Perspectives of facilitators and barriers to cancer clinical trial participation: A mixed-methods study.

e23206 Background: Inclusive clinical trials (CT) are integral to ensure that all patients benefit from advancements in cancer treatment. Having a diverse makeup of CT participants is imperative. Yet nationally, only 5% of trial participants are racial/ethnic minorities despite persistent disparities in cancer incidence and mortality. Determining the barriers and facilitators to CT participation will inform strategies to advance CT diversity, and cancer care equity. Methods: We conducted a mixed methods study exploring perceived barriers and facilitators to CT participation. We asked CT staff and Black adult cancer patients who enrolled in a CT to engage in semi-structured focus groups or interviews via Zoom. Based on emergent themes and data from extant literature we developed and deployed to CT staff a 24 item 5-point Likert style (strongly disagree – strongly agree) survey regarding clinician, institution, and patient-level factors impacting CT participation; one item ranked overall CT participation barriers. Results: Ten patients and thirteen CT staff participated in the focus groups and interviews. Table 1 presents major themes that emerged. CT survey respondents (N = 30) included clinicians (40%) and research associates (43%) and roughly half (55%) were White, non-Hispanic. The majority (80%) responded that their personal skills and confidence with enrolling diverse patients were high. The top ranked barriers to CT enrollment were travel distance (77%) and added financial burden (60%). Facilitators were altruism (70%) and clinician awareness of available trials (73%). Most (60%) endorsed perceptions that enrolling racial/ethnic patients was more challenging than White and that patient attributes (e.g., higher education, timeliness to appointments increased adherence to CTs protocols. Conclusions: Complex, multi-level factors influence CT enrollment and diversity with patient level factors of most concern. Multi-level approaches both internally and community-focused are necessary for CT participation and diversity. Efforts are necessary to mitigate implicit bias among CT staff, particularly as it relates to perceptions of patient attributes. To advance cancer care, CT participation equity must remain a priority.