Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: Enhancing minority participation in clinical trials (EMPaCT)

Abstract

Background The study of disparities in minority recruitment to cancer clinical trials has focused primarily on inquiries among minority populations. Yet, very little is known about the perceptions of individuals actively involved in minority recruitment to clinical trials within cancer centers. Therefore, we sought to assess the perspectives of cancer center clinical and research personnel on barriers and facilitators to minority recruitment. Methods We conducted 91 qualitative interviews at 5 U.S. cancer centers among 4 stakeholder groups: cancer center leaders, principal investigators, research staff, and referring clinicians. All interviews were recorded and transcribed. Qualitative analyses of response data was focused on identifying prominent themes related to barriers and facilitators to minority recruitment. Results The perspectives of the 4 stakeholder groups were largely overlapping with some variations based on their unique roles in minority recruitment. Four prominent themes were identified: 1) Racial and ethnic minorities are influenced by varying degrees of skepticism related to trial participation; 2) Potential minority participants often face multi-level barriers that preclude them from being offered an opportunity to participate in a clinical trial; 3) Facilitators at both the institutional- and participant-level potentially encourage minority recruitment; and 4) Variation between internal and external trial referral procedures may limit clinical trial opportunities for racial and ethnic minorities. Conclusions Multi-level approaches are needed to address barriers and optimize facilitators within cancer centers to enhance minority recruitment for cancer clinical trials.

Patient Navigation As a Model to Increase Participation of African Americans in Cancer Clinical Trials

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A Qualitative Study of Motivations for Minority Recruitment in Cancer Clinical Trials Across Five NCI-Designated Cancer Centers

“…Rather, some stakeholders adhered to a belief that all human subjects should be recruited with equal fervor. There is an ongoing debate in cancer clinical trial recruitment; one perspective notes that stakeholders should target underrepresented groups in order to increase minority recruitment and retention [9], while another perspective states that raising recruitment among all groups will increase minority recruitment [10, 11]. Both views were expressed by our interviewees and we believe that both views may have merit.…”

Is Religiosity Related to Attitudes Toward Clinical Trials Participation?

“…Attracting volunteers to participate in research studies is a well-documented challenge for researchers [1, 2]. It has been a widely accepted estimate that, among all cancer patients, less than five percent participate in a clinical trial.…”