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

摘要 堪萨斯大学癌症中心-中西部农村癌症联盟的总体目标 NCORP（KUCC-MCA Rural NCORP）旨在提高增加临床试验累积的能力， 农村人口参与癌症控制、预防、治疗和护理临床试验， 以及由NCORP研究基地开发和进行的其他人类研究。当癌症影响 所有人口群体、某些亚群体，包括生活在农村社区的人， 他人[1，2]促成风险因素包括年龄较大、保险覆盖面不足、社会经济地位较低、 地位、少数民族和更孤立的地理位置--所有这些都可能成为接受专业的障碍 健康护理由于地理障碍而无法进行临床试验，显然使农村患者处于不利地位， 是他们不参加研究的最常引用的理由。[5]居住在郊区的患者 临床试验的累积率最高，而生活在农村地区的患者的累积率相当低[6，7]。大学 堪萨斯癌症中心（KUCC）的研究人员将加强临床试验的积累和参与， 农村人口通过其领导的中西部癌症联盟（MCA）及其干部的成就 调查人员在农村社区和做法方面有着丰富的经验。作为外联网络， 作为KUCC的一部分，MCA与全州的医院、癌症中心和医疗保健提供者合作， 堪萨斯州的一个多月。这些MCA伙伴关系的目标一直是扩大 在代表性不足的社区开展临床研究，重点是农村和低收入社区。MCA 最近扩大到包括我们的全州农村初级保健实践为基础的研究网络，堪萨斯 患者和提供者参与预防研究（KPPEPR），一个由75个初级保健网络组成的网络 来自堪萨斯各地的供应商，长期以来一直支持癌症预防和控制研究 举措KUCC-MCA Rural NCORP将利用我们作为SWOG成员超过45年的经验， 通过远程医疗提供肿瘤护理的经验，15年成功开展研究的历史， 农村初级保健机构，以及在农村卫生保健领域开展和运行临床试验的10年经验 所有这些都得到KUCC与农村肿瘤学和初级保健实践合作的专业知识的支持， 实现我们的目标。特别是对于KUCC-MCA农村NCORP，我们将评估机构，供应商， 临床试验，和患者的障碍，试验收益，并实施流程，以：1）加强基础设施， 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; 2）扩大 通过在当地农村地区提供可用的NCORP临床试验， 社区; 3）减少堪萨斯农村和低收入患者参与临床试验的障碍 和西部密苏里州通过提供试验参与机会，在他们的家乡社区;和4）杠杆 KUCC/MCA专业知识，用于解决农村癌症与NCORP受助人临床试验参与的差异。

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.