African Americans (AAs) are more likely to develop and die from cancer than any racial and ethnic group in the United States (U.S.). Over the past two decades, there has been an increased focus on participation of AAs in cancer clinical trials (CCTs) to address this disproportionate burden of cancer; however AAs continue to be underrepresented in CCTs. The dearth of AAs participating in CCTs diminishes the generalizability of results of trials. If AAs remain underrepresented in CCTs, the implications include slower progress in elucidating the underlying causes of long-standing health disparities in cancer outcomes. There is an extensive body of science detailing trial participation barriers among AAs, including limited access to specialty care centers where trials are conducted, competing work obligations, and fear and mistrust of clinical research. Despite these barriers, AAs are, inherently, no less willing to participate in CCTs or other types of research studies than other racial or ethnic groups. The absence of differences in willingness to participate suggests that persistent disparities in accrual may, in fact, be due to AAs being offered fewer opportunities than whites to participate in CCTs. Although many interventions have focused on approaches to increase the willingness of AAs to participate, perhaps efforts should be focused on increasing the opportunities among AAs to participate in CCTs. We propose to adapt the IMPaCT patient navigation model and pilot a clinical trials navigator program, IMPaCT 2.0, at Morehouse Healthcare (MH) and Grady Hospital (Grady), one of the largest safety-net hospitals in the nation. We propose to enhance the patient navigation model with a mobile tablet-based clinical trial tracking system (CTTS) (using i2b2 software) to facilitate increased engagement among AA patients regarding CCT participation opportunities and to address deficits in the research infrastructure at these two institutions. Utilizing a qualitative approach, we will identify those barriers and facilitators to AA recruitment at MH/Grady (Specific Aim 1) and incorporate those findings into an adapted clinical trials navigation (CTN) model with an integrated mobile tablet CTTS (Specific Aim 2)., We will implement IMPaCT 2.0 at MH/Grady breast and prostate cancer clinics and evaluate, in a one-group, pre-/post-test design, the feasibility and acceptability (Specific Aim 3).
This Pilot Project proposes to adapt the IMPaCT patient navigation model and pilot a clinical trials navigator program, at Morehouse Healthcare (MH) and Grady Hospital (Grady), one of the largest safety-net hospitals in the nation. We propose to enhance the patient navigation model with a mobile tablet-based clinical trial tracking system (CTTS) (using i2b2 software) to facilitate increased engagement among AA patients regarding CCT participation opportunities and to address deficits in the research infrastructure at these two institutions.
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