Dr. Don Warne at Arizona State University is applying the same IRB ideas being generated by the IRB workgroup to the Native American community. Specifically, his anticipated end result is to bring some standardization to tribal IRB processes or perhaps establish a community IRB for Native American communities. Dr Warne is looking at training programs for the professionals and lay members involved in IRBs. He is also touching on CBPR to identify research opportunities that may yield clinical trial opportunities in Native American communities.

           Virginia Yrun at the University of Arizona is pursuing clinical trial issues related to the Hispanic community, looking at clinical trial participants from the provider perspective. Year 1 of this project consisted of exploratory focus groups with Hispanic patients and providers (community physicians) about barriers and facilitators to referral and recruitment to clinical trials, a profile of AHCCCS physicians regarding referral or recruitment of patients to clinical trials, and the development of items for a patient survey. Primary findings from this research include:

• Only 11% of AZ Medicaid primary care providers report that they have referred or recruited patients to clinical trials within the last three years.



• Hispanic patients have a basic understanding of clinical trials, but some patients believed that clinical trials involve practice by inexperienced physicians.



• Both Hispanic patients and Medicaid physicians would like more information about clinical trials.



• Commonly identified barriers among Hispanic patients to participating in clinical trials include fear of adverse events, lack of trust in the physician, and resource constraints. Commonly identified facilitators to patient participation include trust in the physician, developing more effective medications and treatments, and gaining access to medications and treatments.



• The ethnicity of the physician is not important to Hispanic patients, but the ability to communicate effectively with the physician is very important to Spanish speaking Hispanic patients.

           As a follow-on to Ms. Yrun's work, ABRC is now in the final stages of discussions on a new project to work on collaborative community based clinical trials targeting Hispanic populations in Maricopa. This follow-up project, a partnership between the Arizona Health Policy & Law Institute and Mountain Park Health Center, aims to build on these findings by working with a large Hispanic serving practice in a community-driven process to identify practice-specific interventions to improve the opportunities for Hispanic patients to be referred and recruited to clinical trials. Mountain Park Health Center has five locations in the greater Phoenix area and serves over 50,000 patients. Over 80% of Mountain Park's patients are Hispanic and nearly 75% have incomes below 200% FPL. This project will employ community-based participatory research methods. The Hispanic Community Action Group that has been meeting over the past year in Phoenix will serve as a community-based project steering committee and will provide critical community input to inform the development of innovative strategies and interventions to improve the recruitment of Hispanics to clinical trials in Arizona.