Memorial Sloan-Kettering Cancer Center, New York, USA.
University of Florida, Gainesville, USA.
J Cancer Educ. 2021 Oct;36(5):1039-1044. doi: 10.1007/s13187-020-01731-3.
Participation in cancer clinical trials (CCTs) is critical to improving cancer treatments and quality of care. However, rates of patient participation remain low. Research has shown that a trusted physician recommendation is an important influence on patients' decisions to enroll in a CCT. Improving primary care providers' (PCPs') knowledge, attitudes, and beliefs about CCTs is a promising potential path for improving CCT participation. The aim of this pilot study was to test the effect of an online educational course for PCPs about clinical trials on primary care providers' knowledge, attitudes and beliefs, and behavior. Forty-one PCPs in the New York City area participated in a 1-h online training session on cancer clinical trials. These PCPs had self-selected to complete the training in a previous survey. The objectives of the training module were to (1) educate the PCPs about clinical trials, with a focus on overcoming misconceptions; and (2) discuss roles of PCPs in partnering with oncologists to help patients gain access to clinical trials. The training module included didactics, audio excerpts, and case descriptions. Participants completed a pre-test immediately before taking the course, a post-test immediately after taking the course, and a 3-month post-course survey. All three assessments included a general T/F knowledge test, a 7-item attitude/belief scale, and a knowledge test focused specifically on local resources and access for clinical trials. Forty-one PCPs completed the module and the pre-post course surveys. Eighty percent (33/41) also completed the 3-month post-course survey. General knowledge and local knowledge increased significantly (p < .05) from pre- to post-course. At 3 months post-training, both general and local knowledge scores remained significantly increased from baseline. For those who completed the 3-month post-course survey, attitudes and beliefs increased significantly from pre- to post-course, but this change was not sustained at 3 months post-training. At 3 months post-training, 52% of the PCPs who had an interaction with a recently diagnosed cancer patient reported speaking with patients about CCTs as a result of the training. A brief online course showed significant and sustained improvement in PCPs' general and local knowledge about cancer clinical trials, which translated into self-reported behavior change. Future dissemination of the course and further research into its impact are important next steps.
参与癌症临床试验（CCTs）对于改善癌症治疗和护理质量至关重要。然而，患者参与率仍然很低。研究表明，医生的推荐是影响患者参加 CCT 的重要因素。提高初级保健提供者（PCPs）对 CCT 的知识、态度和信念是提高 CCT 参与率的一个有前途的潜在途径。这项试点研究的目的是测试针对 PCP 关于临床试验的在线教育课程对初级保健提供者的知识、态度和信念以及行为的影响。纽约市地区的 41 名 PCP 参加了 1 小时的在线培训课程，内容是关于癌症临床试验。这些 PCP 之前在一项调查中自愿选择完成培训。培训模块的目标是：（1）教育 PCP 关于临床试验的知识，重点是克服误解；（2）讨论 PCP 在与肿瘤学家合作帮助患者获得临床试验机会方面的作用。培训模块包括讲座、音频摘录和案例描述。参与者在参加课程前立即完成前测，在参加课程后立即完成后测，并在 3 个月后完成课程后调查。所有三项评估都包括一般的 T/F 知识测试、7 项态度/信念量表和一项专门针对当地资源和临床试验机会的知识测试。41 名 PCP 完成了模块和课程前后的调查。80%（33/41）还完成了 3 个月后的课程后调查。一般知识和本地知识显著增加（p < .05），从课前到课后。在培训后 3 个月，一般和本地知识得分仍明显高于基线。对于那些完成 3 个月后课程调查的人，态度和信念从课前到课后显著增加，但这种变化在培训后 3 个月没有持续。在培训后 3 个月，52%与最近诊断出癌症的患者有过互动的 PCP 报告说，由于培训，他们与患者讨论了 CCTs。简短的在线课程显著提高了 PCP 对癌症临床试验的一般和本地知识，这转化为自我报告的行为改变。进一步传播课程并进一步研究其影响是下一步的重要工作。
