Cancer incidence and mortality rates are higher in blacks for almost every kind of cancer. The cancer problem in rural blacks is compounded by a regional lack of cancer specialists and treatment. The Medical College of Virginia/Community Memorial Healthcenter Minority-Based (MCV/CMH M-CCOP) is designed to increase the availability of protocol-based cancer treatment and control research trials to the urban and rural minorities of Richmond and Southside Virginia. Greater than 48% of 720 selected new cancer cases at the MCV/CMH M-CCOP sites are minority, nearly all black. Approximately 82 new treatment and 320 cancer control patients will be entered on trial in Year One and more than 50% of those accruals will be minorities. Organizational and operational plans are presented which will provide the structure for the effective implementation of multidisciplinary research. Community acceptance of new programs is facilitated by advisors from the black community who have provided enthusiastic support. This application will emphasize the unique urban and rural populations available to the M-CCOP, the history of extensive participation in clinical research by the Medical College of Virginia Hospitals (MCV), and the recent MCV initiatives in cancer outreach conducted at the rural M-CCOP site, the Community Memorial Health center (CMH) in South Hill, Virginia. The MCV/CMH M-CCO will collaborate with 3 research bases. MCVH has a longstanding relationship with NSABP and has won awards based onaccrual and quality of data management. The CALB affiliation, through the University of North Carolina at Chapel Hill, began in April 1989. We have a new affiliation with the Fox Chase Cancer Center (FCCC) that provides high quality cancer control protocols. We address patient education and special issues of the rural and urban black population in this application. Strategies to increase minority participation in clinical research include: a) involvement of the Cancer Rehabilitation/Continuing Care home health nurses in protocol patient care, b) consent form reading level modification by the State Department of Adult Basic Education in Virginia, and c) collaboration with cancer control research bases to develop protocols feasible for the minority communities. In addition, the financial and staffing obstacles which could hinder research efforts are discussed along with strategies to overcome them. Finally, a method which measures accessibility to American College of Surgeons certified cancer programs by blacks and whites is demonstrated. A recent analysis shows rural blacks receive treatment at an ACOS facility half as frequently as urban whites. Implications of this analysis and potential for evaluating M-CCOP success are discussed.
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