scholarly journals Using A Behavioral Model to Assess The Barriers And Facilitators to Engaging Local Healthcare Providers In Conducting Interventional Cancer Trials In Nigeria

Author(s):  
Abiola Ibraheem ◽  
Mojisola Oluwasanu ◽  
Akinsegun Akinbami ◽  
Akinyimika Sowunmi ◽  
Stella Odedina ◽  
...  

Abstract BACKGROUND: Globalization of cancer clinical trials is now involving low middle income countries such as Nigeria as a rationale for global equity. With this ongoing clinical trial globalization, it is important to engage stakeholders such as local providers at the institutions where these trials are conducted by improving knowledge and perception of local providers concerning clinical trials.METHODS: This is a qualitative focused group study consisting of ten groups conducted at Lagos State University Teaching Hospital between November 2019 and January 2020 using locally developed probe questions to engage local providers according to departments. Transcripts of semi-structured interviews was analyzed using direct content analysis and was mapped against the implementation theory of capability, opportunity and motivation for behavior change(COM-B) to access the challenges and barriers reported by local providers. RESULTS: 239 local providers participated in this study, the challenges identified by providers were low knowledge about clinical trials, poor attitudes and systemic barriers. The opportunities suggested by local providers to improve the conduct of clinical trial in that environ included clinical trial workshops to improve baseline knowledge and perception and team collaboration between providers. CONCLUSION: As cancer clinical trials are being globalized, the local healthcare community should be brought to par with this new intervention and not be left behind. Training about clinical trials should not be limited to providers actively involved in the clinical trials but all the providers in that region should be empowered by improving the baseline knowledge and perception of clinical trials.

2020 ◽  
Author(s):  
Abiola Ibraheem ◽  
Mojisola Oluwasanu ◽  
Akinsegun Akinbami ◽  
Akinyimika Sowunmi ◽  
Stella Odedina ◽  
...  

Abstract PURPOSE: Globalization of cancer clinical trials is now involving low middle income countries such as Nigeria as a rationale for global equity. With this ongoing clinical trial globalization, it is important to engage stakeholders such as local providers at the institutions where these trials are conducted by improving knowledge and perception of local providers concerning clinical trials.METHODS: This is a qualitative focused group study consisting of ten groups conducted at Lagos State University Teaching Hospital between November 2019 and January 2020 using locally developed probe questions to engage local providers according to departments. Transcripts of semi-structured interviews was analyzed using direct content analysis and was mapped against the implementation theory of capability, opportunity and motivation for behavior change(COM-B) to access the challenges and barriers reported by local providers. RESULTS: 239 local providers participated in this study, the challenges identified by providers were low knowledge about clinical trials, poor attitudes and systemic barriers. The opportunities suggested by local providers to improve the conduct of clinical trial in that environ included clinical trial workshops to improve baseline knowledge and perception and team collaboration between providers. CONCLUSION: As cancer clinical trials are being globalized, the local healthcare community should be brought to par with this new intervention and not be left behind. Training about clinical trials should not be limited to providers actively involved in the clinical trials but all the providers in that region should be empowered by improving the baseline knowledge and perception of clinical trials.


2021 ◽  
pp. 826-832
Author(s):  
Jay G. Ronquillo ◽  
William T. Lester

PURPOSE Cloud computing has led to dramatic growth in the volume, variety, and velocity of cancer data. However, cloud platforms and services present new challenges for cancer research, particularly in understanding the practical tradeoffs between cloud performance, cost, and complexity. The goal of this study was to describe the practical challenges when using a cloud-based service to improve the cancer clinical trial matching process. METHODS We collected information for all interventional cancer clinical trials from ClinicalTrials.gov and used the Google Cloud Healthcare Natural Language Application Programming Interface (API) to analyze clinical trial Title and Eligibility Criteria text. An informatics pipeline leveraging interoperability standards summarized the distribution of cancer clinical trials, genes, laboratory tests, and medications extracted from cloud-based entity analysis. RESULTS There were a total of 38,851 cancer-related clinical trials found in this study, with the distribution of cancer categories extracted from Title text significantly different than in ClinicalTrials.gov ( P < .001). Cloud-based entity analysis of clinical trial criteria identified a total of 949 genes, 1,782 laboratory tests, 2,086 medications, and 4,902 National Cancer Institute Thesaurus terms, with estimated detection accuracies ranging from 12.8% to 89.9%. A total of 77,702 API calls processed an estimated 167,179 text records, which took a total of 1,979 processing-minutes (33.0 processing-hours), or approximately 1.5 seconds per API call. CONCLUSION Current general-purpose cloud health care tools—like the Google service in this study—should not be used for automated clinical trial matching unless they can perform effective extraction and classification of the clinical, genetic, and medication concepts central to precision oncology research. A strong understanding of the practical aspects of cloud computing will help researchers effectively navigate the vast data ecosystems in cancer research.


