Resource Library

Gabriel B. Paving the Way for APPs in Clinical Research. Oncology Issues, November-December 2020.

Bedard T. The Role of Nonphysician Practitioners in Oncology. Oncology-Issues, September-October 2020.

Colligon S. et al. The NP and CNS: Advanced Practice Nurse Roles. Oncology Issues, November-December 2015.

Colligon S. et al. Advanced Practice in Oncology Nursing. Oncology Issues, November-December 2015.

Key M. Bridging the Oncology Practice Gap. Oncology Issues, January-February 2019.

Goodrich A. “Research Nurses: The Glue That Holds Everything Together.” Advanced Practices Voices. Viewpoints. ASH Clinical News. December 1, 2015.
“Many of our clinical colleagues may wonder what we do when we aren’t physically seeing patients,” writes NP Amy Goodrich. The work of APPs in research is often “not tangible, or even visible to other healthcare providers,” she notes. Although the role varies from institution to institution, research APPs are “the glue that holds everything together.” Perspective from an APP in hematologic malignancies and research associate at Johns Hopkins School of Medicine and The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore.

Ma JD, Dullea A, Hagman C, et al. Exploring the expanded role of pharmacists in advance care planning. JCO Oncol Pract.  2021;17(2):102-106.
A two-year prospective study explored the feasibility of a pharmacist-led advance care planning intervention, testing its potential to increase patient and caregiver engagement in advance care planning. Thirty-four patients completed the study. All selected proxies completed the intervention and were able to understand the three end-of-life preferences. At the time of the patient’s death (n = 20), proxies reported that 66.6% received their preferred resuscitation status and 72.2% died in their preferred location. Proxy satisfaction with the advance care planning process was 7.6 ± 2.5 (mean ± SD) on a 11-point Likert scale.

A Pharmacist’s Role in Cancer Research. [newsletter article] Campus News. Medical College of Wisconsin. December 17, 2019.
Carrie Oxencis, PharmD, BCPS, BCOP, clinical assistant professor in the Department of Clinical Sciences at the Medical College of Wisconsin and oncological pharmacist at Froedtert Hospital, is serving as co-PI on a pilot study of a pharmacist intervention to improve adherence to breast cancer hormonal therapy.

Welch MA, Ryan JC, Galinsky IA. The role of the advanced practiced provider in clinical trials: contributions to the management of patients receiving inotuzumab ozogamicin. J Adv Pract Oncol. 2017;8:631-636.
This article details the role and responsibilities of two oncology APPs (a nurse practitioner and a physician assistant) who served as sub-investigators for the phase III INO-VATE trial, which compared inotuzumab ozogamicin to the investigator’s choice of chemotherapy in acute lymphoblastic leukemia. As sub-investigators, these practitioners registered with the FDA, the sponsoring pharmaceutical company, and the research office of their institution.

Zuber K, McCall TC, Bruessow D, et al. Improving health disparities in PA practices: a quality improvement initiative. J Am Acad Physician Assist. 2020;33(1):33-38.
This study assesses the impact of a quality improvement intervention, “Outside the Box: Reducing Health Disparities,” that aims to increase awareness of health disparities and improve healthcare practices among participants. A small convenience sample of nephrology PAs participated in the study, which demonstrated that participation was associated with practice quality improvement in several domains with health disparities. “Results suggest increasing awareness of ideal professional behaviors can result in quality improvements in practices,” the authors write.

Lacasse LL. “The Path to Health Equity Starts with Access to Care.” Cancer CANdor [blog] July 29, 2020. American Cancer Society Cancer Advocacy Network.
An advocacy blog on access as an essential foundational step toward achieving equity in health.

ACCC Model for Improving Care Coordination for Patients with Lung Cancer.
This resource includes an online assessment and quality improvement tool designed with a focus on improving care coordination for patients with lung cancer receiving Medicaid; however, the care coordination model is appropriate for use in any patient population and for cancer programs or practices of any size.

Let’s Be Clear: Communicating to Improve the Patient Experience

Ask Me 3® video tool

Echeverri M, Anderson D, Nápoles AM, Haas JM, Johnson ME, Serrano FSA. Cancer health literacy and willingness to participate in cancer research and donate bio-specimens. Int J Environ Res Public Health. 2018;15(10):2091. Published 2018 Sep 24. doi:10.3390/ijerph15102091
This study looked at the relationship between cancer health literacy and willingness to participate in cancer research and/or donate bio-specimens (WPRDB) among African Americans, Latinos, and Whites. Results confirmed the importance of cancer health literacy. Study participants were more willing to participate in non-invasive studies (e.g., surveys, interviews, and training) or collection of bio-specimens (e.g., saliva, check cells, urine, and blood) and in studies led by their own healthcare clinicians and local healthcare institutions. Participants were less willing to participate in more-invasive studies (e.g., taking medications, undergoing procedures, donating skin/tissues). Improving levels of cancer health literacy and engaging in community-based participatory resources approaches are strategies suggested by the authors to improve understanding and trust in cancer research.

