Abstract C104: Expanding clinical trial offerings to veterans: A modified ethnographic approach to document and analyze forming a research partnership between an academic cancer center and a veterans affairs medical center

Abstract Introduction: Veterans face systemic barriers to accessing clinical trials, including fewer trials at Veterans Affairs medical centers, administrative challenges enrolling in external systems, and individual-level barriers such as financial constraints, scheduling difficulties, distrust in medical research, and high rates of comorbid conditions. Our project addresses these barriers by creating a shared research infrastructure with shared clinical trials through the formation of a partnership between Cleveland Clinic Cancer Institute (CCF) and Louis Stokes Cleveland Veterans Affairs Medical Center (VA). Methods: We documented and analyzed the phenomenon of forming the research partnership across the two health systems using a modified ethnographic approach. We collected monthly "periodic reflections" (PRs) (Finley et al 2018). PRs followed a template that included discussion items such as goals, status updates, adaptations to developing the partnership plan, stakeholder engagement, environment/ context, and future plans. The project utilized purposive and convenience sampling, as well as snowball sampling to recruit additional individuals involved in the partnership. Participants included PIs, Co-Is, research coordinators, trainers, regulatory personnel, leadership, and administrators from both health systems. PRs were entered into NVivo software for qualitative content analysis. The project team immersed in the PRs, used open coding and content analysis to identify key themes and patterns among PRs, and then wrote memos and reports. Findings: The partnership and monthly PRs are ongoing. The partnership began in June 2024, and PRs began in April 2025. PRs included 2-3 participants each month. The partnership began by assembling a multi-institutional team, identifying an initial trial to test the partnership and establish proof of concept for future trials. PRs provided an opportunity for building project institutional memory with project timelines and organizational charts, multi-institutional team building, and in-depth discussion of the subcontracting and regulatory processes. Key project facilitators included engaging motivated and well-suited personnel across institutions for regulatory and training activities, maintaining open lines of communication, and ensuring alignment of protocols across institutions. Project barriers included the need for multiple protocol modifications and synchronizing patient facing language while also meeting the regulatory standards for each health system. Conclusions: Documenting the collaboration process including progress, facilitators, barriers, and teamwork development is an iterative and reflective process aimed to strengthen and expand partnerships between CCF and the VA, while also serving as a model for other health systems. Citation Format: Heather McKee. Hurwitz, Michelle E. Treasure, Margaret Tiktin, India Houston, Caleb B. Mavar, Abhay Singh. Expanding clinical trial offerings to veterans: A modified ethnographic approach to document and analyze forming a research partnership between an academic cancer center and a veterans affairs medical center [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C104.