Abstract A047: The patient experience: Clinical trial knowledge, attitudes and participation among diverse populations
Authors: Strom Carla , Winkfield Karen M. , Tooze Janet A. , Ruiz Jimmy , Shore Kelsey , Weaver Kathryn E. 
Published: September 2020

Introduction: Participation in cancer clinical trials (CTs) is historically low, particularly for underserved populations, including racial/ethnic minorities. Wake Forest Baptist Comprehensive Cancer Center developed a population health navigation program to improve access to cancer care and CTs among Hispanic patients through linguistically and culturally concordant navigation services. The role of the Hispanic Patient Navigator (HPN) includes educating all navigated patients about CTs. To inform expansion of the program, we sought to understand the knowledge and attitudes of underserved patients at WFBCCC regarding CTs and CT participation. Methods: Patients receiving cancer care in the adult oncology clinic at WFBCCC were purposively sampled to enroll a diverse sample with regards to race, ethnicity, insurance coverage, age, and rural-urban residence. Survey domains included CT knowledge (Ellis et al., 2016) attitudes about CTs (positive beliefs and patient involvement scored from 0-100; Jenkinson et al., 2005) and participation in clinical research as part of cancer care. ANOVA and chi-square/Fisher’s exact tests compared responses by race and ethnicity. Results: We enrolled 247 participants (85% participation); 50.6% were White, non-Hispanic (NHW), 27.1% Black, non-Hispanic (NHB), and 22.3% Hispanic, all races. The majority were female (54.5%) with a median time since cancer diagnosis of 2.8 years. Common cancer types included hematologic (36.4%), breast (20.6%), gastrointestinal (12.6%), and thoracic (9.3%). Hispanics were more likely to report less than a high school education (47.3% vs 10.4% NHW and 17.9% NHB) and not having enough money to meet the daily needs of their families (45.5% vs 13.6% NHW and 17.9% NHB), p&lt;.001. NHW, NHB and Hispanic cancer patients reported similar positive attitudes about CTs (positive beliefs mean=77.7, std=17.6) and willingness to participate (patient involvement=76.7, std=18.9), p &gt;.05 for both comparisons. A larger proportion of NHWs had heard of clinical trials (92.8%), compared to 79.1% NHBs, and 56.4% of Hispanics. NHWs also had greater CT knowledge (mean=3.5, 0-7 scale) than NHBs (mean=2.5), and Hispanics (mean=1.9), p&lt;.0001. There was a trend towards slightly lower CT participation among Hispanic patients, with 42.4% of NHWs, 38.8% of NHBs, and 29.1% of Hispanics self-reporting participation in clinical research(p=.089). Conclusions: Results support the continued role of a HPN to provide clinical trials education to cancer patients. Although self-reported clinical trial participation was slightly lower among Hispanics, it approached 30%, and we observed concurrent increases in Hispanic patient enrollment on cancer center trials. Expansion of the population health navigator program to Black patients would provide opportunities to enhance clinical trial knowledge and participation in additional underserved patients.

Citation Format: Carla Strom, Karen M. Winkfield, Janet A. Tooze, Jimmy Ruiz, Kelsey Shore, Kathryn E. Weaver. The patient experience: Clinical trial knowledge, attitudes and participation among diverse populations [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A047.