CTNow pilot study: A multilevel clinical trial education and clinical trial referral coordination intervention for rural oncology providers and patients with cancer.

Abstract

TPS1676 Background: Enhancing patient access to cancer clinical trials is an ASCO and NCI priority. Major barriers to clinical trial access in rural areas include limited awareness and knowledge of available cancer clinical trials among both rural oncology providers and patients with cancer. Our preliminary research found that only 9% of rural cancer patients have knowledge of clinical trials, and many providers lack the time or resources to discuss them in clinical settings. Hawaiʻi’s geographic isolation presents persistent barriers to clinical trial access, particularly for residents of the five rural neighbor islands of Hawaiʻi. Expanding clinical trial access requires not only increasing infrastructure and trial availability; enhancing provider and patient awareness and knowledge is a critical step toward improving access to trials in rural communities. A coordinated, culturally informed, and statewide approach is urgently needed to build trust, increase literacy on clinical research participation, and ensure that clinical trials become an equitable part of standard cancer care for all communities in Hawaiʻi. This pilot trial evaluates the preliminary efficacy of CTNow , a novel multilevel, multicomponent clinical trial education and clinical trial referral coordination intervention designed for rural oncology providers and patients with cancer. Methods: This multi-site pilot trial is currently open in three rural counties in Hawai‘i. The multilevel CTNow intervention includes: 1) two interactive webinar sessions for rural oncology providers; 2) a tablet-based multimedia education program for patients; and 3) referral resources for providers and an optional video chat feature for patients to connect with clinical trials staff for questions and/or referrals to trials. The study team developed intervention components that provide rural-specific provider clinical trial information, along with evidence-based patient education materials adapted for varying levels of health literacy. Key patient inclusion criteria include patient self-report of cancer diagnosis, current/past/planned treatment, and residency in rural areas. Provider participants include rural-based oncologists and advanced practice providers not currently involved in clinical trials. Planned enrollment includes 30 patients with any cancer type and 5 oncology providers practicing in rural Hawaii. The primary endpoint is within-patient and within-provider changes in knowledge of cancer clinical trials from baseline. Secondary endpoints include changes in attitudes toward clinical trials and self-efficacy related to trial participation, and utilization of video chat sessions. Enrollment began in March 2025. To date, 80% of patients and 100% of planned providers have been enrolled. Clinical trial information: NCT06237816 .