Introduction: The under-representation of culturally and linguistically diverse (CALD) communities in cancer clinical trials limits the generalisability of evidence on treatment efficacy and safety and contributes to inequities in cancer care. While disparities in recruitment are well documented, fewer studies report practical strategies to improve trial access. This study examined the feasibility of a bilingual trial navigator (BTN) designed to support Arabic-speaking patients with cancer and their families to access and consider participation in clinical trials across New South Wales.
Methods: This prospective single-arm pilot study evaluated a co-designed BTN intervention. Five BTNs received tailored training in cancer care, clinical research, participation barriers, Good Clinical Practice, and governance. Patients were recruited during routine appointments, with BTN sessions delivered between November 2024 and July 2025. Clinical trial readiness was assessed using pre- and post-intervention surveys. Quantitative data were analysed descriptively and using the Wilcoxon signed-rank test (SPSS v30), while qualitative data were analysed thematically.
Results: Nineteen patients were approached and 13 consented to participate in the pilot (68%). Participants had a mean age of 62.5 (±10.8) years). Most were born overseas (mainly Lebanon (7/13)), and breast cancer was the most common diagnosis. Eleven had incurable disease. Mean research readiness improved following BTN sessions, although the difference was not statistically significant. Implementation learnings included the need to rise clinician awareness, integrating the BTN role within existing cancer care workflows, and establishing continuity and trust with patients and families.
Conclusion and implications: This is the first reported use of a BTN model in Australia, shifting the focus from documenting disparities to implementing solutions. While based on a small pilot, the findings highlight practical considerations for embedding culturally responsive navigation within cancer services and support further and larger evaluation of its impact on equity in cancer clinical trial participation.