The MB-CCOP at Boston Medical Center

波士顿市拥有丰富的学术医疗中心和癌症护理设施。然而，这些资源在减少癌症死亡率的种族差异方面收效甚微，部分原因是缺乏少数民族参加癌症临床试验。波士顿医疗中心（BMC）是新英格兰地区最大的安全网提供者，其独特的定位是实施以少数族裔为基础的社区临床肿瘤学项目（MB- CCOP），试图减少这种差距。超过三分之二的BMC患者是少数民族，大多数是低收入人群。BMC已经有一个成功的癌症临床试验项目（CCTP）和一个最先进的癌症中心，于2006年开业。BMC CCTP成立于1991年，在癌症临床试验中开发了具有文化敏感性的推广、招募、登记和保留方法。我们的CCTP研究护士都接受过患者导航方面的培训，以帮助患者克服许多护理障碍。因此，少数族裔目前占癌症临床试验报名人数的42%。然而，CCTP资源的缺乏限制了我们将服务范围扩展到波士顿最贫困和多样化的社区的程度。BMC的MB-CCOP将提供我们所需的资源，以促进在社区接受初级保健的患者获得BMC的癌症护理服务和癌症临床试验。利用BMC NCI患者导航研究项目的经验，我们将为BMC MB-CCOP采用患者导航模型。导航器将被放置在波士顿的五个社区卫生中心（CHCs），以促进沟通过程和推荐适当的患者进行BMC临床试验评估。同时，BMC的MB-CCOP将为我们的肿瘤学家提供与我们所服务的患者群体相关的更大的癌症临床试验组合。我们的具体目标是：1)为CHC患者提供患者导航，方便他们获得BMC癌症治疗和临床试验；2)及时筛查所有癌症患者参与临床试验；3)向社区医生及其患者提供外展和教育，4)测试这些方法在增加少数族裔应计收益方面的有效性。

The City of Boston is rich with academic medical centers and cancer care facilities. However, these resources have done little to reduce racial and ethnic disparities in cancer mortality, in part due to a lack of minority enrollment in cancer clinical trials. Boston Medical Center (BMC), the largest safety net provider in New England, stands uniquely positioned to implement a Minority-Based Community Clinical Oncology Program (MB- CCOP) in attempts to reduce this disparity. More than two-thirds of BMC patients are minorities and most are low-income. BMC already has a successful Cancer Clinical Trials Program (CCTP) and a state-of-the-art cancer center that opened in 2006. Established in 1991, the BMC CCTP has developed methods for culturally sensitive outreach, recruitment, enrollment and retention in cancer clinical trials. Our CCTP research nurses have all been trained in patient navigation to help patients overcome their many barriers to care. As a result, minorities now account for 42% of cancer clinical trial enrollment. However, the lack of resources in our CCTP limits the extent to which we can offer our services beyond the confines of the institution into Boston's most impoverished and diverse communities. The MB-CCOP at BMC will provide the resources we need to facilitate access to both BMC's cancer care services and cancer clinical trials by patients receiving primary care in the community. Taking advantage of the experience at BMC with the NCI Patient Navigator Research Program, we will employ a patient navigation model for the BMC MB-CCOP. Navigators will be placed at five of Boston's community health centers (CHCs) to facilitate the communication process and the referral of appropriate patients for evaluation of clinical trials at BMC. At the same time, an MB-CCOP at BMC will provide our oncologists access to a much larger portfolio of cancer clinical trials relevant to the patient population we serve. Our specific aims are: 1) to provide patient navigation for CHC patients to facilitate access to BMC cancer care and clinical trials; 2) to promptly screen all cancer patients for clinical trial participation; 3) to provide outreach and education to community physicians and their patients, and 4) to test the effectiveness of these methods in increasing minority accruals.