Driving Cutting Edge Clinical Trial Enrollment in Rural Populations: West Virginia's Mobile Clinical Trials Unit

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Clinical trial access to all populations is critically important to maintain scientific integrity, generalizability of results, and access to novel treatments only available through trials. Rural populations in the United States are underrepresented in clinical trials for multiple reasons, including geographic proximity of trial sites which have been demonstrated to be clustered around urban areas. Rural Americans are more likely to die from cancer, heart disease, stroke, and chronic lung diseases than persons living in urban areas, and the gap widened in recent years for cancer, heart disease, and chronic lung disease. Not surprisingly, many of the states with the worst health outcomes in 2019 contain large rural areas. Reasons for these disparities are likely multi-factorial, yet recent data in cancer suggest that availability of clinical trials may actually improve health outcomes. Mobile clinical trial units have been demonstrated to double enrollment in prevention trials among individuals with cognitive impairment with mobile unit participant enrollment exceeding enrollment in the main clinic. In the same study, other positive results included, increased community visibility of research and a community view that efforts were being made to accommodate them. The goal of this proposal is to vastly increase clinical trial access for rural West Virginia (WV) populations through procurement of a mobile laboratory with which to conduct clinical trial recruitment and follow-up visits throughout the state, including remote areas. The mobile facility contains a reception area where potential trial participants are welcomed and basic non-medical information is gathered. Two fully outfitted exam rooms provide privacy for medical assessment of clinical trial participants. A lab area (complete with refrigerator) for drawing and processing patient samples and a fully functional bathroom are also included in the mobile unit. A slide-out wall provides for the additional space facilitating adequate reception and exam room space and a retractable awning will provide for outdoor activity or waiting space, weather permitting. Importantly, outfitting the mobile unit with a diesel engine will ensure our ability to travel up and down the WV mountains to remote rural sites, thereby, bringing cutting- edge trials to the most out-of-the-way areas of our state.