Table 2.

Barriers and strategies for clinical trial accrual for AYA patients with examples of interventions

Barrier themesStrategies that can address barriersExamples of interventionExemplar papers/trials (PubMed)
Communication amongst members of team Forums to discuss cases
Institutional policies
Identifying unique AYA care
Working groups 
Tumor boards
AYA champions
AYA programs
AYA working groups 
PMID:3222270940
PMID: 3526464220
PMID: 3207778219  
Regulatory barriers Share resources
Assess workload/budget and staffing
Stakeholder engagement 
Shared IRB/central IRB
Novel trial designs(basket/umbrella)
Rapid activation of trials
Committee with stakeholders 
PMID:3204894141
PMID: 3224006842  
Physician barriers Incentivize
Educate
Flexible institutional policies 
AYA champions
AYA tumor boards
Incentives
Educational opportunities 
PMID: 2221313426
PMID: 2466935413
PMID: 3600667843  
Patient convenience Make it easy for patient to get to the trial
Take trial to patient
Education regarding trials and resources 
Patient navigation
Community engagement
Educational initiatives
Social work support 
PMID: 3878547438
PMID: 3429761135
PMID: 3648042544
PMID: 3490540545
PMID: 3060622446
PMID: 2917093047  
Institutional barriers Policies that are flexible
Age restrictions
Standard operating procedures
Channels of communication between peds and medical oncology 
Incentivize institutions/scorecard
AYA specific pathways for intake
Screening procedures for enrollments 
PMID: 3608985928
PMID: 3392671012
PMID: 3526464220
PMID: 3825291148  
Barrier themesStrategies that can address barriersExamples of interventionExemplar papers/trials (PubMed)
Communication amongst members of team Forums to discuss cases
Institutional policies
Identifying unique AYA care
Working groups 
Tumor boards
AYA champions
AYA programs
AYA working groups 
PMID:3222270940
PMID: 3526464220
PMID: 3207778219  
Regulatory barriers Share resources
Assess workload/budget and staffing
Stakeholder engagement 
Shared IRB/central IRB
Novel trial designs(basket/umbrella)
Rapid activation of trials
Committee with stakeholders 
PMID:3204894141
PMID: 3224006842  
Physician barriers Incentivize
Educate
Flexible institutional policies 
AYA champions
AYA tumor boards
Incentives
Educational opportunities 
PMID: 2221313426
PMID: 2466935413
PMID: 3600667843  
Patient convenience Make it easy for patient to get to the trial
Take trial to patient
Education regarding trials and resources 
Patient navigation
Community engagement
Educational initiatives
Social work support 
PMID: 3878547438
PMID: 3429761135
PMID: 3648042544
PMID: 3490540545
PMID: 3060622446
PMID: 2917093047  
Institutional barriers Policies that are flexible
Age restrictions
Standard operating procedures
Channels of communication between peds and medical oncology 
Incentivize institutions/scorecard
AYA specific pathways for intake
Screening procedures for enrollments 
PMID: 3608985928
PMID: 3392671012
PMID: 3526464220
PMID: 3825291148  

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