Physician perspectives on increasing minorities in cancer clinical trials:An Eastern Cooperative Oncology Group (ECOG) initiative

PURPOSE: This paper describes the ECOG NMA Minority Accrual Initiative to a ssure minority participation in cancer clinical trials. METHODS: Focus groups were held to identify physician reported barriers to the enrollment of minority patients in Cleveland, OH, Indianapolis, IN, San ta Clara County, CA, and Philadelphia, PA. Community physicians affiliated with the National Medical Association (NMA), and Eastern Cooperative Oncolo gy Group (ECOG) investigators participated in the focus groups. A four-step process consisting of focus group workshops were conducted to (i) identify barriers, (ii) develop potential solutions to the barriers, (iii) define s olutions to barriers involving specific clinical trials, and (iv) implement the solutions. RESULTS: Focus group participants identified physician lack of information, patient fears and suspicion, the fear of losing patients, and distrust of the health care system as the major barriers to enrollment of African Ameri cans. We found significant differences between community physicians and can cer program physicians in several areas. Community physicians emphasized pe rsonal contacts to address the lack of information and to overcome patient fears and suspicions, while the cancer program physicians emphasized printe d materials. There was no difference by region in the barriers identified i n the focus group workshops; however, the proposed solutions to overcoming the barriers were specific to each site. CONCLUSION: The four-step process developed by the ECOG and the NMA used th e focus group methodology to identify and overcome barriers to participatio n of African Americans in cancer clinical trials. Outreach efforts to educa te patients, their families, and community physicians about cancer clinical trials should be directed at overcoming patient suspicions and providing p ractical information to physicians about specific trials and how to enroll patients. (C) 2000 Elsevier Science Inc. All rights reserved.