African American Cancer Survivors’ Perspectives on Cancer Clinical Trial Participation in a Safety-Net Hospital: Considering the Role of the Social Determinants of Health

Hernandez, Natalie; Durant, Raegan W.; Lisovicz, Nedra; Nweke, C; Belizaire, Carmela; Cooper, Dexter L.; Soiro, F; Rivers, Desiree; Sodeke, Stephen O.; Rivers, Brian M.

doi:10.1007/s13187-021-01994-4

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…Another qualitative study interviewing African American cancer survivors at a safety-net hospital identified that a lack of understanding of cancer clinical trials was one of the major barriers of participation in cancer trials [28,30]. The study reported that many survivors were confused and even could not be differentiated between a cancer clinical trial and treatment of cancer [31]. Our findings are consistent with these studies and suggest the need to provide culturally and linguistically appropriate cancer clinical trial information to AA cancer survivors to ensure understanding of important clinical trial terms and concepts.…”

Section: Discussionmentioning

confidence: 99%

Disparities in awareness of and willingness to participate in cancer clinical trials between African American and White cancer survivors

et al. 2022

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Background Cancer clinical trials (CCTs) are essential for cancer care, yet the evidence is scarce when it comes to racial disparities in CCT participation among cancer survivors in the Midwest. This study aimed to 1) assess disparities in the awareness of and willingness to participate in CCTs between African American and White cancer survivors; and 2) compare perceptions about CCTs between the two racial groups. Methods The study was based on cross-sectional data from the survey “Minority Patient Participation in Cancer Clinical Trials” that collected information from 147 Black and White cancer survivors from Nebraska between 2015 and 2016. Chi-square tests and logistic regressions were used to assess differences between Black and White cancer survivors regarding their awareness, willingness, and perceptions associated with CCT participation. Results After adjusting for the effects of socio-demographic, health status, and psychosocial variables, Black cancer survivors were much less likely than White cancer survivors to be aware of CCTs (AOR 0.26; CI 0.08–0.81), to express willingness to participate in CCTs (AOR 0.03; CI 0.01, 0.32) and to actually participate in CCTs (AOR 0.13; CI 0.04–0.38). Black cancer survivors reported a lower level of trust in physicians and were less likely than White cancer survivors to believe that CCTs make a significant contribution to science. Conclusions Relative to White cancer survivors, Black cancer survivors had much lower awareness of and willingness to participate in CCTs. Part of these differences might be related to the differential perception of CCTs, psychosocial factors, and trust in physicians between the two groups.

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Section: Discussionmentioning

confidence: 99%

Disparities in awareness of and willingness to participate in cancer clinical trials between African American and White cancer survivors

et al. 2022

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“…An additional 56 articles were excluded in the full-text review. The reasons for exclusion, in order of frequency, were wrong patient population (20), abstract only (13), wrong study design (11), wrong study outcomes (eight), and wrong intervention (four). Our process resulted with 15 articles that met all inclusion criteria (Fig 1).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Similar to previous studies, our results may also show that increasing awareness of available and relevant studies improved the enrollment and retention of Black patients with cancer in CCTs. 20,21 Combining approaches that engage key stakeholders along the clinical trial trajectory-from community members, to patients, to caregivers, and to cancer care providershowever, seems to be most effective. Hamel et al 57 posit that community engagement strategies may help to overcome the barrier of medical mistrust.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13][14][15] Commonly identified patient-level impediments to successful recruitment of Black populations to CCTs include individuals' fear and mistrust of researchers and medical institutions, 16 religious beliefs, 14 health illiteracy, 9,[17][18][19] and limited awareness that studies may be available or relevant to them. 20,21 Social barriers associated with participation in CCTs such as the cost of cancer care, lost wages from time off work, securing childcare, and managing travel burden have also been implicated in patients' inability to enroll in or continue to participate in clinical trials. 22,23 Patient decisions about enrollment in CCTs also depend on the ability of recruiters to communicate information about the trial or study clearly and effectively, with an understanding of how patients' values may influence their decisions.…”

