Agritourism has emerged globally as a tool to diversify farm income, and the need for non-formal educational programming in this area has become obvious. In Arkansas, Cooperative Extension educators have lacked empirical data to guide program development. One clear need, according to literature, is for operators to improve marketing communications skills. Researchers surveyed agritourism operators in Arkansas to describe demographics, educational needs (especially related to marketing communications), and educational delivery preferences. Results indicated that operators were typically older than 50 and that 60% had been in operation for longer than 10 years. Key issues and educational needs related to marketing communications included promotion and marketing, advertising, media relations, and signage. Communications tactics commonly used by the respondents included word-ofmouth (WOM); websites; print, radio, and television advertising; and local media relations. Preferred delivery methods for educational programming related to agritourism included periodic newsletters, regional workshops, and news releases.

9 Background: The use of biosimilar drugs in the treatment of cancer offer an opportunity for oncology providers to decrease total cost of care while preserving quality. However, it remains unclear whether providers and patients may resist biosimilar use due to concerns over safety and efficacy. Our national network of 5 practices with over 100 clinics committed to a conversion to therapeutic biosimilars for trastuzumab and bevacizumab after their introduction in July 2019. Methods: Common steps to foster therapeutic biosimilar conversion included frequent communication from medical directors to providers and staff, incorporation of biosimilars into default treatment regimen orders, providing clinical teams lists identifying candidates for conversion, and tracking reasons why biosimilar switch did not occur. Most practices prioritized converting patients initiating new treatments, then later transitioning patients receiving maintenance therapy. This phased approach was taken to ensure that prior authorization and patient consent could be obtained prior to conversion. Rates of biosimilar use were calculated by comparing the number of administrations for which a biosimilar was given to the total number of administrations for which a biosimilar could have been given. Cost savings were calculated by comparing the difference in Medicare allowed rates for each originator and biosimilar drug pair at the time of administration. Results: Biosimilar use increased over time at all practices, from 0% to an average of 67% for trastuzumab and 78% for bevacizumab. The decrease in cost attributed to the use of biosimilars in the study period totaled over $4.4 million. Challenges to biosimilar use included physician preference for the originator drug, difference in preferred agents across payers, and challenges with biosimilar drug storage. Patients rarely had concerns over efficacy and safety. Conclusions: Therapeutic biosimilar adoption in a large oncology network is feasible and can lead to significant cost savings. [Table: see text]

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