2020 ◽  
Author(s):  
Santam Chakraborty ◽  
Indranil Mallick ◽  
Hung N Luu ◽  
Tapesh Bhattacharyya ◽  
Arunsingh Moses ◽  
...  

Abstract Introduction The current study was aimed at quantifying the disparity in geographic access to cancer clinical trials in India. Methods We collated data of cancer clinical trials from the clinical trial registry of India (CTRI) and data on state-wise cancer incidence from the Global Burden of Disease Study. The total sample size for each clinical trial was divided by the trial duration to get the sample size per year. This was then divided by the number of states in which accrual was planned to get the sample size per year per state (SSY). For interventional trials investigating a therapy, the SSY was divided by the number of incident cancers in the state to get the SSY per 1,000 incident cancer cases. The SSY data was then mapped to visualise the geographical disparity.Results We identified 181 ongoing studies, of whom 132 were interventional studies. There was a substantial inter-state disparity - with a median SSY of 1.55 per 1000 incident cancer cases (range 0.00 - 296.81 per 1,000 incident cases) for therapeutic interventional studies. Disparities were starker when cancer site-wise SSY was considered. Even in the state with the highest SSY, only 29.7 % of the newly diagnosed cancer cases have an available slot in a therapeutic cancer clinical trial. Disparities in access were also apparent between academic (range: 0.21 - 226.60) and industry-sponsored trials (range: 0.17 - 70.21).Conclusion There are significant geographic disparities in access to cancer clinical trials in India. Future investigations should evaluate the reasons and mitigation approaches for such disparities.


2018 ◽  
Vol 48 (11) ◽  
pp. 995-1000 ◽  
Author(s):  
Nobuaki Ochi ◽  
Tatsuyuki Kawahara ◽  
Yasunari Nagasaki ◽  
Nozomu Nakagawa ◽  
Tomoko Yamagishi ◽  
...  

2008 ◽  
Vol 26 (27) ◽  
pp. 4458-4465 ◽  
Author(s):  
Julie Lemieux ◽  
Pamela J. Goodwin ◽  
Kathleen I. Pritchard ◽  
Karen A. Gelmon ◽  
Louise J. Bordeleau ◽  
...  

Purpose It is estimated that only 5% of patients with cancer participate in a clinical trial. Barriers to participation may relate to available protocols, physicians, and patients, but few data exist on barriers related to cancer care environments and protocol characteristics. Methods The primary objective was to identify characteristics of cancer care environments and clinical trial protocols associated with a low recruitment into breast cancer clinical trials. Secondary objectives were to determine yearly recruitment fraction onto clinical trials from 1997 to 2002 in Ontario, Canada, and to compare recruitment fraction among years. Questionnaires were sent to hospitals requesting characteristics of cancer care environments and to cooperative groups/pharmaceutical companies for information on protocols and the number of patients recruited per hospital/year. Poisson regression was used to estimate the recruitment fraction. Results Questionnaire completion rate varied between 69% and 100%. Recruitment fraction varied between 5.4% and 8.5% according to year. More than 30% of patients were diagnosed in hospitals with no available trials. In multivariate analysis, the following characteristics were associated with recruitment: use of placebo versus not (relative risk [RR] = 0.80; P = .05), nonmetastatic versus metastatic trial (RR = 2.80; P < .01), and for nonmetastatic trials, protocol allowing an interval of 12 weeks or longer versus less than 12 weeks (from diagnosis, surgery, or end of therapy) before enrollment (RR = 1.36; P < .01). Conclusion Allowable interval of 12 weeks or longer to randomly assign patients in clinical trials could help recruitment. In our study, absence of an available clinical trial represented the largest barrier to recruitment.


2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 79-79
Author(s):  
Donald W. Northfelt ◽  
Chara Chamie ◽  
Farhia Omar ◽  
Janet Okamoto ◽  
Timothy Mathews ◽  
...  

