The UCSD Cancer Center is an Organized Research Unit of the University of California, San Diego. It is comprised of over 120 members with academic appointments in 15 university departments, plus several members from other academic and research institutions throughout the region. Its mission is to reduce the incidence of, and morbidity and mortality from, cancer. The Cancer Center has had continuous funding as an NCI designated cancer center since April 1, 1979 and is oriented toward excellent basic, translational, behavioral, and clinical research. The low clinical trials accrual rates nationwide are recognized as a major barrier to achieving the rapid progress desired in the prevention, diagnosis, and treatment of cancer. The accrual of a representative sample of women and members of minority groups to clinical trials has been even more difficult to accomplish, limiting the broad applicability of these research findings. Over the past five years, UCSD Cancer Center has developed and pilotlested various components of a region wide infrastructure designed to reduce oncologists' barriers to clinical trials referral and to educate community oncologists about open clinical trials. Eight program components and numerous sub-components aimed at promoting clinical trials accrual have been tested. They include: 1) The Clinical Trials Dinner Meeting Series; 2) the Consortium of Regional Cancer Center Leaders; 3) a network of clinical trials web sites; 4) a randomized trial to evaluate methods to disseminate clinical trials information; 5) an """"""""in- reach"""""""" data base; 6) research-driven community outreach programs; 7) a media partnership; and 8) a legislative advocacy thrust. This proposal will continue to test, develop, supplement, and report upon the effectiveness of these various program components in promoting accrual to clinical trials. Multiple approaches to assess the impact of the interventions within standard infrastructure were tested and found to be ineffective. The clinical trials. infrastructure has had extensive revisions to allow for accurate endpoint assessment with future efforts.
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