Recruiting participants to cancer prevention clinical trials: lessons from successful community oncology networks.

PURPOSE/OBJECTIVES To describe the organizational designs and task environments of community oncology networks with high accrual rates to cancer prevention clinical trials. DESIGN Replicated case study design; structural contingency theory. SETTING Local Community Clinical Oncology Programs (CCOPs) funded by the National Cancer Institute to test preventive and therapeutic interventions in community settings. SAMPLE Primary sample: oncology professionals affiliated with four CCOPs ranking among the top 10 in earned cancer control accrual credits in fiscal years 1999-2003. Secondary sample: oncology professionals affiliated with three CCOPs ranking among the top 10 three to four times during the study period. A total of 63 people participated in the interviews. METHODS Primary sample: on-site interviews with CCOP investigators, clinical research staff, and nononcology physicians. Secondary sample: telephone interviews with each CCOP's nurse administrator and at least one prevention research nurse. MAIN RESEARCH VARIABLES Staffing patterns, organizational processes, recruitment strategies, and environmental characteristics. FINDINGS All of the CCOPs employed dedicated prevention research staff. Recruitment through media publicity, mass mailings, or group information sessions worked best when prevention trials had flexible eligibility requirements and evaluated interventions with few health risks. Prevention trials evaluating agents with known toxicities in high-risk populations required more targeted recruitment through cancer screening programs, physician referral networks, and one-on-one discussions with protocol candidates. CONCLUSIONS High-performing CCOPs configured their structures, processes, and recruitment strategies to fit with accrual goals. They also benefited from stable and supportive task environments. IMPLICATIONS FOR NURSING Nurse-coordinated research networks have great potential to generate new knowledge about cancer prevention that can reduce cancer incidence and mortality significantly.