A Multi-level Approach to Connecting Individuals to Cancer Clinical Research

Increasing patient participation in cancer clinical trials (CCTs) is vital to the advancement of oncology across the continuum of care. Low trust in clinical research and recruitment approaches that fail to address multilevel barriers to CCT participation are key reasons for poor study recruitment. Community health educators (CHEs) improve trust in research among many communities; yet relying exclusively on CHE availability can limit intervention reach. Virtual CHEs (vCHEs) improve scalability by extending CHE capabilities and capitalizing on remote recruitment techniques. The purpose of the current project is to increase the referral of patients to NCI-supported CCTs via a tailored, multi-level intervention. The ALEX Research Referral Portal utilizes adaptive virtual human technology that provides users with tailored CCT information. Through AI-enabled technology, human CHEs can become vCHEs to reach patients through digital outreach. Clinicians can utilize the portal to refer patients to CCTs; however, patients, families, and community members can also use the portal to easily navigate key information and make self-referrals. The ability to streamline research information from https://clinicaltrials.gov/ to patients, and then CCT referral from patient to study coordinators, is expected to improve referral to CCTs. The ALEX Research Portal will be developed with unique a multi-cancer center collaborative opportunity to provide access to patients in Florida and the nation, and in coordination with cancer centers conducting CCTs associated with national networks (ETCTN, NCTN, NCORP). Guided by the Interactive Systems Framework, this project will be conducted in three phases: establish a baseline of referrals and accrual of patients to CCTs across multiple Florida Cancer Centers (Phase 1), adapt and pilot the ALEX Research Referral Portal using a randomized controlled clinical trial (Phase 2), and scale the intervention by dissemination through national networks (Phase 3). The proposed study will result in an empirically-tested intervention that can easily be adapted and disseminated across the state and nation to overcome multi-level challenges associated with recruiting participants to CCTs.