Shared Decision-Making: Practical Implementation for the Oncology Team

[Abstract #180] Shared Decision-Making Attitudes and Practices in Multidisciplinary Cancer Care Teams. Mangir C, et al.
Poster presented at the 2020 ASCO Quality Care Symposium, October 9 to October 10, 2020. Key takeaway: Shared decision-making (SDM) is commonly accepted amongst cancer care team members as essential to patient engagement, but clarity in terminology, sufficient training and resources, and formal integration of SDM into practice is limited. Poster includes strategies for improvement of incorporation of SDM into practice.

American Society of Clinical Oncology. Health Equities. Disparities in Cancer Research: A Precursor to Disparate Cancer Outcomes. In Clinical Cancer Advances 2021: ASCO’s Report on Progress Against Cancer. J Clin Oncol. February 2, 2021. Available at https://ascopubs.org/doi/full/10.1200/JCO.20.03420.
This section of ASCO’s 2021 Report on Progress Against Cancer highlights the need for renewed attention to addressing disparities in cancer research through the lens of health equity. Suggested strategies to improve equity in cancer clinical research include: broadening eligibility criteria; using umbrella and basket trial design; increasing trial availability; expanding patient education, recruitment, and support; deploying patient navigation; novel consent strategies; and financial assistance in reference to the 20% of Americans who are covered under Medicaid. Medicaid is not federally required to cover routine costs of care for clinical trials. Thus, for a large number of patients with cancer clinical trial participation is not possible due to the added financial burden.

ASCO Road to Recovery. View an infographic that highlights key takeaways from ASCO’s Road to Recovery report, which makes recommendations for cancer care delivery and clinical research as the nation moves forward from the COVID-19 public health emergency. The report makes five recommendations for ensuring that lessons learned during the pandemic are used to “craft a more equitable, accessible, and efficient clinical research system that protects patient safety, ensures scientific integrity, and maintains data quality”:

• Access the full report: Pennell NA, Dillmon M, Levit LA, et al. American Society of Clinical Oncology Road to Recovery Report: Learning From the COVID-19 Experience to Improve Clinical Research and Cancer Care.  J Clin Oncol. 2021;39(2):155-169.

Li A, Bergan RC. Clinical trial design: Past, present, and future in the context of big data and precision medicine. Cancer. 2020;126(22):4838-4846. A concise review of the changing landscape of cancer clinical trial design with descriptions of the impact of big data and precision medicine on study design.

Bierer BE, White SA, Meloney LG, et al. Achieving diversity, inclusion, and equity in clinical research guidance document Version 1.1. 2021. Cambridge and Boston, MA: Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center).
The MRCT Center brought together stakeholders from all sectors of oncology to create this comprehensive Guidance Document and Toolkit. The guidance is lengthy, but key finds are available in an executive summary and a companion toolkit offers practical resources. A recorded webinar series, available on the MRCT website, focuses in on specific topics covered in the guidance. The aim is to clarify the importance of, advance the goals of, and provide practical and actionable ways to improve diverse representation of participants in clinical research.

Fehl A, et al. Breast cancer in the transgender population. J Adv Pract Oncol. 2019;10(4):387-394.
The authors highlight challenges in the screening, diagnosis, and treatment of transgendered individuals with breast cancer, includes a case study.

Quinn GP, Alpert AB, Sutter M, Schabath MB. What oncologists should know about treating sexual and gender minority patients with cancer. J Oncol Pract. 2020;16:309-316.
Practical information for oncology advanced practitioners, as well as oncologists.

[ACCC Webinar] Closing the Oncology Research Gap: Pharmacy's Role Defined

[CANCER BUZZ MINI-PODCAST] Ep 60: Advancing Clinical Trial Equity
In this episode, Colleen Lewis, MSN, ANP-BC, AOCNP, talks about the critical role oncology advanced practitioners can play in moving the needle on equity and inclusion in cancer clinical trials.

[CANCER BUZZ MINI-PODCAST] Ep 63: Advanced Practitioners’ Role in Research
In this episode, we'll explore how oncology advanced practitioners (APs) can play a greater role in clinical research and, according to a recent national study, have a strong interest in doing so.

