Abstract A22: The ENACCT pilot education program: A community-centered intervention addressing cancer clinical trials education

Fewer than 3% of adult cancer patients participate in cancer clinical trials, with rates even lower among ethnic and racial minorities, older adults, rural residents and low-income groups. A coordinated, multi-pronged approach is critical to addressing patient, physician and system barriers to participation. Despite attention paid by many institutions and government agencies on cancer clinical trials, no program has ever focused on community engagement and education regarding cancer clinical research. Community-based cancer clinical trial education interventions are well positioned as an innovative approach to positively impact relevant knowledge, attitudes and behaviors. The Pilot Education Program (PEP), a pilot project of the Education Network to Advance Cancer Clinical Trials (ENACCT), was launched in 2005 in three communities nationwide. The goal of PEP was to demonstrate the impact and feasibility of a comprehensive, community-driven outreach and education intervention to increase awareness about cancer clinical trials, enhance their acceptability, and improve access to them, resulting in greater inquiry and ultimately patient accrual. Specifically, PEP explored 1) how community-focused education efforts can help to spread the word about cancer clinical trials throughout local communities and 2) how community-driven advocacy efforts can help to reduce local access barriers to clinical trials. The pilot utilized a train-the-trainer model to engage health care providers and community leaders while providing educational workshops for clinical trials staff addressing recruitment and retention practices. Community partnerships coordinated efforts to reduce local structural and policy barriers to clinical trials participation, and worked with state and local cancer coalitions and commissions to enhance cancer clinical trials education and improve access. Evaluation data was captured through surveys, interviews, focus groups and field observation. To date, PEP has recruited 75 trainers, and reached 882 community members (63% minority), 374 health care providers (16% minority) and 61 cancer clinical trial staff (18% nurses) through workshops. Overall, nearly 5,800 individuals were exposed to educational activities about cancer clinical trials as part of wider intervention efforts, including community outreach activities and dissemination of educational materials. Sixty-six percent of community leader trainees reached said they spoke to others about cancer clinical trials. Ninety-four percent of health care providers said they were willing to discuss cancer clinical trials with their patients. Among cancer clinical trial staff, 80% indicated intention to work with community groups on cancer clinical trials education. Further, seventy-seven unique patient profiles were created with a national cancer clinical trials matching service associated with PEP. The methods and strategies implemented within PEP appear promising in improving knowledge among community leaders and health care providers, fostering greater peer-to-peer education about cancer clinical trials, and helping to catalyze change in local cancer research systems. These preliminary findings suggest that community-centered interventions can be an effective means of reducing barriers to cancer clinical trials participation.