Table 4.

Framework for barriers identified and changes desired and implemented.

Barriers expressed	Desired institutional change	Ways COG can foster this change	Interventions currently implemented or in process
Poor communication between medical oncology and pediatric oncology	Improve communication with medical oncology AYA Program with medical oncology AYA Navigator	Enhance Medical oncology engagement Educate regrading enrollment barriers Disseminate trial information	Include medical oncologists in AYA RI Network /Joint leadership NCTN cross-network trial development AYA RI network group webinars focusing on barriers and facilitators to enrollment
Administrative logistical barriers	Unified trial screening Expand age limit for pediatric oncology intake AYA Program Shared AYA Navigator	Foster development of AYA Trials Clarify site enrollment procedures	NCTN cross-network trial development
Cross-enrollment challenges	Unified trial screening Increased research resources	Clarify site enrollment procedures Systemic NCTN changes	Development of COG FAQ NCTN cross-network trial development
Complex COG trials	Increase education on trials	Educate and disseminate information on current trials	AYA RI Network webinars focused on individual AYA relevant trials
Trials not available	Increase research resources	Foster development of AYA Trials	NCTN cross-network trial development