finding an appropriate trial, traveling to the trial site, travel costs, lodging and medical expenses. The Lazarex Cancer Foundation (LCF) was founded in 2006 with mission to improve care, giving hope, dignity, and life to advanced ca pts by providing assistance with options and costs to cts par, community outreach, and education. LCF developed processes to removing the barriers to cts par by improving equitable access to cancer care, increasing cts enrollment, retention and minority par, and increasing cts referrals. Methods: To determine the extent of benefit of LCF, we conducted a retrospective analysis of LCF beneficiaries participating in cts by reviewing and summarizing the number of pts, states and countries of residence, age, type of cancer, location and distance to cts site, type of assistance, and number of advocacy/outreach. Results: From 1/01/2010 – 12/31/2016 2179 pts were assisted financially; age range 1-102 yrs, median 50-60; (43%) male, (53%) female, (3.4%) undeclared. (6.4%) were African American, 10.3% Hispanic, 3.6 Asian Pacific Islander, other minority 2.1, and Caucasian 72.7%;total minority 22.5%. Pts resided in 50 states with largest CA , TX , MA , and FL. Cts were at 199 sites – 43 NCI CCC, 7 NCI DCC and 149 other cancer centers. Most common diagnoses were breast, leukemia, colorectal cancers. type tumors. Median household income was $75,000. Financial assistance to travel to and living expenses at the cts site was the most frequently identified need. Conclusions: Relieving pts of financial burden allows greater access to and participation in cancer clinical trials. Further research and greater resources are needed to define patient needs and determine methods to eliminate barriers to enrollment and retention investigate coverage thresholds that minimize adverse financial outcomes and identify ca pts at greatest risk for financial toxicity to increase par in cts.

Apoyo con Cariño: Strategies to Promote Recruiting, Enrolling, and Retaining Latinos in a Cancer Clinical Trial

Background: We present and describe tailored strategies to address known barriers to minority participation in clinical trial research. The strategies used allowed our team to engage communities and successfully recruit, enroll, and retain a diverse underserved population of Latinos with advanced cancer for this clinical trial. Methods: Participants were recruited from 3 urban and 7 rural sites. We identified 4 critical barriers to recruitment for this underserved population: (1) mistrust; (2) language and communication barriers; (3) lack of access to academic cancer center; and (4) inability to participate due to transportation, childcare, or work responsibilities. We developed tailored strategies to engage referring sites and patients to participate in the clinical trial. Results: We identified 318 potentially eligible participants; 34 were found to be ineligible, and 223 consented to participate in the study, representing a 79.0% enrollment rate. All patients (100%) self-identified as Latino, and 47.5% spoke Spanish as their primary language. Patients were socioeconomically disadvantaged: 53.6% had an annual income <$15,000 USD, and 50.2% had less than a high school education. A total of 177 participants completed the 3-month follow-up; 26 died before the 3-month follow interview, and 20 did not complete the follow-up evaluation (9% withdrawal rate). Conclusions: Our community-informed strategies were highly effective for recruiting, enrolling, and retaining an underserved diverse population of Latinos. The barriers we identified and the strategies we used have the potential to inform research to increase minority participation in cancer clinical trials. ClinicalTrials.gov identifier: NCT01695382.

Qualitative analysis of clinical research coordinators' role in phase I cancer clinical trials.

BackgroundClinical research coordinators play a pivotal role in phase I cancer clinical trials.PurposeWe clarified the care coordination and practice for patients provided by clinical research coordinators in phase I cancer clinical trials in Japan and elucidated clinical research coordinators' perspective on patients' expectations and understanding of these trials.MethodFifteen clinical research coordinators participated in semi-structured interviews regarding clinical practices; perceptions of patients' expectations; and the challenges that occur before, during, and after phase I cancer clinical trials.DiscussionQualitative content analysis showed that most clinical research coordinators observed that patients have high expectations from the trials. Most listened to patients to confirm patients' understanding and reflected on responses to maintain hope, but to avoid excessive expectations; clinical research coordinators considered avoiding unplanned endings; and they aimed to establish good relationships between patients, medical staff, and among the professional team.ConclusionsClinical research coordinators were insightful about the needs of patients and took a meticulous approach to the phase I cancer clinical trial process, allowing time to connect with patients and to coordinate the inter-professional research team. Additionally, education in advanced oncology care was valuable for comforting participants in cancer clinical trials.

Real-world Data for Clinical Evidence Generation in Oncology.

