Abstract A048: Clinical trials knowledge and participation in rural and urban cancer survivors at a Comprehensive Cancer Center in the Appalachian region
Authors: Weaver Kathryn E , Tooze Janet A , Ruiz Jimmy , Strom Carla , Shore Kelsey M , Winkfield Karen M 
Published: September 2020

Abstract
Introduction: Enhanced participation in clinical trials has been proposed as a strategy to reduce rural cancer disparities. We examined rural-urban differences in clinical trials knowledge and participation among cancer patients seeking oncology care to prepare for outreach activities with rural communities in our cancer center catchment area. Methods: We purposively sampled patients presenting for oncology care to enroll a diverse sample with regards to race, ethnicity, insurance coverage, age, and rural-urban residence. Participants completed a single survey assessing their patient experience, including 7 items assessing oncology clinical trial knowledge (Ellis et al., 2016), two scales assessing attitudes towards clinical trials (positive beliefs and patient involvement) scored from 0-100 (Jenkinson et al., 2005), and reported participation in clinical research or trials as part of cancer treatment. Rural residence was categorized according to the Federal Office of Rural Health Policy (Rural Urban Commuting Areas Codes 4-10). T-tests and chi-square/Fisher’s exact test compared responses of rural and urban residents. Results: A majority of survey participants (85% participation rate, N=249, 54.4% female; 50.2% White non-Hispanic, 26.9% Black non-Hispanic, 22.1% Hispanic; 22.1% rural; 47.4% High School education or less) were currently receiving active treatment (60.8%); the median time since cancer diagnosis was 2.8 years. Common cancer types included hematologic (36.1%), breast (20.5%), gastrointestinal (12.9%), and thoracic (9.6%). Most participants had heard of a clinical trial (81.1%); 38.6% reported participation in a clinical trial as part of their cancer treatment. Overall clinical trial knowledge was low (mean correct answers= 2.9 of 7, std=1.9); participants held relatively positive clinical trial attitudes (positive beliefs mean=78.8, std=15.8 & patient involvement=76.9, std=15.1). There were no significant differences by rural/urban residence for knowledge or beliefs (all p&gt;.10). There was a statistically significant difference in reported clinical trial participation; 52.7% of rural participants reported participating in a clinical research study/trial vs 34.5% of urban participants, p&lt;.05. Conclusion: We observed relatively high clinical research participation and positive attitudes among cancer patients seeking care at a Comprehensive Cancer Center. Community outreach efforts should address gaps in clinical trials knowledge and practical barriers to enrollment for both rural and urban patients. With support, rural cancer research participants could serve as research ambassadors or navigators for other residents in their communities.
Citation Format: Kathryn E Weaver, Janet A Tooze, Jimmy Ruiz, Carla Strom, Kelsey M Shore, Karen M Winkfield. Clinical trials knowledge and participation in rural and urban cancer survivors at a Comprehensive Cancer Center in the Appalachian region [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 A048.