79 Background: Novel mechanisms are needed to provide high quality oncologic clinical care and clinical trial access to underserved and minority populations (UMP). UMP are underrepresented in cancer clinical trials, thus limiting the generalizability of the research. As a National Cancer Institute-Comprehensive Cancer Center, Mayo Clinic has the responsibility to ensure that its cancer care reaches a diverse patient population. Mayo Clinic in Arizona developed a clinical oncology practice in collaboration with the US Indian Health Service at Phoenix Indian Medical Center (PIMC), in part to address these needs. The relationship between Mayo and PIMC is invaluable and serves a crucial need in the community. The Mayo consultants serve as staff physicians in the “Oncology Center of Excellence” at PIMC and see 100 – 200 tribal members annually with new diagnoses of cancer or blood disorders. Being onsite at PIMC allows Mayo consultants to integrate seamlessly into the wider PIMC practice. Methods: Descriptive demographic data from the MCA-PIMC clinical practice were obtained from the PIMC practice database 2008 - 2017. Enrollment of MCA-PIMC patients into MCA cancer clinical trials were prospectively enumerated. Results: Between the time period of 2008-2017, 356 breast cancer patients and 259 colorectal cancer patients were seen by Mayo Clinic oncologists and the PIMC nurse practitioner. During the period of 2016-2017, there were 13 clinical trial referrals from PIMC with 8 of those patients being enrolled in Mayo cancer clinical trials. Conclusions: High quality oncologic clinical care can be provided via unique collaborations between academic oncology program and UMP-focused care provider. This mechanism allows access to cancer clinical trial opportunities for UMP. Prior to the established partnership, there were no Native American patients referred to clinical trials from PIMC, showing the critical pathway that has been forged. Importantly, this is the only known program of its kind in the country. By imbedding the cancer provider in the community, we are able to build trust with the underserved community and create a pathway to a quality care and clinical research.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19217-e19217
Author(s):  
Gautam Valecha ◽  
Nishitha Thumallapally ◽  
Sandy El Bitar ◽  
Terenig O. Terjanian ◽  
Louise Madrigal ◽  
...  

e19217 Background: Clinical trials offer several advantages to the patients including access to innovative treatments with improved survival rates, closer monitoring and follow-up with removal of health disparity; and aim to advance the science of medicine. Yet, worldwide enrollment rates in cancer clinical trials have been only about 5 percent, despite the fact that a significantly higher percentage of Americans have a desire to participate in clinical trials [1, 2]. We conducted a single institution study to gain knowledge about clinical trial awareness in our cancer patient population as well as to identify the barriers within provider-consumer communication that prevent enrollment. Methods: A 10-question survey was distributed by medical assistants and surveys (n=222) were collected at the end of each clinic visit. Responders included racial/ethnic minorities and underserved patients, representative of the ethnic diversity in the Staten Island Borough of New York City. Demographic data including age, gender, zip code, race and ethnicity were recorded. Additionally, Charlson comorbidity index and tumor stage was also recorded. Results: 159/222 patients (71.62%) completed the survey. Of these patients, 47 (29.55%) answered every question on the survey, while 112/159 patients (70.44%) answered only few of the questions. The completed surveys are linked by zip code to the different boroughs of Staten Island, which allows us to identify hubs with lack of clinical trial awareness knowledge. Conclusions: Despite the several advantages for patients and medical field, enrollment rates in clinical trials remain very low. Our study results help in gaining knowledge about clinical trial awareness among oncology patients, correlated to comorbidity and tumor stage. In addition, demographic hubs with lack of knowledge are identified as targets for community outreach and education. A multilevel approach will be developed to address identified barriers that exist for patients, and will be implemented at community level, to reduce ethnic bias in trial enrollment and increase trial participation among an ethnically diverse population. References: 1. Unger JM, Cook E, Tai E, Bleyer A: The Role of Clinical Trial Participation in Cancer Research: Barriers, Evidence, and Strategies. Am Soc Clin Oncol Educ Book. 2016, 35:185-198. 10.1200/EDBK_156686 2. Comis RL, Miller JD, Aldigé CR, Krebs L, Stoval E: Public attitudes toward participation in cancer clinical trials. J Clin Oncol. 2003, 21:830-835. 10.1200/JCO.2003.02.105.


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