title: An institutional strategy to increase minority recruitment to therapeutic trials.
abstract: OBJECTIVE
  Participation in therapeutic clinical trials rarely reflects the race and ethnic composition of the patient population. To meet National Institutes of Health-mandated goals, strategies to increase participation are required. We present a framework for institutional enhancement of minority clinical trial accrual.
  
  
  METHODS
  We implemented structural changes on four levels to induce and sustain minority accrual to clinical trials: (1) leadership support; (2) center-wide policy change; (3) infrastructural process control, data analysis, and reporting; and (4) follow-up with clinical investigators. A Protocol Review and Monitoring Committee reviews studies and monitors accrual, and the Program for the Elimination Cancer Disparities leads efforts for proportional accrual, supporting the system through data tracking, Web tools, and feedback to investigators.
  
  
  RESULTS
  Following implementation in 2005, minority accrual to therapeutic trials increased from 12.0 % in 2005 to 14.0 % in 2010. The "rolling average" minority cancer incidence at the institution during this timeframe was 17.5 %. In addition to therapeutic trial accrual rates, we note significant increase in the number of minorities participating in all trials (therapeutic and nontherapeutic) from 2005 to 2010 (346-552, 60 % increase, p < 0.05) compared to a 52 % increase for Caucasians.
  
  
  CONCLUSIONS
  Implementing a system to aid investigators in planning and establishing targets for accrual, while requiring this component as a part of annual protocol review and monitoring of accrual, offers a successful strategy that can be replicated in other cancer centers, an approach that may extend to other clinical and translational research centers.
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Victoria V
authors.initials: VV
authors.lastname: Anwuri
authors.forename: Lannis E
authors.initials: LE
authors.lastname: Hall
authors.forename: Katherine
authors.initials: K
authors.lastname: Mathews
authors.forename: Brian C
authors.initials: BC
authors.lastname: Springer
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Tappenden
authors.forename: Dione M
authors.initials: DM
authors.lastname: Farria
authors.forename: Sherrill
authors.initials: S
authors.lastname: Jackson
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Eberlein
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods*; D054625:Healthcare Disparities; D006801:Humans; D008913:Minority Groups; D009369:Neoplasms / Q000208:ethnology* / Q000628:therapy; D010358:Patient Participation; D018579:Patient Selection; D014481:United States