A qualitative study of barriers and facilitators to adolescents and young adults’ participation in cancer clinical trials: Oncologist and patient perspectives

2021 ◽  
Author(s):  
Renata Abrahão ◽  
Elysia M. Alvarez ◽  
Austin R. Waters ◽  
Crystal C. Romero ◽  
Melissa M. Gosdin ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Qualitative Study ◽  
Patient Perspectives ◽  
Barriers And Facilitators ◽  
Adolescents And Young Adults ◽  
Cancer Clinical Trials

A qualitative study of barriers and facilitators to enrollment of adolescents and young adults onto cancer clinical trials at NCI community oncology research program (NCORP) sites.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19050-e19050 ◽  
Author(s):  
Elizabeth Siembida ◽  
Holli Ann Loomans-Kropp ◽  
Irene Tami-Maury ◽  
Lillian Sung ◽  
Brad H. Pollock ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Qualitative Interviews ◽  
Community Setting ◽  
Barriers And Facilitators ◽  
Adolescents And Young Adults ◽  
Cancer Clinical Trials ◽  
Stakeholder Views ◽  
Oncology Research ◽  
The Impact

e19050 Background: Cancer clinical trials (CCTs) contribute to improving patient survival and quality of life; however, adolescents and young adults (AYAs, 15-39 years old), are underrepresented in CCTs, especially in the community setting. We aimed to identify barriers and facilitators to AYA CCT enrollment in the NCORP. Methods: We conducted 43 one-on-one semi-structured qualitative interviews with key stakeholders involved in the enrollment of AYAs across a diverse group of NCORP primary (n = 5) and affiliate (n = 10) sites. Interviews were conducted remotely by 3 trained interviewers using the Zoom platform. Stakeholders were recruited from high and low AYA enrolling sites (AYA/total site enrollments > 10% and < 3%, respectively). Stakeholders were overall NCORP Site PIs (n = 5), lead NCORP administrators (n = 4), clinical research associates (n = 11), medical and pediatric oncologists involved in the enrollment of AYAs (n = 7), regulatory research associates (n = 5), nurse navigators (n = 6), and patient advocates (n = 5). Interviews were audiotaped and transcribed. Thematic analysis was conducted to identify themes and relate them back to our primary research questions regarding barriers and facilitators to AYA CCT enrollment. Results: Stakeholder views on enrollment barriers centered on 5 main themes: (1) lack of site-level prioritization or discussion of AYA enrollment; (2) limited number of clinical trials for AYAs available nationally, with few trials opened locally; (3) insufficient resources and research staff; (4) concerns about the cost effectiveness of opening AYA trials due to low numbers of eligible patients; and (5) patient misconceptions about CCTs. Stakeholder views on enrollment facilitators centered on 3 main themes: (1) presence of an AYA program focused on increasing enrollment; (2) having a designated site AYA “champion”; and (3) having site leadership identify AYA enrollment as a priority. Stakeholders agreed that incentivizing AYA enrollments via increased reimbursement and/or study credits could potentially lead to increased enrollment. Conclusions: In addition to identifying multiple shared barriers to AYA CCT enrollment, our study also identified possible interventions for enrollment improvement, including designation of AYA “champions”, increased reimbursement for AYA enrollments, and improving AYA’s understanding of CCTs. Further studies are needed to assess the impact of interventions aimed at increasing AYA enrollment across the NCORP.

scholarly journals Evaluation of Adolescents’ and Young Adults’ Attitudes Toward Participation in Cancer Clinical Trials

2020 ◽  
Vol 16 (3) ◽  
pp. e280-e289
Author(s):  
Jeremy Lewin ◽  
Jennifer A. H. Bell ◽  
Kate Wang ◽  
Victoria Forcina ◽  
Seline Tam ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Logistic Regression ◽  
Adolescents And Young Adults ◽  
Cancer Clinical Trials ◽  
Patient Centered ◽  
Logistic Regression Models ◽  
Age Related ◽  
Tumor Types

