Barriers and Facilitators to Implementing the Clinical Trial Navigator Program: A Qualitative Analysis

Purpose: The Clinical Trials Navigator (CTN) Program was launched in 2019 to increase enrollment in cancer clinical trials. It is free for all Canadians, and over 550 people have participated. This study has the objective of assessing the perspectives of people with cancer regarding the implementation of clinical trial navigation in Canada. Methods: People with cancer and their caregivers (n=21) were recruited from across Canada to participate in a 30–60-minute semi-structured interview. Based on the Consolidated Framework for Implementation Research (CFIR) domains, we assessed the facilitators, and barriers to access clinical trial navigation in Canada. Thematic analyses were performed by two independent researchers in duplicate using inductive and deductive coding. Results: 10 Interviewees had contacted the CTN Program (Pre-CTN) but had not yet received navigation for clinical trials, 10 had never contacted the CTN Program (Non-CTN) and 1 completed the CTN Program (Post-CTN). The results indicate participants valued early and direct access to information trials and perceived the CTN Program as a unique, trustworthy resource created by Canadians. Participants reported a sense of relief knowing they can find a trial when needed. Not all oncologists provided information for identifying clinical trials, and the CTN Program was therefore perceived as an important solution. Conclusion: Our results illustrate the gaps in the Canadian clinical trial ecosystem and emphasize the value of the CTN Program. The CTN Program addresses issues such as the timeliness and legitimacy of clinical trials information, increases patient sense of control and alleviates the burden of unexplored options.