Implementating a Clinical Trial Navigator Program for Cancer Patients: Barriers & Facilitators Identified Through Stakeholder Perspectives

Background: Patient navigation has been highlighted as a solution to improve clinical trial access. The Clinical Trial Navigator (CTN) Program is a Canadian cancer clinical trial navigation program that can be accessed online by patients or healthcare professionals (HCP). Trained individuals search and provide patients and/or oncologists a report of potentially eligible trials for free. Over 550 patients have used the Program since its launch in 2019, but systemic implementation within cancer centers has yet to occur. Objectives: We aimed to identify facilitators and barriers to implementing the CTN Program in Canadian cancer centers through stakeholder insights. Methods: We conducted 33 virtual, semi-structured interviews (45 min each) with healthcare/clinical research professionals (n=9) and patient-focused stakeholders (n=24). Interviews were guided by the Consolidated Framework for Implementation Research (CFIR) and analyzed using thematic analysis with deductive and inductive coding. Results: Participants emphasized patient navigation as a key solution to identifying and accessing clinical trials, reducing oncologist workload. Key barriers included financial and logistical stress for patients enrolling in trials at different institutions and challenges in obtaining required medical information for effective searches. When patients initiated searches, they often needed additional support discussing results with their oncologist. Conclusion: Findings highlight critical considerations for implementing the CTN Program in Canadian cancer centers. Planned program adaptations aim to address these barriers, with future evaluation on uptake and effectiveness.