{"title":"Abstract A20: Hispanic patient navigation: An intervention to increase clinical trial participation","authors":"Carla Strom, K. Weaver, J. Ruiz, K. Winkfield","doi":"10.1158/1538-7755.DISP17-A20","DOIUrl":null,"url":null,"abstract":"Background: Hispanics are the fastest-growing population in North Carolina and have unique health care needs related to culture and language. To meet their needs and address the historically low participation in cancer clinical trials, we developed a bilingual Hispanic Clinical Trial Navigator (HCTN) position to support Hispanic adult and pediatric patients treated at Wake Forest Baptist Comprehensive Cancer Center (WFBCCC). The HCTN is a novel approach to integrate culturally and linguistically competent navigation with support around clinical trial decision making. The purpose of this analysis was to evaluate the services provided during the program9s first year and its impact on clinical trial participation. Methods: Retrospective data from 11/1/2015 to 10/31/2016 were obtained from a navigation database, WFBCCC cancer registry, and clinical trial system. Data are reported in the aggregate, and clinical trial participation rates were compared to data prior to the hiring of the HCTN (11/1/2014-10/31/2015). Results: There were 108 pediatric and adult patients navigated during the first year; 55 breast screening/diagnostic and 53 cancer treatment. The majority of patients were female (87%) with a mean age of 45 years. The most common diagnoses among treatment patients were breast (47%), hematologic (34%), and gastrointestinal (6%) malignancies. Major patient barriers identified include treatment logistics/transportation (87%), financial/insurance (70%) information/education (55%), and continuity of care (53%). In addition to education and referrals, the HCTN was able to remove potential barriers to trial participation through transportation assistance (31%), meal vouchers (21%), and parking validation (40%). In the year prior to the HCTN there were 88 newly diagnosed Hispanic patients with a clinical trial participation rate of 20% in treatment/non-treatment intervention studies. With HCTN navigation, clinical trial participation among Hispanic patients navigated was 34%. Conclusions: Our data indicate an initial success in increasing Hispanic participation in cancer clinical trials utilizing an HCTN. Navigation is now available in a majority of community cancer centers and is used as an opportunity to provide culturally and linguistically appropriate patient support around cancer and clinical trials. Placing HCTNs in cancer treatment settings could be a cost-effective and efficient method of providing navigation, while also facilitating state-of-the-art care through clinical trials. Opportunities exist for additional studies of navigation to increase clinical trial participation in underserved populations. Citation Format: Carla Strom, Kathryn E. Weaver, Jimmy Ruiz, Karen M. Winkfield. Hispanic patient navigation: An intervention to increase clinical trial participation [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A20.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"62 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Behavioral and Social Science","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1158/1538-7755.DISP17-A20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Background: Hispanics are the fastest-growing population in North Carolina and have unique health care needs related to culture and language. To meet their needs and address the historically low participation in cancer clinical trials, we developed a bilingual Hispanic Clinical Trial Navigator (HCTN) position to support Hispanic adult and pediatric patients treated at Wake Forest Baptist Comprehensive Cancer Center (WFBCCC). The HCTN is a novel approach to integrate culturally and linguistically competent navigation with support around clinical trial decision making. The purpose of this analysis was to evaluate the services provided during the program9s first year and its impact on clinical trial participation. Methods: Retrospective data from 11/1/2015 to 10/31/2016 were obtained from a navigation database, WFBCCC cancer registry, and clinical trial system. Data are reported in the aggregate, and clinical trial participation rates were compared to data prior to the hiring of the HCTN (11/1/2014-10/31/2015). Results: There were 108 pediatric and adult patients navigated during the first year; 55 breast screening/diagnostic and 53 cancer treatment. The majority of patients were female (87%) with a mean age of 45 years. The most common diagnoses among treatment patients were breast (47%), hematologic (34%), and gastrointestinal (6%) malignancies. Major patient barriers identified include treatment logistics/transportation (87%), financial/insurance (70%) information/education (55%), and continuity of care (53%). In addition to education and referrals, the HCTN was able to remove potential barriers to trial participation through transportation assistance (31%), meal vouchers (21%), and parking validation (40%). In the year prior to the HCTN there were 88 newly diagnosed Hispanic patients with a clinical trial participation rate of 20% in treatment/non-treatment intervention studies. With HCTN navigation, clinical trial participation among Hispanic patients navigated was 34%. Conclusions: Our data indicate an initial success in increasing Hispanic participation in cancer clinical trials utilizing an HCTN. Navigation is now available in a majority of community cancer centers and is used as an opportunity to provide culturally and linguistically appropriate patient support around cancer and clinical trials. Placing HCTNs in cancer treatment settings could be a cost-effective and efficient method of providing navigation, while also facilitating state-of-the-art care through clinical trials. Opportunities exist for additional studies of navigation to increase clinical trial participation in underserved populations. Citation Format: Carla Strom, Kathryn E. Weaver, Jimmy Ruiz, Karen M. Winkfield. Hispanic patient navigation: An intervention to increase clinical trial participation [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A20.
背景:西班牙裔是北卡罗来纳州增长最快的人口,他们在文化和语言方面有独特的医疗保健需求。为了满足他们的需求,并解决历史上癌症临床试验参与率低的问题,我们开发了一个双语西班牙裔临床试验领航员(HCTN)职位,以支持在维克森林浸信会综合癌症中心(WFBCCC)接受治疗的西班牙裔成人和儿科患者。HCTN是一种新颖的方法,将文化和语言能力的导航与临床试验决策的支持结合起来。本分析的目的是评估项目第一年提供的服务及其对临床试验参与的影响。方法:从导航数据库、WFBCCC癌症登记处和临床试验系统获取2015年1月11日至2016年10月31日的回顾性数据。汇总报告数据,并将临床试验参与率与聘请HCTN之前(2014年11月1日- 2015年10月31日)的数据进行比较。结果:第一年有108名儿童和成人患者导航;55例乳腺癌筛查/诊断,53例癌症治疗。大多数患者为女性(87%),平均年龄45岁。在接受治疗的患者中,最常见的诊断是乳腺(47%)、血液(34%)和胃肠道(6%)恶性肿瘤。确定的主要患者障碍包括治疗物流/运输(87%)、财务/保险(70%)、信息/教育(55%)和护理连续性(53%)。除了教育和推荐之外,HCTN还能够通过交通援助(31%)、膳食券(21%)和停车验证(40%)消除参与试验的潜在障碍。在HCTN之前的一年中,有88名新诊断的西班牙裔患者,在治疗/非治疗干预研究中的临床试验参与率为20%。使用HCTN导航,西班牙裔患者的临床试验参与率为34%。结论:我们的数据表明,在利用HCTN增加西班牙裔参与癌症临床试验方面取得了初步成功。现在大多数社区癌症中心都可以使用导航,并以此为契机,为癌症和临床试验提供文化和语言上适当的患者支持。将hctn放置在癌症治疗环境中可能是一种具有成本效益和有效的导航方法,同时还可以通过临床试验促进最先进的护理。有机会进行更多的导航研究,以增加服务不足人群的临床试验参与。引文格式:Carla Strom, Kathryn E. Weaver, Jimmy Ruiz, Karen M. Winkfield。西班牙裔患者导航:增加临床试验参与的干预措施[摘要]。见:第十届AACR会议论文集:种族/少数民族和医疗服务不足人群的癌症健康差异科学;2017年9月25-28日;亚特兰大,乔治亚州。费城(PA): AACR;癌症流行病学杂志,2018;27(7增刊):摘要nr A20。