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The Impact of an Online Training Program About Cancer Clinical Trials on Primary Care Physicians’ Knowledge, Attitudes and Beliefs, and Behavior

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Abstract

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.

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References

  1. Hickner J, Kent S, Naragon P, Hunt L (2007) Physicians’ and patients’ views of cancer care by family physicians: a report from the American Academy of Family Physicians National Research Network. Fam Med 39(2):126–131

    PubMed  Google Scholar 

  2. Klabunde CN, Ambs A, Keating NL, He Y, Doucette WR, Tisnado D, Clauser S, Kahn KL (2009) The role of primary care physicians in cancer care. J Gen Intern Med 24(9):1029–1036. https://doi.org/10.1007/s11606-009-1058-x

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sprague Martinez L, Freeman ER, Winkfield KM (2017) Perceptions of cancer care and clinical trials in the black community: implications for care coordination between oncology and primary care teams. Oncologist 22(9):1094–1101. https://doi.org/10.1634/theoncologist.2017-0122

    Article  PubMed  PubMed Central  Google Scholar 

  4. Trials, Institute of Medicine Committee on Cancer Clinical, and The N. C. I. Cooperative Group Program (2010) In: Nass SJ, Moses HL, Mendelsohn J (eds) A national cancer clinical trials system for the 21st century: reinvigorating the NCI cooperative group program. National Academies Press (US), Washington (DC) Copyright 2010 by the National Academy of Sciences. All rights reserved

    Google Scholar 

  5. Commission on Cancer, American College of Surgeons (2016) Cancer program standards: Ensuring patient-centered care. https://www.facs.org/quality-programs/cancer/coc/standards/2016

  6. Denicoff AM, McCaskill-Stevens W, Grubbs SS, Bruinooge SS, Comis RL, Devine P, Dilts DM, Duff ME, Ford JG, Joffe S, Schapira L, Weinfurt KP, Michaels M, Raghavan D, Richmond ES, Zon R, Albrecht TL, Bookman MA, Dowlati A, Enos RA, Fouad MN, Good M, Hicks WJ, Loehrer PJ Sr, Lyss AP, Wolff SN, Wujcik DM, Meropol NJ (2013) The National Cancer Institute-American Society of Clinical Oncology Cancer Trial Accrual Symposium: summary and recommendations. J Oncol Pract 9(6):267–276. https://doi.org/10.1200/jop.2013.001119

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lara PN Jr, Higdon R, Lim N, Kwan K, Tanaka M, Lau DH, Wun T et al (2001) Prospective evaluation of cancer clinical trial accrual patterns: identifying potential barriers to enrollment. J Clin Oncol 19(6):1728–1733. https://doi.org/10.1200/jco.2001.19.6.1728

    Article  PubMed  Google Scholar 

  8. American Cancer Society Cancer Action Network (2018) Barriers to patient enrollment in therapeutic clinical trials for cancer. https://www.fightcancer.org/sites/default/files/National%20Documents/Clinical-Trials-Landscape-Report.pdf

  9. Joseph G, Dohan D (2009) Diversity of participants in clinical trials in an academic medical center: the role of the ‘good study patient?’. Cancer 115(3):608–615. https://doi.org/10.1002/cncr.24028

    Article  PubMed  Google Scholar 

  10. Ulrich CM, James JL, Walker EM, Stine SH, Gore E, Prestidge B, Michalski J, Gwede CK, Chamberlain R, Bruner DW (2010) RTOG physician and research associate attitudes, beliefs and practices regarding clinical trials: implications for improving patient recruitment. Contemp Clin Trials 31(3):221–228. https://doi.org/10.1016/j.cct.2010.03.002

    Article  PubMed  Google Scholar 

  11. Chen L, Grant J, Cheung WY, Kennecke HF (2013) Screening intervention to identify eligible patients and improve accrual to phase II-IV oncology clinical trials. J Oncol Pract 9(4):e174–e181. https://doi.org/10.1200/jop.2012.000763

    Article  PubMed  PubMed Central  Google Scholar 

  12. Flocke SA, Antognoli E, Daly BJ, Jackson B, Fulton SE, Liu TM, Surdam J, Manne S, Meropol NJ (2017) The role of oncology nurses in discussing clinical trials. Oncol Nurs Forum 44(5):547–552. https://doi.org/10.1188/17.Onf.547-552

