Abstract 1000: Clinician and clinical trial staff perspectives on factors that impact enrollment of Black women in breast cancer trials
Authors: Sandoval Christen , Cohn Eliza Brumer , Carnahan Leslie R. , Henderson Vida , Mersha Tigist , Hippalgaonkar Neha , Horowitz Joe , Khan Sarah , Salum Kauthar , Williams Ana , Coleman Lolita , Brent Beluah , Murphy Anne Marie , Thomas Paris , Khosla Paramjeet , Hoskins Kent , Nguyen Ryan 
Published: March 2024

Background: Black women (BW) are more likely to present with advanced-stage disease and to die following a breast cancer (BC) diagnosis compared with women from other racial and ethnic groups, yet BW are underrepresented in BC clinical trials (CT). Clinicians and CT staff play a key role in patient participation in CT, however, there is limited data on their perspectives on facilitators and barriers for BW in BC trials.

Objective: The goal of the FOR ME (Fostering Opportunities in Research through Messaging and Education) study is to develop, optimize, and test a decision-aid intervention (web-based video) for clinical care teams to use with BW who have been recently diagnosed with BC to promote shared decision-making and CT participation. We provide insight into the facilitators and barriers from clinicians and CT staff to effectively discuss and enroll BW in BC trials. The identified themes will be used to inform video content and dissemination strategies.

Methods: Key informant interviews (KIIs) (n=20) were conducted by phone and video conferencing. Each KII was recorded and professionally transcribed. Thematic analysis and inductive coding approaches were used to analyze the data. First, a subset of transcripts was annotated, and then annotations were compiled into a preliminary codebook. Inter-coder reliability was established to improve quality and to establish the final codebook. Dedoose was used to analyze quotations and code co-occurrences, application frequencies, and relationships.

Results: In total, 16 clinicians and 4 clinical trial staff across academic and community practices were interviewed. Participants expressed multiple opportunities and barriers to CT participation. Facilitators included formal training on communication around clinical trials among clinical trial staff, previous exposure to discussing and enrolling patients in CT during fellowships and other training, institutional support for CT databases, reviewing CTs during tumor boards, and the presence of dedicated research support staff. Barriers included a lack of formal training in communicating CT to patients among clinicians, lack of institutional investment in CT infrastructure, time constraints of clinical visits, and the clinician’s perception of the patient's willingness and ability to complete a CT.

Conclusions: Clinicians and clinical trial staff have a unique and important role to play in CT participation for BW who have BC, however, there are barriers, including training, time, awareness of available trials, and institutional support. Clinical trial staff report formal training in communicating clinical trial information to patients, while there is a lack of this type of training for clinicians. Future research in the FOR ME study will integrate patient, clinician, care team, and advocate perspectives into a web-based decision aid.

Citation Format: Christen Sandoval, Eliza Brumer Cohn, Leslie R. Carnahan, Vida Henderson, Tigist Mersha, Neha Hippalgaonkar, Joe Horowitz, Sarah Khan, Kauthar Salum, Ana Williams, Lolita Coleman, Beluah Brent, Anne Marie Murphy, Paris Thomas, Paramjeet Khosla, Kent Hoskins, Ryan Nguyen. Clinician and clinical trial staff perspectives on factors that impact enrollment of Black women in breast cancer trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1000.