Understanding the Barriers to Pediatric Oncologist Engagement and Accrual to Clinical Trials in National Cancer Institute Designated Community Oncology Research Programs

QUESTION ASKED: What do pediatric oncologists and research associates at National Cancer Institute Community Oncology Research Programs (NCORPs) experience regarding clinical trial enrollment barriers, educational needs, and understanding/navigating organizational structure? SUMMARY ANSWER: The majority of participants reported a limited understanding of their NCORP structure and processes, a need for more education, as well as inadequate time and resources to manage their desired clinical research portfolio. WHAT WE DID: We conducted two quality improvement surveys of pediatric clinical research staff atNCORP sites. The first was a web-based inquiry sent via e-mail to NCORP Children s Oncology Group (COG) principal investigators (PIs) and lead clinical research associates (CRAs) containing questions designed to assess their general understanding of NCORP organization and structure as well as their educational and service needs. The second was a one-on-one telephone interview of COG PIs to identify specific barriers to physician engagement and patient enrollment in clinical trial research. WHAT WE FOUND: The majority of NCORP COG PIs and CRAs (63%) expressed a lack in understanding of the NCORP, and approximately half expressed the need to receive education on strategies to work with medical oncologists, increase adolescent and young adult (AYA) clinical trial accrual, and increase cancer control study enrollment. The majority of COG PIs (78%) experienced at least one shared barrier to clinical trial enrollment. The most frequently cited barriers were inadequate protected time and research support (39% each). BIAS, CONFOUNDING FACTORS: Our findings could be influenced by the biases inherent to surveys, including participant and interviewer bias. The surveys were primarily designed to help the COG NCORP Committee to improve its educational program and develop interventions to better serve the needs of its members and may not be generalizable beyond the domain of NCORP COG members. REAL-LIFE IMPLICATIONS: Maximizing clinical trial enrollment is a key strategy to progress in the treatment of patients with cancer. Oncologists and lead CRAs serve critical roles in clinical trial design and implementation. These key individuals report inadequate education, time, and resources as potential barriers to full engagement in clinical research. Addressing these barriers has the potential to increase the rate of enrollment in clinical trials and therefore contribute to progress in cancer therapy for children and AYAs.