Conventional cancer clinical trials can be slow and costly, often produce results with limited external validity, and are difficult for patients to participate in. Recent technological advances and a dynamic policy landscape in the United States have created a fertile ground for the use of real-world data (RWD) to improve current methods of clinical evidence generation. Sources of RWD include electronic health records, insurance claims, patient registries, and digital health solutions outside of conventional clinical trials. A definition focused on the original intent of data collected at the point of care can distinguish RWD from conventional clinical trial data. When the intent of data collection at the point of care is research, RWD can be generated using experimental designs similar to those employed in conventional clinical trials, but with several advantages that include gains in efficient execution of studies with an appropriate balance between internal and external validity. RWD can support active pharmacovigilance, insights into the natural history of disease, and the development of external control arms. Prospective collection of RWD can enable evidence generation based on pragmatic clinical trials (PCTs) that support randomized study designs and expand clinical research to the point of care. PCTs may help address the growing demands for access to experimental therapies while increasing patient participation in cancer clinical trials. Conducting valid real-world studies requires data quality assurance through auditable data abstraction methods and new incentives to drive electronic capture of clinically relevant data at the point of care.

1470P - Decisions and supports around clinical trial participation: A national study by Cancer Trials Ireland

Background: We conducted a national survey of cancer patients (pts) to determine what factors influence their decision to participate in a cancer clinical trial (CCT) and what supports they use(d). Methods: Pts with a diagnosis of malignancy, ≥ 18 years, able to provide informed consent and complete a questionnaire independently were eligible. Questionnaires were administered to pts attending 14 cancer centres from 22nd April to Nov 23rd 2016. Results: 1,090 pts completed the questionnaire (386 (35.6%) men and 697(64.4%) women). Median age was 60 years (IQR 50-69). 311 (29.5%) had previously been offered a CCT and 303 pts had participated. Factors most frequently ranked as important regarding decisions about CCT participation included; chance to advance research (n = 846, 81.0%); living longer/feeling better (n = 851, 81.5%); recommendation by cancer doctor (n = 797, 76.3%); closer monitoring (n = 528, 50.5%); fear of more side-effects (381,36.5%) or death (n = 337,32.3%); concerns about the treatment not working (n = 446,42.7%); increased hospital visits (n = 292, 28.0%); age (n = 355, 34.0%). Only 83 pts (9.3%) independently asked about participating in a CCT. Pts were asked about hypothetical participation in a CCT of a new drug that appeared safe but which could be better than/similar to/or worse than standard treatment (ST). 687 (65%) pts reported they would consider participation but more than half 336 (51.1%) of those reconsidered when a subsequent question re-stated the possibility the study drug could be worse than ST. Of those previously offered a CCT most (n = 214, 68.8%) had decided without help. When making decisions about CCT participation; family (n = 175, 56.2%), internet (n = 67, 21.5%) and GP (n = 48, 15.4%) were frequent sources of support. Most sources encouraged (n = 169, 54.3%) or were neutral about participation (n = 72, 23.2%). Cancer doctors and specialist nurses scored highest in terms of pts’ trust about CCT information; 250 (69.8%) and 196 (59.4%) pts gave them full scores respectively. Conclusions: Decisions about CCT’s are complex, based on personal and altruistic factors and may be influenced by the type and detail of information given and by who provides it. Few pts we surveyed asked about a CCT, but most who had been offered a CCT had participated. Legal entity responsible for the study: Catherine M. Kelly Funding: Cancer Trials Ireland with funding from Abbvie, Bayor, Amgen and Inveva for this project Disclosure: All authors have declared no conflicts of interest.

A population-level investigation of cancer clinical trials participation in a UK region.

The aim of this study was to document cancer trial participation since establishment of the Northern Ireland Cancer Trials Network and investigate population and disease factors associated with trial participation. An independent cohort of over 51 000 cancer patients from the Northern Ireland Cancer Registry covering the same population (2007-2012) was linked to a database of 1316 interventional cancer trial participants in a UK region. The primary outcome measure was participation in an intervention clinical trial. Patients were followed up until 31 March 2013. Kaplan-Meier tests and Cox proportional hazard models using person days at risk to allow for death were used to investigate factors associated with trial participation. Multivariate analysis assessed the impact of age, cancer type and stage, distance from the cancer centre (radiotherapy), marital status, deprivation quintile and rurality. Participation was analysed separately for children (<15 years) and young individuals (15-24 years). Trial recruitment increased three-fold with establishment of a network. Participation was the highest for children at 21%, but relatively low at 2.05% for adults, although higher for haematological malignancies (4.5%). Lower likelihood of trial participation in adults was associated with female sex, older age, distance from regional Cancer Centre and stage 1 disease. The introduction of a regional Cancer Trials Network was associated with increased participation; however, trial participation remains relatively low at the population level especially among elderly patients. Linkage of clinical trials and cancer registry database provide an easy mechanism to monitor trial representativeness at the population level.

