Uniting Postcolonial, Discourse, and Linguistic Theory to Explore Participation of African Americans in Cancer Research as an Effect of Social and Historical Race Relationships

Abstract

This article uses a historical framework of postcolonialism; discourse analytic concepts (significance, identity, and relationships); and 5 social and cultural linguistic principles of emergence, positionality, indexicality, relationality, and partialness as a theoretical and methodological triangulation approach to data analysis of focus group discussion. Exemplars of focus group data from a study exploring African American participation in research demonstrate the application of this combined framework as a useful tool for analysis. This approach allows for examination of identity and interaction and generates a more rigorous and complete understanding of how individuals use language to construct identity as participants or nonparticipants in research.

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

“…In conclusion, facilitating the recruitment and retention of Black participants into CCTs requires the development of culturally competent strategies and interventions that address multilevel barriers 14,16,54 and acknowledge historical racism in research. 32 Ten of the included studies specifically responded to the cultural, and linguistic, diversity across Black communities by using images of local residents in campaigns and/or employing community members to deliver the intervention, which likely contributed to their success. 38,41,[44][45][46][47][48][50][51][52] Involving communities in the development of such strategies and interventions through the use of focus groups, community advisory boards, and the inclusion of community members as research partners may also facilitate issues around the Black population's general lack of awareness of studies that may be available or relevant to them, increase trust in the research overall, improve the translation of findings into viable treatments and therapies, and enhance health systems' ability and willingness to address institutional barriers.…”

“…6,[28][29][30][31] Systemlevel barriers to CCT recruitment include health system factors such as the lack of accessible clinics or facilities with clinical trials and the overall limited availability of applicable clinical trials for patients of color. 32 Much of the treatment of cancers highly prevalent in Black individuals continue to be based largely on outcomes from clinical trials with fewer than 10% Black representation. Hence, current treatments may be inadequate in Black patients with these cancer diagnoses.…”

“…6,28-31 System-level barriers to CCT recruitment include health system factors such as the lack of accessible clinics or facilities with clinical trials and the overall limited availability of applicable clinical trials for patients of color. 32…”