Open Access Research article

Facilitating accrual to cancer control and supportive care trials: the clinical research associate perspective

David VanHoff1, Tanya Hesser2, Katherine Patterson Kelly34, David Freyer5, Susan Stork6 and Lillian Sung27*

Author Affiliations

1 Helen DeVos Children’s Hospital at Spectrum Health, A member of the Grand Rapids Clinical Oncology Program, Grand Rapids, MI, USA

2 Child Health Evaluative Sciences, Toronto, ON, Canada

3 Nursing Research and Quality Outcomes, Washington, DC, USA

4 Center for Cancer and Blood Disorders, Children’s National Medical Center, Washington, DC, USA

5 Children’s Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA

6 Blank Cancer and Blood Disorders Center, Blank Children’s Hospital, Des Moines, IA, USA

7 The Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada

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BMC Medical Research Methodology 2013, 13:154  doi:10.1186/1471-2288-13-154

Published: 31 December 2013



Accrual to Cancer Control and Supportive Care (CCL) studies can be challenging. Our objective was to identify facilitators and perceived barriers to successful Children’s Oncology Group (COG) CCL accrual from the clinical research associate (CRA) perspective.


A survey was developed that focused on the following features from the institutional perspective: (1) Components of successful accrual; (2) Barriers to accrual; (3) Institutional changes that could enhance accrual; and (4) How COG could facilitate accrual. The survey was distributed to the lead CRA at each COG site with at least 2 CCL accruals within the previous year. The written responses were classified into themes and sub-themes.


57 sites in the United States (n = 52) and Canada (n = 5) were contacted; 34 (60%) responded. The four major themes were: (1) Staff presence and dynamics; (2) Logistics including adequate numbers of eligible patients; (3) Interests and priorities; and (4) Resources. Suggestions for improvement began at the study design/conception stage, and included ongoing training/support and increased reimbursement or credit for successful CCL enrollment.


The comments resulted in suggestions to facilitate CCL trials in the future. Soliciting input from key team members in the clinical trials process is important to maximizing accrual rates.

Cancer control; Supportive care; Clinical research associate; Accrual; Clinical trial