A community-academic partnership to explore informational needs of African American women as a primer for cancer clinical trial recruitment

ABSTRACTBackground: African Americans (AAs) are less likely to participate in cancer clinical trials (CCTs) despite experiencing disproportionately higher rates of cancer mortality. As a way to address these ongoing disparities, this study sought to qualitatively explore informational needs regarding CCTs among AA women and identify message considerations for educational information targeting AA women and their community.Methods: Three focus groups were conducted in which AA women viewed a DVD created as a decisional tool for CCT participation and provided feedback regarding content.Results: Results indicated general fear regarding CCTs, which is partially attributable to the impact of historic research abuses, lack of information regarding CCTs, and lack of cultural relevance of the education and outreach materials for AA communities. Recruitment of AAs to CCTs may be enhanced by educational and outreach approaches that increase awareness of CCTs as well as involvement of the AA community in developing such interventions.Conclusion: Interventions should include the perspectives of AA women, as key stakeholders and decision-makers for their family and provide research information in a multimedia format that will facilitate family discussion and decision-making regarding CCTs.

Primary care physicians' attitudes and beliefs about cancer clinical trials.

Cancer clinical trials give patients access to state-of-the-art treatments and facilitate the translation of findings into mainstream clinical care. However, patients from racial and ethnic minority groups remain underrepresented in clinical trials. Primary care physicians are a trusted source of information for patients, yet their role in decision-making about cancer treatment and referrals to trial participation has received little attention. The aim of this study was to determine physicians' knowledge, attitudes, and beliefs about cancer clinical trials, their experience with trials, and their interest in appropriate training about trials. A total of 613 physicians in the New York City area primarily serving patients from ethnic and racial minority groups were invited via email to participate in a 20-min online survey. Physicians were asked about their patient population, trial knowledge and attitudes, interest in training, and personal demographics. Using calculated scale variables, we used descriptive statistical analyses to better understand physicians' knowledge, attitudes, and beliefs about trials. A total of 127 physicians completed the survey. Overall, they had low knowledge about and little experience with trials. However, they generally had positive attitudes toward trials, with 41.4% indicating a strong interest in learning more about their role in trials, and 35.7% indicating that they might be interested. Results suggest that Black and Latino physicians and those with more positive attitudes and beliefs were more likely to be interested in future training opportunities. Primary care physicians may be an important group to target in trying to improve cancer clinical trial participation among minority patients. Future work should explore methods of educational intervention for such interested providers.

Factores asociados con la participación de pacientes en ensayos clínicos en cáncer

BackgroundCancer clinical trials require the voluntary participation of patients for their adequate development. Not all patients wish to do this, thus affecting their development. In other studies, the most important identified reasons in that influence the decision have been lack of information about study design, randomisation methods, and kind of treatment, use of placebos, toxicity, and side effects of the investigational medicinal product. ObjectiveTo evaluate the volition to participate in clinical trials, as well as to establish the reasons associated with this in a sample of patients. MethodsA cross-sectional observational study was conducted on a sample of cancer patients. This included a logistic regression analysis, taking the volition to participate in clinical trials as the dependent variable, along with a group of explanatory variables. ResultsA total of 366 patients were interviewed. Although 84% did not know about clinical trials, 63% were willing to participate. The reasons the remaining percentage gave for declining to participate were fear, lack of information about risks and benefits, rights, and informed consent. ConclusionAdditional studies are required to identify the reasons associated with participation in cancer clinical trials. Furthermore, strategies are required for improving the information and communication for patients to take part in clinical trials.

Abstract LB-001: Impact of direct physician engagement with racial/ethnic minorities for oncology clinical trial access and accrual model

Abstract Background While nearly twenty percent of adults are eligible, cancer clinical trial (CCT) accrual in the United States lingers around five percent. Participation rates are significantly lower among racial/ethnic minorities and the medically underserved, who are likely to have poorer outcomes than the larger population. As the burden of forging medical milestones should be equally withstood, CCT participation is increasingly a concern of healthy equity and social justice among racial/ethnic minorities. This program proposes a promising strategy for engaging physician-oncologists and communities to stream-line clinical trial awareness, access and accrual of racial/ethnic minorities in a culturally-sensitive manner. Methods This study recruited 40 community and academic-research sites to provide CCT education days at a local, large, pre-dominantly African American church congregation, (N=253) participants, over one-year. Pre/post-testing of general clinical trial knowledge was conducted each-day. CCT education included a 3-patient panel-discussion of their trial experiences. Four physician-oncologists provided expertise on the significance of minority representation in CCTs. The physician-oncologists discussed the types of CCTs that were locally available for specific-types of cancer. Expected result was provision of recruitment opportunities of potentially-eligible participants for CCTs and address gaps in CCT knowledge. Results Participants (N=253) were: (75%) African-American, (13%) Hispanic/Latino, (2%) American Indian/Alaskan Native, (6%) Asian, and (2%) Hawaiian/Pacific Islander. Pre-survey (N=104) responses included: How much do you know about clinical research?; a lot (23%), general sense (51%), very-little (21%), never heard of it, (3%). Thirty-eight percent had prior research participation. Post survey (N=171) responses, participants indicated: would very likely (51%) and somewhat-likely (41%) participate in a CCT if invited by doctor. An additional (3%) were somewhat-unlikely or very-unlikely (6%) to participate in CCT if invited by doctor. Post-survey, cited reasons for not participating in CCT: never invited to participate (28.5%); lack of information about trials (16.5%); didn’t know who to talk to about trials (6.5%); worried about my rights (1%); hassle of participation (2%); insurance (2%); worried about health risk (6.5%); other (6.5%); no reply (30.5%). Conclusions Physician invitation to participate was the most notable factor in CCT accrual. Incorporating physician engagement strategies as part of the trial design to directly connect with under-represented groups in CCTs provides an opportunity to assess patient knowledge, encourage education before participation and address any reservations about participating in research. Citation Format: Jameisha B. Brown, Claudia R. Baquet, Aime T. Franco. Impact of direct physician engagement with racial/ethnic minorities for oncology clinical trial access and accrual model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-001. doi:10.1158/1538-7445.AM2017-LB-001