    Article  PubMed  PubMed Central  Google Scholar 

  13. Meropol NJ, Wong YN, Albrecht T, Manne S, Miller SM, Flamm AL, Benson AB 3rd et al (2016) Randomized trial of a web-based intervention to address barriers to clinical trials. J Clin Oncol 34(5):469–478. https://doi.org/10.1200/jco.2015.63.2257

    Article  PubMed  Google Scholar 

  14. Michaels M, Weiss ES, Guidry JA, Blakeney N, Swords L, Gibbs B, Yeun S, Rytkonen B, Goodman R, Jarama SL, Greene AL, Patel S (2012) The promise of community-based advocacy and education efforts for increasing cancer clinical trials accrual. J Cancer Educ 27(1):67–74. https://doi.org/10.1007/s13187-011-0271-6

    Article  PubMed  Google Scholar 

  15. Robinson MK, Tsark JU, Braun KL (2014) Increasing primary care physician support for and promotion of cancer clinical trials. Hawaii J Med Public Health 73(3):84–87 quiz 88

    PubMed  PubMed Central  Google Scholar 

  16. Bylund CL, Weiss ES, Michaels M, Patel S, D’Agostino TA, Peterson EB, Binz-Scharf MC, Blakeney N, McKee MD (2017) Primary care physicians’ attitudes and beliefs about cancer clinical trials. Clin Trials 14(5):518–525. https://doi.org/10.1177/1740774517717722

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kirkpatrick (1967) Evaluation of training. In: Craig R, Bittlel I (eds) Training and development handbook. McGraw Hill, New York

    Google Scholar 

  18. Hutchinson L (1999) Evaluating and researching the effectiveness of educational interventions. BMJ 318:1267–1269

    Article  CAS  Google Scholar 

  19. Avis NE, Smith KW, Link CL, Hortobagyi GN, Rivera E (2006) Factors associated with participation in breast cancer treatment clinical trials. J Clin Oncol 24(12):1860–1867. https://doi.org/10.1200/jco.2005.03.8976

    Article  PubMed  Google Scholar 

  20. Lawrence RA, McLoone JK, Wakefield CE, Cohn RJ (2016) Primary care physicians’ perspectives of their role in cancer care: a systematic review. J Gen Intern Med 31(10):1222–1236. https://doi.org/10.1007/s11606-016-3746-7

    Article  PubMed  PubMed Central  Google Scholar 

  21. Klabunde CN, Han PK, Earle CC, Smith T, Ayanian JZ, Lee R, Ambs A, Rowland JH, Potosky AL (2013) Physician roles in the cancer-related follow-up care of cancer survivors. Fam Med 45(7):463–474

    PubMed  PubMed Central  Google Scholar 

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Funding

This work was financially supported by grants from the National Institute of Health and National Cancer Institute (U54CA132378 and U54 CA137788) and the Memorial Sloan Kettering Cancer Center Core Grant (P30 CA008748).

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Authors and Affiliations

  1. Memorial Sloan-Kettering Cancer Center, New York, USA

    Carma L. Bylund & Thomas A. D’Agostino

  2. University of Florida, Gainesville, USA

    Carma L. Bylund

  3. Education Network to Advance Cancer Clinical Trials, Bethesda, USA

    Margo Michaels

  4. Health Access and Action Consulting Newton, Massachusetts, USA

    Margo Michaels

  5. Albert Einstein College of Medicine, Bronx, USA

    Elisa S. Weiss & Shilpa Patel

  6. The Leukemia & Lymphoma Society, Rye Brook, NY, USA

    Elisa S. Weiss

  7. The Center for Health Care Strategies, Hamilton, USA

    Shilpa Patel

  8. Albany Stratton VA Medical Center, Albany, USA

    Thomas A. D’Agostino

  9. CUNY - City College of New York, New York, USA

    Maria Christina Binz-Scharf

  10. Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, USA

    Diane McKee

  11. Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, USA

    Diane McKee

Authors
  1. Carma L. Bylund
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  2. Margo Michaels
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  3. Elisa S. Weiss
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  4. Shilpa Patel
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  5. Thomas A. D’Agostino
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  6. Maria Christina Binz-Scharf
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  7. Diane McKee
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Correspondence to Carma L. Bylund.

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Bylund, C.L., Michaels, M., Weiss, E.S. et al. The Impact of an Online Training Program About Cancer Clinical Trials on Primary Care Physicians’ Knowledge, Attitudes and Beliefs, and Behavior. J Canc Educ 36, 1039–1044 (2021). https://doi.org/10.1007/s13187-020-01731-3

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  • DOI: https://doi.org/10.1007/s13187-020-01731-3

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