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Proof of Concept for PRE-ACT

Innovative video-based education more effective than text in encouraging cancer patients to consider clinical trials, new study shows

Innovations in Cancer - Spring 2016


Division Chief, Hematology & Oncology, UH Seidman Cancer Center, Dr. Lester E. Coleman, Jr. Chair in Cancer, Research & Therapeutics; Professor of Medicine, Case Western Reserve University School of Medicine

When it comes to encouraging cancer patients to enroll in clinical trials, a little information goes a long way and format matters, according to a new study published in the Journal of Clinical Oncology.

Neal J. Meropol, MD, Chief of Hematology & Oncology at University Hospitals Seidman Cancer Center, led a team of researchers from Case Western Reserve University School of Medicine and UH Case Medical Center, enrolling patients from five cancer centers nationwide. They gauged whether the video education program, Preparatory Education about Clinical Trials (PRE-ACT), developed by Dr. Meropol and collaborators, was more effective than information delivered as simple written text in persuading cancer patients to consider participating in a clinical trial. PRE-ACT first involves patients taking an online survey, which gauges each individual patient’s knowledge and attitudes about clinical trials. Then, based on the patient’s answers, it presents video clips to address their specific concerns.

“Unfortunately, although clinical trials are critical for advancing cancer treatment and ultimately serve as the basis for new standards of care, very few patients participate,” Dr. Meropol says. “We want to close the patient knowledge gap and positively affect their attitudes toward clinical trials.”

In this study, half of the patients received PRE-ACT, while the other half received general, written information about clinical trials, not tailored to their responses on the initial survey. The findings showed that among 1,255 cancer patients taking part in an educational program, 21 percent of patients chose to enroll in cancer clinical trials – a significant boost from typical participation. The American Cancer Society estimates that fewer than 5 percent of cancer patients typically choose to participate in clinical trials. What’s more, the PRE-ACT videos were shown to be more effective than text at improving knowledge and decreasing negative attitudes that can be barriers to patients taking part in clinical trials.

“Although both the PRE-ACT videos and the written materials improved participants’ knowledge, reduced attitude-related barriers, and improved their preparation to consider clinical trials as a treatment option, we found that PRE-ACT was better than the written information in reducing barriers,” Dr. Meropol says.

In addition, participants rated the Web-based video educational program significantly higher than the textbased education material in satisfaction with the amount of information presented, the way the information was presented, and the feeling of being more prepared for them to consider clinical trials for cancer treatment.

“By identifying knowledge gaps and negative attitudes and addressing those before patients meet their doctors to discuss cancer treatment, the patient will be better prepared to make a good decision about whether a clinical trial will be an appropriate option for them,” says Dr. Meropol. “We hope PRE-ACT will result in increased participation in clinical trials by cancer patients through improving knowledge and attitudes and facilitating treatment decision-making.”

Dr. Meropol has partnered with the American Society of Clinical Oncology to make PRE-ACT widely available to cancer patients worldwide at The development of this Web-based program was supported by the National Cancer Institute (NCI). “I encourage you to review the site and discuss it with your patients,” Dr. Meropol says.

For more information about using PRE-ACT to help boost recruitment in your clinical trials, contact Dr. Meropol at