PURPOSE: Participation in cancer clinical trials (CCTs) for adolescents and young adults (AYAs) remains the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CCT participation. METHODS: A mixed-methods approach was used. AYAs and non-AYAs (≥ 40 years) completed the Cancer Treatment subscale of the Attitudes Toward Cancer Trials Scales and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test, and logistic regression models were constructed to evaluate the effect of demographics on perceptions of CCTs. RESULTS: Surveys were distributed to 61 AYAs (median age, 29 years; range, 17-39 years) and 74 non-AYAs (median age, 55 years; range, 40-88 years). Compared with non-AYAs, AYAs perceived CCTs to be unsafe/more difficult (Personal Barrier/Safety domain; P = .01). There were no differences based on age in other domains. AYAs were also more concerned with CCT interference in their long-term goals ( P = .04). Multivariable ordered logistic regression identified increased personal barriers in the Personal Barrier/Safety domain for AYAs ( P = .01), in patients with English as a second language (ESL; P < .01), and in patients previously not offered a clinical trial ( P = .03). Long-term goals were identified as a barrier in particular tumor types ( P = .01) and in patients with ESL ( P < .01), with a trend identified in AYAs ( P = .12). CONCLUSION: Age-related differences in attitudes toward CCTs suggest that tailored approaches to CCT accrual are warranted. Patient-centered delivery of information regarding CCTs, particularly in patients with ESL and who are trial naïve, may improve accrual.

Use of Communication Technology to Improve Clinical Trial Participation in Adolescents and Young Adults With Cancer: Consensus Statement From the Children's Oncology Group Adolescent and Young Adult Responsible Investigator Network

2021 ◽  
Author(s):  
Viswatej Avutu ◽  
Varun Monga ◽  
Nupur Mittal ◽  
Aniket Saha ◽  
Jeffrey R. Andolina ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Young Adults ◽  
Consensus Statement ◽  
Adolescents And Young Adults ◽  
Trial Participation ◽  
Cancer Clinical Trials ◽  
Oncology Group ◽  
Tumor Boards ◽  
Remote Patient

Adolescents and young adults (AYAs; age 15-39 years) with cancer are under-represented in cancer clinical trials because of patient, provider, and institutional barriers. Health care technology is increasingly available to and highly used among AYAs and has the potential to improve cancer care delivery. The COVID-19 pandemic forced institutions to rapidly adopt novel approaches for enrollment and monitoring of patients on cancer clinical trials, many of which have the potential for improving AYA trial participation overall. This consensus statement from the Children's Oncology Group AYA Oncology Discipline Committee reviews opportunities to use technology to optimize AYA trial enrollment and study conduct, as well as considerations for widespread implementation of these practices. The use of remote patient eligibility screening, electronic informed consent, virtual tumor boards, remote study visits, and remote patient monitoring are recommended to increase AYA access to trials and decrease the burden of participation. Widespread adoption of these strategies will require new policies focusing on reimbursement for telehealth, license portability, facile communication between electronic health record systems and advanced safeguards to maintain patient privacy and security. Studies are needed to determine optimal approaches to further incorporate technology at every stage of the clinical trial process, from enrollment through study completion.

scholarly journals Inclusion of Adolescents and Young Adults in Cancer Clinical Trials

2015 ◽  
Vol 31 (3) ◽  
pp. 197-205 ◽  
Author(s):  
Aaron R. Weiss ◽  
Brandon Hayes-Lattin ◽  
Matthew A. Kutny ◽  
Wendy Stock ◽  
Kristin Stegenga ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Adolescents And Young Adults ◽  
Cancer Clinical Trials

scholarly journals Challenges in the recruitment of adolescents and young adults to cancer clinical trials

Cancer ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2385-2393 ◽  
Author(s):  
Megan E. Burke ◽  
Karen Albritton ◽  
Neyssa Marina
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Adolescents And Young Adults ◽  
Cancer Clinical Trials

805-P: Barriers and Facilitators of Participation in Clinical Trials among Youth and Young Adults with Type 1 Diabetes and Their Caregivers

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 805-P
Author(s):  
SARAH C. WESTEN ◽  
LINDSAY M. ANDERSON ◽  
SAMANTHA A. BARRY ◽  
SYDNEY LOOK ◽  
STEFANIA PINTO ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Type 1 Diabetes ◽  
Young Adults ◽  
Barriers And Facilitators ◽  
Youth And Young Adults
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