Project 1:

7.项目摘要 非裔美国人（AAs）比美国任何种族和民族更容易患上癌症并死于癌症。 美国（U.S.）。在过去的二十年里，越来越多的人关注认可机构参与 癌症临床试验（CCT）来解决这种不成比例的癌症负担;然而， 在有条件现金转移支付中任职人数不足。参与CCT的AA的缺乏降低了结果的普遍性， 审判如果AA在CCT中的代表性仍然不足，其影响包括在阐明 癌症结果长期存在健康差异的根本原因。有大量的 科学详细说明AA之间的试验参与障碍，包括进入专科护理中心的机会有限 在哪里进行试验，竞争的工作义务，以及对临床研究的恐惧和不信任。尽管 这些障碍，AA，本质上，不愿意参与CCT或其他类型的研究， 其他种族或民族。参与意愿方面没有差异表明， 事实上，应计费用的差异可能是由于AA比白人获得的参与机会更少。 CCT。虽然许多干预措施都侧重于提高指定机构的意愿， 参与，也许应该集中精力增加AA参与的机会， CCT。我们建议调整IMPaCT患者导航模型并试点临床试验导航程序， IMPaCT 2.0，在莫尔豪斯医疗保健（MH）和格雷迪医院（格雷迪），最大的安全网之一， 全国的医院。我们建议使用基于移动的平板电脑的临床 试验跟踪系统（CTTS）（使用i2 b2软件），以促进AA患者的参与度增加 关于CCT的参与机会，并解决这两个研究基础设施的不足 机构职能体系利用定性方法，我们将确定AA招聘的障碍和促进因素， MH/Grady（特定目标1），并将这些发现纳入适应性临床试验导航（CTN） 模型与集成的移动的平板电脑CTTS（具体目标2）。我们将在MH/Grady实施IMPaCT 2.0 乳腺癌和前列腺癌诊所，并评估，在一组，前/后测试设计，可行性和 具体目标（3）。

7. PROJECT SUMMARY African Americans (AAs) are more likely to develop and die from cancer than any racial and ethnic group in the United States (U.S.). Over the past two decades, there has been an increased focus on participation of AAs in cancer clinical trials (CCTs) to address this disproportionate burden of cancer; however AAs continue to be underrepresented in CCTs. The dearth of AAs participating in CCTs diminishes the generalizability of results of trials. If AAs remain underrepresented in CCTs, the implications include slower progress in elucidating the underlying causes of long-standing health disparities in cancer outcomes. There is an extensive body of science detailing trial participation barriers among AAs, including limited access to specialty care centers where trials are conducted, competing work obligations, and fear and mistrust of clinical research. Despite these barriers, AAs are, inherently, no less willing to participate in CCTs or other types of research studies than other racial or ethnic groups. The absence of differences in willingness to participate suggests that persistent disparities in accrual may, in fact, be due to AAs being offered fewer opportunities than whites to participate in CCTs. Although many interventions have focused on approaches to increase the willingness of AAs to participate, perhaps efforts should be focused on increasing the opportunities among AAs to participate in CCTs. We propose to adapt the IMPaCT patient navigation model and pilot a clinical trials navigator program, IMPaCT 2.0, at Morehouse Healthcare (MH) and Grady Hospital (Grady), one of the largest safety-net hospitals in the nation. We propose to enhance the patient navigation model with a mobile tablet-based clinical trial tracking system (CTTS) (using i2b2 software) to facilitate increased engagement among AA patients regarding CCT participation opportunities and to address deficits in the research infrastructure at these two institutions. Utilizing a qualitative approach, we will identify those barriers and facilitators to AA recruitment at MH/Grady (Specific Aim 1) and incorporate those findings into an adapted clinical trials navigation (CTN) model with an integrated mobile tablet CTTS (Specific Aim 2)., We will implement IMPaCT 2.0 at MH/Grady breast and prostate cancer clinics and evaluate, in a one-group, pre-/post-test design, the feasibility and acceptability (Specific Aim 3).