title: Overcoming barriers to cancer clinical trial accrual: impact of a mass media campaign.
abstract: BACKGROUND
  Annually, only 3% of adult patients participate in cancer clinical trials (CCT). Accrual barriers include lack of CCT awareness and uncertain third-party coverage. In 2002, a California law (SB37) required all insurers to reimburse costs related to CCT. The objective of the current study was to increase awareness of CCT and SB37 through a mass multimedia campaign (MMC) in the University of California (UC) Davis (UCD) Cancer Center catchment area. The authors assessed willingness to participate in and accrual to CCT.
  
  
  METHODS
  Changes in CCT/SB37 awareness and willingness to participate were investigated before the MMC versus after the MMC and in UCD respondents versus UC San Diego (UCSD) catchment respondents-a control group that was not exposed to the MMC-by Pearson chi-square and logistic regression analyses.
  
  
  RESULTS
  Of 1081 post-MMC respondents, 957 were from UCD, and 124 from UCSD. UCD respondents had a greater awareness of CCT (59% vs 65%; P < .01) and SB37 (17% vs 32%; P < .01) compared with UCSD respondents. Willingness to participate did not change in either cohort. Awareness level predicted willingness (odds ratio, 2.3; P < .01). Blacks, Asians, and lowest income (<$25 K per year) groups were the least willing to participate (P < .01, P < .04, and P < .02, respectively). The CCT accrual rate at UCD was unchanged.
  
  
  CONCLUSIONS
  CCT and SB37 awareness increased significantly in the UCD cohort after the MMC. However, it was unclear whether this increase was attributable entirely to the MMC or to varying demographic variables. Enhancing patient willingness and accrual will require targeting other variables, such as physician or resource barriers, rather than just CCT and reimbursement awareness.
authors.affiliation: University of California Davis Cancer Center, Sacramento, California 95817, USA.
authors.forename: Ari
authors.initials: A
authors.lastname: Umutyan
authors.forename: Christine
authors.initials: C
authors.lastname: Chiechi
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Beckett
authors.forename: Debora A
authors.initials: DA
authors.lastname: Paterniti
authors.forename: Corinne
authors.initials: C
authors.lastname: Turrell
authors.forename: David R
authors.initials: DR
authors.lastname: Gandara
authors.forename: Sharon W
authors.initials: SW
authors.lastname: Davis
authors.forename: Ted
authors.initials: T
authors.lastname: Wun
authors.forename: Moon S
authors.initials: MS
authors.lastname: Chen
authors.forename: Primo N
authors.initials: PN
authors.lastname: Lara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D002986:Clinical Trials as Topic / Q000331:legislation & jurisprudence; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010358:Patient Participation / Q000191:economics; D045808:Refusal to Participate