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PURPOSE: Cancer trial participants do not reflect the racial and ethnic diversity in the population of people with cancer in the United States. As a result of multiple system-, patient-, and provider-level factors, including implicit bias, cancer clinical trials are not consistently offered to all potentially eligible patients. MATERIALS AND METHODS: ASCO and ACCC evaluated the utility (pre- and post-test knowledge changes) and feasibility (completion rates, curriculum satisfaction metrics, survey questions, and interviews) of a customized online training program combined with facilitated peer-to-peer discussion designed to help research teams identify their own implicit biases and develop strategies to mitigate them. Discussion focused on (1) specific elements of the training modules; (2) how to apply lessons learned; and (3) key considerations for developing a facilitation guide to support peer-to-peer discussions in cancer clinical research settings. We evaluated discussion via a qualitative assessment. RESULTS: Participant completion rate was high: 49 of 50 participating cancer programs completed training; 126 of 129 participating individuals completed the training (98% response rate); and 119 completed the training and evaluations (92% response rate). Training increased the mean percentage change in knowledge scores by 19%-45% across key concepts (eg, causes of health disparities) and increased the mean percentage change in knowledge scores by 10%-31% about strategies/actions to address implicit bias and diversity concerns in cancer clinical trials. Knowledge increases were sustained at 6 weeks. Qualitative evaluation validated the utility and feasibility of facilitated peer-to-peer discussion. CONCLUSION: The pilot implementation of the training program demonstrated excellent utility and feasibility. Our evaluation affirms that an online training designed to raise awareness about implicit bias and develop strategies to mitigate biases among cancer research teams is feasible and can be readily implemented in cancer research settings.

e18599 Background: Low participation of Black, Hispanic, Latinx and other underrepresented racial/ethnic groups in clinical research remains a problem across the U.S. Recent studies have highlighted that stereotypes, assumptions, and bias play a role in lack of diversity in cancer trial participation. To help address this, the Association of Community Cancer Centers (ACCC) and American Society of Clinical Oncology (ASCO) piloted an implicit bias training program for clinical research teams. Methods: Adapted from the Duke University Just Ask™ program, the pilot program is comprised of eLearning modules which can be completed in about 60 minutes. Features include education on diversity, equity, and bias in clinical trial participation, case vignettes, and strategies to mitigate disparities. A call was issued to members of both organizations. After completing the training, all individual participants were asked to complete a retrospective pre/post survey to assess change in knowledge and attitude. Focus groups explored participants’ experience with the training. Another survey was administered 6 weeks later to assess sustainability of changes. Results: Research teams from 50 programs were selected for the pilot. 129 individuals consented, and 126 completed the training and evaluations (98% response rate). 48% of participants reported that they had completed training on implicit bias and/or related topics prior to the pilot. Increased levels of knowledge were reported across all key training concepts, with an average % increase from 19% to 45%. Similar increases were observed for strategies for addressing implicit bias, with an average % increase from 10% to 31%. At 6 weeks post-training, there was a slight decrease in knowledge across most items, from -1% to -8%. Most (92%) participants reported satisfaction with the course, and most (92%) indicated they would recommend it to a colleague and would recommend implementing it at their program. Suggestions to improve the course included streamlining content and providing additional tools and resources. Conclusions: Pilot findings support the feasibility and utility of the training, which can help cancer programs to address disparities in clinical research. Next steps include modifying the course based on participant feedback, disseminating the training and supplementary resources, and exploring options for assessing the impact on upstream outcomes such as diversity in trial participation.[Table: see text]

e24164 Background: Biomarker testing has advanced precision medicine in cancer. However, not all eligible patients benefit from biomarker-driven therapies due to suboptimal testing rates. A working group of 20 patient advocacy groups representing solid/hematologic malignancies, three professional societies, and 18 pharmaceutical and diagnostics companies identified patient confusion inconsistent testing terms as a possible contributing factor to biomarker testing underutilization. The group aimed to address patients’ confusion by identifying and adopting consistent, plain language terms for biomarker and germline genetic testing that are applicable across cancer types. Methods: Following a stakeholder roundtable discussion on barriers to precision medicine, working group members participated in interviews on their goals for consistent testing terminology for their constituents. We then conducted a framework analysis covering five themes: available testing by cancer type; purpose of test; biospecimen source; terms used in patient education; and preferred plain language term. Working group members were surveyed on preferences for germline testing terminology and also deployed a preliminary patient survey to their constituents to gain insight on preferences for germline testing terms. Results: Interviews, framework analysis, and surveys revealed notable differences across cancer communities. We identified at least 33 different terms related to biomarker, genetic and genomic testing being used in patient education and clinical care among the different cancer communities and stakeholders. Terminology was complicated by the variety of testing modalities and gene mutations tested for across cancers. Following multiple discussions, working group members agreed on two umbrella terms to distinguish between somatic and germline testing with additional context for specific cancer communities. “Biomarker testing” was selected as the somatic testing term. “Genetic testing for an inherited mutation” and “genetic testing for inherited cancer risk” were selected as preferred germline testing terms. Conclusions: Our findings highlight the disparate testing terminology landscape and the need for consistent terms to reduce patient confusion, improve communication, facilitate shared decision-making and assure concordance in policy development.

