The Improving Methods for Patient Accural to Clinical Trials (IMPACT) project lays the groundwork for a multi-year research program seeking to improve methods for patient accrual in clinical trials. It leverages the strengths of two campuses via a collaboration of faculty and researchers at Weill Cornell Medical College and the Department of Communication in Cornell’s College of Agriculture and Life Sciences. The overall aim of the project is to investigate factors underlying low enrollment in clinical trials in an effort to provide data-supported recommendations for the accrual of patients in clinical trials.

Low patient accrual in clinical trials poses a serious concern for the advancement of medical science in the United States. As the National Cancer Institute states on its clinical trial information portal: “Cancer clinical trials have brought enormous advances in the areas of cancer prevention, treatment and diagnosis. However, less than five percent of adults diagnosed with cancer each year will get treated through enrollment in a clinical trial. With broader enrollment, the effort to find new and better ways to treat and prevent cancer might be swifter.” Despite the centrality of communication to many of these challenges, communication research is largely absent from the literature. Also absent is research related to risk communication, which is clearly related to this topic. This suggests an opportunity to provide a new perspective on a topic that has received widespread attention, yet still leaves many avenues open for investigation.

We begin by examining a specific disease: cancer. We seek to uncover strategies that can be cloned at an institutional level and propose to undertake the research in several phases. Each phase will result in data-supported recommendations upon which researchers can begin to base recruitment strategies, as well as provide the foundation for future phases. Two major surveys have been conducted in the last 12 months. In Spring 2007, data were collected from 500 individuals via a national random digit dialing (RDD) telephone survey of U.S. residents, age 18 and over. The RDD method ensured that every telephone household within the U.S. had an equal chance of being included in the survey, providing results unlikely to vary more than 4.4 percentage points from answers that would be obtained if all U.S. residents were interviewed. The focus of this survey was what factors influenced individuals` willingness to talk with their doctors about enrolling in a clinical trial. The second survey was conducted in Fall 2007 with two samples: 1) the U.S. general population, and 2) people who use services of the Leukemia and Lymphoma Society (LLS) and who expressed an interest in participating in the research. The purpose of this survey was to examine what influences an individual to seek information about clinical trial enrollment. We conducted a comparative study since clinical trial participation, in general, is more relevant to the LLS sample. A comparison will allow us to examine how their responses are similar to or different from the national sample, which might offer us useful information to improve communication about clinical trial enrollment. In total, 1,500 interviews have been completed: 500 in Spring 2007 and 1,000 in Fall 2007.

We are currently working to understand the implications of our findings for research and practice. This is a key next step in our work.

The Leukemia and Lymphoma Society