title: Physician perspectives on increasing minorities in cancer clinical trials: an Eastern Cooperative Oncology Group (ECOG) Initiative.
abstract: OBJECTIVE
  This paper describes the ECOG-NMA Minority Accrual Initiative to assure 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, Santa Clara County, CA, and Philadelphia, PA. Community physicians affiliated with the National Medical Association (NMA), and Eastern Cooperative Oncology 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 solutions 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 Americans. We found significant differences between community physicians and cancer program physicians in several areas. Community physicians emphasized personal contacts to address the lack of information and to overcome patient fears and suspicions, while the cancer program physicians emphasized printed materials. There was no difference by region in the barriers identified in the focus group workshops; however, the proposed solutions to overcoming the barriers were specific to each site.
  
  
  CONCLUSIONS
  The four-step process developed by the ECOG and the NMA used the focus group methodology to identify and overcome barriers to participation of African Americans in cancer clinical trials. Outreach efforts to educate patients, their families, and community physicians about cancer clinical trials should be directed at overcoming patient suspicions and providing practical information to physicians about specific trials and how to enroll patients.
authors.affiliation: Oncology Section, Medical Service, VA Palo Alto Health Care System, CA, USA.
authors.forename: H A
authors.initials: HA
authors.lastname: Pinto
authors.forename: W
authors.initials: W
authors.lastname: McCaskill-Stevens
authors.forename: P
authors.initials: P
authors.lastname: Wolfe
authors.forename: A C
authors.initials: AC
authors.lastname: Marcus
mesh_terms: D001291:Attitude of Health Personnel; D002986:Clinical Trials as Topic; D017144:Focus Groups; D006801:Humans; D008913:Minority Groups; D009369:Neoplasms / Q000208:ethnology*; D018579:Patient Selection; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014481:United States