Section: Introductionmentioning

confidence: 99%

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A Scoping Review of Strategies to Increase Black Enrollment and Retention in Cancer Clinical Trials

Arring

Aduse‐Poku

Jiagge

et al. 2022

JCO Oncology Practice

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To address health disparities faced by Black patients with cancer, it is critical that researchers conducting cancer clinical trials (CCTs) equitably recruit and retain Black participants, develop strategies toward this aim, and document associated outcomes. This narrative scoping literature review, as part of a larger study, aimed to identify, describe, and categorize strategies and interventions intended to improve the recruitment and retention of Black participants with breast, lung, prostate, colorectal, or multiple myeloma cancer into CCTs. We conducted comprehensive searches in PubMed, Embase, Cochrane Library, PsycInfo, CINAHL, Scopus, and Web of Science with three main concepts: Black persons, neoplasms, and clinical trial recruitment. The search resulted in 1,506 articles, of which 15 met inclusion criteria. Five main categories of recruitment and retention strategies and interventions were identified based on their specific population focus and type of approach: (1) participant identification, (2) provider awareness/resources, (3) focused research staff interventions, (4) patient and community–focused awareness strategies, and (5) participant-directed resources. Thirteen studies had recruitment acceptance rates of over 30%. Eight studies with acceptance rates of ≥ 50% reported implementing ≥ 5 strategies, with an average use of seven strategies across multiple categories. Five studies with acceptance rates ≥ 50% implemented strategies in ≥ 3 categories. Four studies reported retention rates ≥ 74%. Three studies with reported retention rates ≥ 74% used strategies in ≥ 3 categories, and all included strategies aimed at meeting participant needs beyond the study. Our results show that many efforts that aim to increase the recruitment and retention of Black participants into CCTs have great potential, but the most promising strategies use a multiprong approach.

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Increasing Clinical Trial Participation of Black Women Diagnosed with Breast Cancer

Fairley,

Lillard,

Berk

et al. 2023

J. Racial and Ethnic Health Disparities

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Despite racial disparities in breast cancer mortality, Black women remain underrepresented in clinical trials. In this mixed methods research, 48 Black women were engaged via focus group discussions and in-depth interviews to better understand the lived experience of women with breast cancer. The results of this qualitative study informed the development of a subsequent online survey to identify barriers, motivators, and other factors that influence decision-making by Black women diagnosed with breast cancer when considering clinical trial participation. Among the 257 Black survey participants, most (95%) were aware of clinical trials; of those, most viewed them as lifesaving (81%) and/or benefiting others (90%). Negative perceptions such as serious side effects (58%), not receiving real treatment (52%), or risk of potential harm (62%) were indicated. Barriers included financial expenses (49%), concerns that their condition could be made worse (29%), that they would receive a placebo (28%), or that treatment was unapproved (28%). Participants were more likely than their health care providers (HCPs) to initiate discussions of clinical trials (53% versus 33%), and 29% of participants indicated a need for more information about risks and benefits, even after having those conversations. The most trustworthy sources of information on clinical trials were HCPs (66%) and breast cancer support groups (64%). These results suggest that trusted communities are key for providing education on clinical trials. However, there is also a need for HCPs to proactively discuss clinical trials with patients to ensure that they are adequately informed about all aspects of participation.

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African American Cancer Survivors’ Perspectives on Cancer Clinical Trial Participation in a Safety-Net Hospital: Considering the Role of the Social Determinants of Health

Cited by 11 publications

References 24 publications

Disparities in awareness of and willingness to participate in cancer clinical trials between African American and White cancer survivors

Disparities in awareness of and willingness to participate in cancer clinical trials between African American and White cancer survivors

A Scoping Review of Strategies to Increase Black Enrollment and Retention in Cancer Clinical Trials

Increasing Clinical Trial Participation of Black Women Diagnosed with Breast Cancer

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