Using Project ECHO Cancer Clinical Trials: Increase Participation and Access to Cancer Clinical Trials in Pennsylvania

Submission Date: February 2026

State/Territory Submitted on the Behalf of: Pennsylvania

States/Territories Involved: Pennsylvania

Funding Source: CDC

CDC Funding:

Yes

Grant Number:

DP22-2202 Cancer Prevention and Control

Other Federal Funding:

N/A

Other Funding:

Other

Domain Addressed:

Community-Clinical Linkages, Health Systems Strategies

Public Health Issue:

Despite significant therapeutic advances, access to cancer clinical trials (CCTs) remains disproportionately limited for patients from rural, low-income, and underrepresented minority populations. Pennsylvania’s 10-year cancer survival rate is 64.5% (2014–2018), and the 2023–2033 Pennsylvania Cancer Control Plan aims to increase survival to 66.5% by 2033. The Pennsylvania Cancer Control Program (PACCCP), in partnership with the Pennsylvania Cancer Coalition (PCC), established the Cancer Clinical Trials Collaborative (PCC-CCTC) to expand clinical trial access and participation and reduce disparities. An environmental scan identified 50 patient- and provider-level barriers. Project ECHO was selected as a high-impact strategy to address them.

Project Objectives:

The Project ECHO Cancer Clinical Trials 1 objectives are to overcome patient and provider barriers; increase access to and participation in cancer clinical trials; boost recruitment and participation of racially and ethnically diverse individuals; identify and reduce barriers to participation; expand access to clinical trials across Pennsylvania; educate healthcare providers, cancer survivors, and family members; and provide resources to inform clinical trial partners and the public.

Program Action:

PACCCP recognized the need for a Pennsylvania-specific environmental scan to identify barriers to cancer clinical trials. In partnership with the Pennsylvania Cancer Coalition (PCC) and the Penn State Project ECHO Hub, PACCCP developed the first Cancer Clinical Trials Project ECHO program to increase provider knowledge and confidence; reduce geographic and sociodemographic disparities in clinical trial access and participation. PACCCP led a five-session curriculum via Project ECHO’s hub-and-spoke model, covering clinical trial fundamentals, partnerships, and recruitment; patient perspectives, community outreach, and pathways for local clinicians to serve as site principal investigators. The program targeted a broad, interprofessional audience.

Data/Other Information Collected:

Pre- and post-session surveys assessed participant knowledge, confidence, perceived barriers, and behavioral intentions. Preliminary results: Ninety-three registrants participated, representing cancer centers, hospitals, community organizations, health departments, and FQHCs. Participants included MDs, RNs, BSNs, MPH-trained professionals, PhDs, LCSWs, and other allied health providers. Common provider-level barriers to clinical trial enrollment were limited awareness (42%) and a need for additional training (33%). Perceived patient-level barriers included limited trial awareness/understanding (46%) and travel or lodging challenges (43%).

Impact/Accomplishments:

The Project ECHO Cancer Clinical Trials initiative represents the first application of the ECHO model to cancer clinical trials. Baseline findings identified critical provider and patient-level barriers to trial engagement. Provider-related barriers fell into six categories: Knowledge & Training, Time & Workload, Staffing & Support, Institutional & Regulatory, Cultural & Communication, and Outreach & Access. Patient-related barriers included Trust & Understanding, Language & Culture, Logistics & Access, Financial Barriers, and Health Literacy. Pennsylvania successfully identified and ranked the 50 most significant barriers across these domains.

This statewide initiative demonstrates the feasibility and potential of tele-mentoring to enhance equitable clinical trial access and overcome participation barriers. It is a scalable model that can be expanded to other states and regions, and interest in replicating this approach is already underway.

Challenges/Lessons Learned:

The National Cancer Institute expanded Advanced Practice Providers APPs roles in NCI-sponsored clinical trials. The use of APPs in cancer clinical trials have advanced clinical research in some cancer centers in Pennsylvania. APPs are essential to identifying eligible patients, educating them on clinical trial and treatment options, increasing access and participation, and increasing awareness. To sustain and standardize these contributions, cancer centers should adopt policy changes that formally institutionalize APP roles.

Despite limited financial resources, strong partnerships among PACCCP, PCC, and cancer centers continue to enhance information sharing, support, and access to specialized cancer care.

Next Steps:

The outcomes of Project ECHO will be used to inform statewide priority initiatives to expand participation in and access to cancer clinical trials across Pennsylvania. PACCCP will continue partnering with the PCCCCTC to address patient- and provider-level barriers. The Project ECHO model has demonstrated effectiveness in addressing these challenges, and the planning for Project ECHO Cancer Clinical Trials II is underway.
Moving forward, Project ECHO will remain a core strategy to reduce barriers to cancer care and clinical trial participation. A manuscript is in development, abstracts are being submitted for national conferences, and technical assistance will support replication in other states and regions.

Program Areas:

Cancer

State Contact Information:

PA
April Barry, LCSW, MSW, PN, Evaluation Manager, PCC Cancer Clinical Trials Co-chair
Comprehensive Cancer Control Program, PA Department of Health
7173293017
abarry@pa.gov

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