[CANCER BUZZ MINI-PODCAST] Ep 65: Integrating Advanced Practitioners into Research
In this episode, we'll hear the evolution of the advanced practitioners (APs) role at her institution, where APs have a larger voice in the research process and clinical trial protocols, serve as champions to advocate for patients and research staff, and collaborate with their team to promote best practices in clinical trial delivery.

[ACCCBuzz Blog] Pride Month & Equality in Cancer Care

[ACCCBuzz Blog] Older Adults with Cancer & Clinical Trials

ASCO-ACCC Initiative to Increase Racial & Ethnic Diversity in Clinical Trials

From the Institute for Healthcare Improvement (IHI), an 8-part series of very short videos featuring David R. Williams, PhD, MPH, Professor of Public Health at the Harvard T.H. Chan School of Public Health and IHI President Emeritus Don Berwick in conversation.
In video #4, Dr. Williams describes three promising strategies to reduce implicit (or conscious) bias. Watch individual segments (4 minutes) or the full interview (about 33 minutes).

Part 3: Does Racism Play a Role in Health Inequities? (4 mins.)

Part 4: How Can Providers Reduce Unconscious Bias? (4 mins.)

Agrawal S, Enekwechi A. It’s Time to Address the Role of Implicit Bias Within Health Care Delivery. Health Affairs blog. January 15, 2020.
This Health Affairs blog is a compelling call to action: “Health care cannot be an observer of these issues [implicit bias] or continue to suggest that inequity is produced by broader social forces alone. Our response must have the urgency this issue deserves.” The authors put forward strategies to address implicit bias within healthcare organizations including bias training, basic standards for improved communication (interpreters, translation services, etc.), creation of the chief equity officer role, diversification of the pipeline, and more.

Gupta A. What are the Harms in Not Addressing Bias in Health Care. IHI video. (2 mins.) July 2017.
In this brief video, Anurag Gupta, MPhil, JD, founder and CEO of Be More America, demonstrates both the human and system-wide potential lost due to bias in healthcare, where 1 in 8 Americans are employed.

Loftus EG. Examining Cancer Health Disparities in the LGBTQ Community. Cancer Research Catalyst. [Blog] September 22, 2019. American Association for Cancer Research.
This blog shares clinicians’ real-world experiences of disparities experienced by individuals with cancer in the LGBTQ community and emphasizes the critical need for better data collection on sexual orientation and gender identity “with broad categories and open-ended questions that allows individuals to correctly describe themselves.”

Miranda E. Addressing Equity Starts by Looking Inward. Institute for Healthcare Improvement. [Blog] March 3, 2021.
This blog shares a concise snapshot of the actions M Health Fairview (a collaboration between University of Minnesota, University of Minnesota Physicians, and Fairview Health Services, a member of the IHI Leadership Alliance) is taking to address health inequities and to work toward more equitable outcomes for patients. The blog includes some lessons learned to date.

Niranjan SJ, Martin MY, Fouad MN, Vickers SM, Wenzel JA, Cook ED, Konety BR, Durant RW. Bias and stereotyping among research and clinical professionals: Perspectives on minority recruitment for oncology clinical trials. Cancer. 2020;126: 1958-1968.

Penner LA, Dovidio JF, Gonzalez R, et al. The effects of oncologist implicit racial bias in racially discordant oncology interactions. J Clin Oncol. 2016;(34)24:2874-2880.
This study explored the impact of oncologist implicit racial bias on oncology interactions. The study involved 18 non-Black medical oncologists and 112 Black patients, as well as observers. Results showed that oncologists with higher implicit racial bias [as measured by results from the Implicit Association Test (IAT)] had shorter interactions with patients. Both patients and observers (of video recordings of interactions) rated these clinicians’ communication as less patient-centered and supportive. Higher oncologist implicit bias was associated with patients having a harder time recalling the contents of the interaction. Oncologist implicit bias also predicted less patient confidence in the treatments and greater perceived difficulty in completing these treatments. The authors conclude: “. . . implicit racial bias is a likely source of racial treatment disparities and must be addressed in oncology training and practice.”

Pratt-Chapman ML, Potter J. Cancer care considerations for sexual and gender minority patients. Oncol Issues. 2019;34(6):26-36.
Resources and strategies for members of the multidisciplinary cancer care team to provide affirming care for sexual and gender minority patients. Includes a terminology glossary, a sample intake form, and recommendations to improve communication with sexual and gender minority patients.

Project Implicit. Project Implicit is a non-profit organization and international collaborative network of researchers investigating implicit social cognition, or thoughts and feelings that are largely outside of conscious awareness and control. Project Implicit is the product of a team of scientists whose research has produced new ways of understanding attitudes, stereotypes, and other hidden biases that influence perception, judgment, and action. Learn more about the online Implicit Association Tests available through Project Implicit.