GO2 for Lung Cancer, Washington, DC, United States.
Memorial Sloan Kettering Cancer Center, New York, NY, United States.
BMC Health Serv Res. 2024 Aug 5;24(1):891. doi: 10.1186/s12913-024-11376-3.
Increased engagement with community-based practices is a promising strategy for increasing clinical trials access of diverse patient populations. In this study we assessed the ability to utilize a patient-advocacy organization led clinical network to engage diverse practices as field sites for clinical research.
GO2 for Lung Cancer led recruitment efforts of 17 field sites from their Centers of Excellence in Lung Cancer Screening Network for participation in an implementation-effectiveness trial focused on smoking cessation integration into screening programs for lung cancer. Sites were engaged by one of three methods: 1) Pre-Grant submission of letters of support, 2) a non-targeted study information dissemination campaign to network members, and 3) proactive, targeted outreach to specific centers informed by previously submitted network member data. Detailed self-reported information on barriers to participation was collected from centers that declined to join the study.
Of 17 total field sites, 16 were recruited via the targeted outreach campaign and 1 via pre-grant letter of support submission. The sites covered 13 states and 4 United States geographic regions, were varied in annual screening volumes and years of screening program experience and were predominantly community-based practices (10 of 17 sites). The most reported reason (by 33% of sites) for declining to participate as a field site was inadequate staffing bandwidth for trial activities. This was especially true in community-based programs among which it was reported by 45% as a reason for declining.
Our results suggest that this model of field site recruitment leveraging an existing partnership between an academic research team and an informal clinical network maintained by a disease-specific patient advocacy organization can result in engagement of diverse, community-based field sites. Additionally, reported barriers to participation by sites indicate that solutions centered around providing additional resources to enable greater capacity for site staff may increase community-practice participation in research.
加强与社区实践的合作是增加不同患者群体参与临床试验的有前途的策略。在这项研究中，我们评估了利用患者倡导组织领导的临床网络来吸引不同实践作为临床研究现场的能力。
GO2 肺癌研究团队通过其肺癌筛查网络卓越中心的努力，招募了 17 个现场站点参与一项实施效果试验，该试验侧重于将戒烟整合到肺癌筛查计划中。站点通过以下三种方法之一参与：1）预先提交支持信，2）向网络成员进行非目标研究信息传播活动，3）根据先前提交的网络成员数据，积极主动地针对特定中心进行外联。从拒绝加入研究的中心收集了有关参与障碍的详细自我报告信息。
在 17 个总现场站点中，有 16 个是通过有针对性的外展活动招募的，1 个是通过预先提交的支持信招募的。这些站点覆盖了 13 个州和 4 个美国地理区域，年筛查量和筛查项目经验各不相同，主要是社区实践（17 个站点中的 10 个）。拒绝作为现场站点参与的最常见原因（占站点的 33%）是用于试验活动的人员配备带宽不足。在社区为基础的项目中尤其如此，其中有 45%的站点报告说这是拒绝的原因。
我们的研究结果表明，这种利用学术研究团队与疾病特异性患者倡导组织维护的非正式临床网络之间现有合作关系的现场站点招募模式，可以吸引不同的社区实践参与。此外，站点报告的参与障碍表明，以提供更多资源为中心的解决方案，以提高站点工作人员的能力，可能会增加社区实践对研究的参与。
