Table 2.

Reported barriers and facilitators to enrollment.

Question	Response category	Definition	Example of response
1. What are the main barriers to accrual of AYA patients onto COG clinical trials at your institution? If applicable, please include barriers to collaboration with medical oncology for clinical trial accrual in your response	Administrative logistical barriers	Administrative barriers at site level that negatively impact AYA trial enrollment	‘Perceived age barrier by hospital executives’
	Perceived medical oncology lack of interest	Perceived lack of enthusiasm to enroll AYA patients to trials; refusal to transfer care of AYA patients to pediatric oncology	‘Some medical oncologists rather keep patients than refer them if they cannot enroll on trial themselves’
	Cross enrollment challenges	Site level regulatory and structural barriers that hinder AYA patients to be enrolled across cooperative group trials and between medical and pediatric oncology	‘Adult facility is on different campus’
	Pediatric and medical oncology communication issues	Reported negative relationship between medical and pediatric oncology which does not involve regular communication and negatively impacting site level trial enrollment for AYAs	‘Lack of an established pathway for knowledge sharing between pediatric and medical oncologists’
	Limited trial availability	AYA focused clinical trials are limited in availability at site level	‘Adult sites and physicians in Australia not able to participate in COG trials’
	Complexity of COG trials	COG trials are deemed to be too burdensome and complicated at institution by members	‘Perceived complication of COG trials from the medical oncologist point of view – they are often felt to be too complicated and require too many resources to administer in the medical oncology setting’
2. What are the main facilitators to accrual of AYA patients (ages 15–39) onto COG clinical trials at your institution? If applicable, please include facilitators to collaboration with medical oncology for clinical trial accrual in your response	AYA champions	Existence of an individual at institution with focus on AYA clinical trial enrollment at site level	‘We have a champion within the medical oncology group who is able to enroll patients on COG trials’
	Supportive research infrastructure	Presence of a research infrastructure deemed conducive to AYA clinical trial enrollment at site level	‘Strong clinical research infrastructure at my institution allows us to have most non-phase 1 studies open.’
	Good pediatric and medical oncology communication	Reported positive relationship between medical and pediatric oncology involving regular communication positively impacting AYA clinical trial enrollment	‘Dialogue between adult and peds to triage specially to ensure they have availability to open COG clinical trials has been a facilitator’
	AYA screening process	Processes in place at site level that allows patients to be identified as AYAs and screened for available clinical trials at institution	‘Our pediatric Clinical Research Group (GRG) CRAs now screen new patient notifications for potential clinical trial eligibility and maintain a database of patients who are screened’
	Hospital logistics	Administrative policies supporting and allowing AYA Clinical trial enrollment	‘We allow patients to be treated up to age 39 at our Children’s Hospital’
	Presence of formal AYA program	Existence of a dedicated team of individuals at institution providing care to AYA patients	‘AYA program in place with a co-directorship-pediatric oncologist and a medical oncologist.’
	Single campus/IRB	Institutional structured such that there is one campus and single IRB between medical and pediatric oncology	‘Singular IRB and CTSR program allowing more providers to be co investigators on trials’