93 Background: In 2019, the Association of Community Cancer Centers (ACCC) developed an immuno-oncology (IO) wallet card to address the continuous need for immune-related adverse event education and resources, particularly for IO patients and the non-oncology providers from whom they receive care. The wallet card was distributed to ACCC’s membership of cancer programs via mailings and online, which included a short survey for users to complete at time of download. Methods: To better understand the demographics and motivations of individuals who access the IO wallet card, an exploratory analysis was performed on data collected through the download survey. Data included the survey responses from all downloads between March and September 2019 (n = 141), which was then cleaned to remove duplicates, incomplete responses, and responses from ACCC staff, international users, pharmaceutical representatives, consultants, and patients. Analysis was then performed on the resulting data set of downloads from US-based health care providers (n = 86). Results: Cancer program administrators and nurses accounted for the majority of downloads (30% and 20%, respectively), as well as individuals from comprehensive community cancer programs (44%) and NCI-designated comprehensive cancer programs (16%). Fewer downloads came from other oncology disciplines (2-9%) and small practices (2-6%). Survey responses indicated that the majority of downloads were due to the cancer program not already having the resource (47%), or for comparison with a wallet card developed by the cancer program (15%) or another organization (10%). Patient education materials provided by these institutions included wallet cards (45%), as well as print materials developed by the cancer program (16%), another professional organization (7%), or distributed by drug companies (5%). Conclusions: These finding shed light on the primary audiences accessing the IO wallet card, how this resource may complement other IO patient education materials, and areas where additional education may be needed. Specifically, IO wallet card dissemination or related education may need to be tailored to better reach specific oncology disciplines as well as those practicing in smaller clinics.

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. Due to its less common occurrence and slow progression, however, community-based oncology providers are less likely to regularly diagnose and treat patients with CLL. In addition, these providers may have unique difficulties in treating patients with CLL due to limited access to clinical trials, innovative therapies, and/or local/regional experts for referral or consults. Given these barriers, the Association of Community Cancer Centers (ACCC) developed educational resources to support community-based providers treating patients diagnosed with CLL, including the development of a national CLL heatmap. The primary objective of the CLL heatmap was to increase awareness of the current national CLL landscape as well as facilitate peer-to-peer networks. Thus, the heatmap was designed as an incidence-to-provider profile that highlights where CLL is most frequently diagnosed with an overlay of where specialist providers are located. CLL incidence data was extracted from the National Association of Central Cancer Registries, and a list of CLL experts was gathered from the CLL Society. The term "expert" was loosely defined by recommendations from the CLL Society medical advisory board, executive team, and CLL patient and caregiver community. Once the data was input into the heatmap, additional filters were added for unique data visualization, including raw case numbers, crude case rates per 100,000, and age adjusted rates per 100,000. The heatmap was launched on the ACCC website in May 2019. The final heatmap highlights significant gaps and disparities related to CLL incidence and expertise. For example, when viewing raw CLL case rates, highly populated states like California, New York, Texas, and Florida show the highest incidence. However, when adjusting for the crude rate or age, the highest incidence shifts to states such as Montana, Maine, and the North-Central region. Most importantly, in both scenarios, there are many geographic areas where CLL experts are extremely limited or lacking altogether. Overall, this data visualization tool provides an invaluable resource to community-based cancer providers, patients and caregivers, advocacy groups and educators, and health services researchers. Not only is it useful in quickly assessing where additional educational programming may be needed, but also provides important context for CLL diagnosis, treatment, and quality improvement. In the future, additional research could benefit from expansion of the CLL heatmap to account for other aspects of care or inform the replication of the heatmap for other less common cancers. Disclosures Koffman: NOVARTIS: Membership on an entity's Board of Directors or advisory committees; TGTX: Equity Ownership; MGEN: Equity Ownership; Gilead: Equity Ownership; Verastem: Equity Ownership, Honoraria; BGNE: Equity Ownership; AZN: Equity Ownership, Honoraria; PTLA: Equity Ownership; MEIP: Equity Ownership; JNJ: Equity Ownership, Honoraria; SNSS: Equity Ownership; Abbvie: Equity Ownership; BMY: Equity Ownership, Honoraria.

Safety-net hospitals are resource-constrained and serve complex patients yet are innovators in chronic disease care. Their strategies include personalized care, multidisciplinary teams, and information systems yielding real-time data. Safety-net providers are prime examples from which the health care community can learn to improve the delivery of chronic disease care.