Evaluation of adolescents and young adults (AYA) attitudes towards participation in cancer clinical trials.

10047 Background: Participation in clinical trials (CT) for AYA ( &lt; 39 years) remain the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CT participation. Methods: A mixed methods approach included 1) qualitative: interpretive descriptive methodology guided individual semi-structured interviews with 21 AYA for factors influencing CT enrollment and 2) quantitative: AYA and non-AYA (≥40) matched for histology completed Cancer Treatment subscale of Attitudes toward Cancer Trials Scales (ACTS-CT) (Schuber, 2008) and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test and ordered logistic regression models were constructed for prediction of the effect of baseline demographics. Results: The major themes influencing CT participation were: (1) family/peer group opinion (2) CT impact on daily/future life (e.g. school; starting a family) and (3) illness severity/psychological readiness for CT information. Surveys were distributed to 61 AYA (median age: 29 years (17-39)); 74 non-AYA (55 (40-88)). Compared with non-AYA, AYA perceived CT to be unsafe/more difficult (Personal Barrier/Safety domain; p = 0.01). AYA were also more concerned with CT interference in their long term goals (p = 0.04). Logistic regression identified participants who had previously been offered a CT (p = 0.01) or who spoke English as their first language (80% of cohort)(p = 0.01) reported less barriers to CT. There were no differences based on age in other domains (Personal Benefits; Personal/Social Value; Trust in CT). In all participants, differences were seen in the Personal Benefits domain if respondents had children (p = 0.05) or were currently working (p = 0.04). Conclusions: Age-related differences in attitudes towards CT suggest that tailored approaches to CT accrual of different patient groups may be warranted. Patient-centered delivery of information regarding CT, particularly for those in whom English is a second language and who are trial-naïve, may improve accrual and warrants further prospective, randomized study.

Are NCI-designated cancer centers websites linguistically accessible?

e18078 Background: The digital divide has shifted from disparities in internet access to disparities in content and design. Technology overlooks limited English proficient (LEP) patients, resulting in a lack of translated online content, possibly increasing disparities in cancer prevention, treatment and clinical trial participation. We sought to determine the language accessibility for the websites of the NCI-Designated CC. Methods: In January 2017, we performed a cross-sectional review of the language accessibility of NCI-Designated CC homepages using manual review and informatics methods (i.e., web scraping). Web scraping automates data extraction from online content. The primary outcomes were presence of translated content, number of languages available and method of translation defined as no translation, Google Translate (GT) or manual translation. Manual translation was categorized as limited (few phrases), moderate (1 webpage) or full ( &gt; 1 webpage or entire site). We used logistic regression to assess the relationship between translated website content and CC county demographics: percent LEP, median income and percent of households with an internet subscription. We performed Spearman Rank Correlation by ranking translation effort: no translation, GT, limited, moderate and full translation. Results: Of 69 NCI-Designated CC websites, 54 (78.3%) were without translation, 12 (17.4%) were manually translated and 3 (4.3%) used GT. Of 12 manually translated websites, 6 had fully, 4 had moderate and 2 had limited translations. Of 16 languages offered, Spanish was the most common (100%), followed by Chinese (50%) and Arabic (33%). We found no significant increase in the odds of having a translated website as related to LEP population, median income or percent of households with internet subscription by CC county. There was no correlation between the translation effort and LEP population, internet subscription or median income by CC county. Conclusions: We found that most NCI-Designated CC offered no translations of their website content. Despite cancer health disparities and the increasing role of health technology, the NCI-Designated CC websites currently remain inaccessible to LEP patients.