The University of Kansas Cancer Center's- MCA Rural NCORP

摘要 堪萨斯大学癌症中心-中西部癌症联盟农村中心的首要目标 NCORP(KUCC-MCA农村NCORP)是为了增强增加临床试验收益和 农村人口参与癌症控制、预防、治疗和护理提供临床试验，如 以及由NCORP研究基地开发和进行的其他人体研究。当癌症影响到 所有人口群体、某些亚群，包括那些生活在农村社区的人，比 其他。[1，2]促成风险的因素包括年龄较大、保险覆盖范围不足、社会经济状况较差 地位、少数族裔和更孤立的地理位置--所有这些都可能成为获得专业知识的障碍 医疗保健。由于地理障碍而无法获得临床试验显然对农村患者和 是他们最常被引用的不参加研究的理由。[5]居住在郊区的患者有 临床试验的收益率最高，而生活在农村地区的患者的收益率相当低[6，7]。这所大学 堪萨斯癌症中心(KUCC)的 农村人口通过其领导的中西部癌症联盟(MCA)及其已完成的干部 具有丰富农村社区和实践工作经验的调查人员。作为外展网络 在KUCC中，MCA与全州的医院、癌症中心和医疗保健提供者建立了合作伙伴关系 堪萨斯州已经有十多年了。这些MCA伙伴关系的目标一直是扩大 对代表性不足的社区进行临床研究，重点是农村和低收入社区。MCA 最近扩大到包括堪萨斯州的全州农村初级保健实践研究网络 参与预防研究的患者和提供者(KPPEPR)，一个由超过75名初级保健人员组成的网络 来自堪萨斯州各地长期支持癌症预防和控制研究的提供者 首创精神。KUCC-MCA农村NCORP将利用我们作为SWOG成员超过45年的经验，20年 通过远程医疗提供肿瘤学护理的经验，15年成功开展研究的历史 农村初级保健环境，以及在农村卫生保健领域开设和运行临床试验的10年经验 网络-全部由KUCC在与农村肿瘤学和初级保健实践合作方面的专业知识支持，以 完成我们的目标。具体来说，对于KUCC-MCA农村NCORP，我们将评估机构、提供者、 临床试验和患者对试验收益的障碍，并实施流程以：1)增强基础设施 地方癌症中心和初级保健办公室，以支持农村社区的临床试验收益；2)扩大 通过在当地农村地区提供可用的NCORP临床试验，获得跨MCA网络的临床试验 社区；3)减少堪萨斯州农村和低收入患者参与临床试验的障碍 和密苏里州西部，在他们的家乡社区提供参与试验的机会；以及4)利用 KUCC/MCA在解决农村癌症差异方面的专业知识，以及与NCORP受赠者一起参与临床试验。

Abstract The overarching goal for The University of Kansas Cancer Center – Midwest Cancer Alliance Rural NCORP (KUCC-MCA Rural NCORP) is to enhance capacity for increasing clinical trials accrual and participation of rural populations in cancer control, prevention, treatment, and care delivery clinical trials, as well as in other human research developed and conducted by NCORP Research Bases. While cancer affects all population groups, certain subgroups, including those living in rural communities, are more at risk than others.[1, 2] Contributing risk factors include older age, inadequate insurance coverage, lower socio-economic status, minority race, and more isolated geography—all of which can be barriers to receiving specialty healthcare. Inaccessibility of clinical trials due to geographical barriers clearly disadvantages rural patients and is their most frequently cited reason for not enrolling in studies.[5] Patients living in suburban areas have the highest accrual rates to clinical trials, while those by patients living in rural areas is quite low[6, 7]. The University of Kansas Cancer Center (KUCC) is strongly positioned to enhance clinical trial accrual and participation of rural populations through its leadership of the Midwest Cancer Alliance (MCA) and its cadre of accomplished investigators with extensive experience working with rural communities and practices. As the outreach network of the KUCC, the MCA has partnered with hospitals, cancer centers, and health care providers across the state of Kansas for over a decade. The goal of these MCA partnerships has always been to extend the reach of clinical research into under-represented communities, with a focus on rural and low-income communities. MCA recently expanded to include our state-wide rural primary care practice based research network, Kansas Patients and Providers Engaged in Prevention Research (KPPEPR), a network of over 75 primary care providers from across Kansas with a longstanding history of supporting cancer prevention and control research initiatives. KUCC-MCA Rural NCORP will leverage our over 45-year experience as a SWOG-member, 20-year experience providing oncology care via telemedicine, 15-year history of successfully conducting research in rural primary care settings, and 10-year experience opening and running clinical trials within rural health care networks—all supported by KUCC expertise in partnering with rural oncology and primary care practices to accomplish our goals. Specifically for the KUCC-MCA Rural NCORP, we will assess institutional, provider, clinical trial, and patient barriers to trial accrual, and implement processes to: 1) Enhance the infrastructure of local cancer centers and primary care offices to support clinical trials accrual in rural communities; 2) Expand access to clinical trials across the MCA network by offering available NCORP clinical trials in local rural communities; 3) Decrease barriers to clinical trial participation for rural and low-income patients across Kansas and western Missouri by providing trial participation opportunities in their home communities; and 4) Leverage KUCC/MCA expertise for addressing rural cancer disparities to clinical trial participation with NCORP grantees.