The City of Boston is rich with academic medical centers and cancer care facilities. However, these resources have done little to reduce racial and ethnic disparities in cancer mortality, in part due to a lack of minority enrollment in cancer clinical trials. Boston Medical Center (BMC), the largest safety net provider in New England, stands uniquely positioned to implement a Minority-Based Community Clinical Oncology Program (MB- CCOP) in attempts to reduce this disparity. More than two-thirds of BMC patients are minorities and most are low-income. BMC already has a successful Cancer Clinical Trials Program (CCTP) and a state-of-the-art cancer center that opened in 2006. Established in 1991, the BMC CCTP has developed methods for culturally sensitive outreach, recruitment, enrollment and retention in cancer clinical trials. Our CCTP research nurses have all been trained in patient navigation to help patients overcome their many barriers to care. As a result, minorities now account for 42% of cancer clinical trial enrollment. However, the lack of resources in our CCTP limits the extent to which we can offer our services beyond the confines of the institution into Boston's most impoverished and diverse communities. The MB-CCOP at BMC will provide the resources we need to facilitate access to both BMC's cancer care services and cancer clinical trials by patients receiving primary care in the community. Taking advantage of the experience at BMC with the NCI Patient Navigator Research Program, we will employ a patient navigation model for the BMC MB-CCOP. Navigators will be placed at five of Boston's community health centers (CHCs) to facilitate the communication process and the referral of appropriate patients for evaluation of clinical trials at BMC. At the same time, an MB-CCOP at BMC will provide our oncologists access to a much larger portfolio of cancer clinical trials relevant to the patient population we serve.
Our specific aims are: 1) to provide patient navigation for CHC patients to facilitate access to BMC cancer care and clinical trials;2) to promptly screen all cancer patients for clinical trial participation;3) to provide outreach and education to community physicians and their patients, and 4) to test the effectiveness of these methods in increasing minority accruals.
The overarching goal of the MB-CCOP at BMC is to enhance minority enrollment to cancer clinical trials utilizing community-based patient navigation in an effort to reduce the racial and ethnic disparities of cancer mortality in Boston.
