Abstract A20: Hispanic patient navigation: An intervention to increase clinical trial participation
Authors: Strom Carla , Weaver Kathryn E. , Ruiz Jimmy , Winkfield Karen M. 
Published: February 2019

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.