Video intervention increases participation of black breast cancer patients in therapeutic trials

Abstract

There is a striking racial and ethnic disparity in incidence and mortality of cancer yet minorities remain markedly underrepresented in clinical trials. This pilot study set out to determine the impact of a 15-min culturally tailored educational video on three outcomes relating to clinical trials: likely participation, attitudes (assessed based on six barriers), and actual enrollment. Breast cancer patients with Stage I-III, if diagnosed within previous 6 months, or metastatic disease who self-identified as black or African American were invited to participate. The primary outcome measure was the decision to participate in a therapeutic clinical trial after the intervention. Patients’ intention to enroll on a therapeutic clinical trial and the change in attitudes toward clinical trials were measured by the previously developed Attitudes and Intention to Enroll in Therapeutic Clinical Trials (AIET) questionnaire. Of the 200 patients that participated, 39 (19.5%) patients signed consent to participate in a therapeutic clinical trial; 27 (13.5%) patients enrolled, resulting in a 7.5% increase from our baseline comparison of 6% clinical trial enrollment rate in black cancer patients (p < .001). Pre-test versus post-test assessment demonstrated the proportion of patients expressing likelihood to enroll in a therapeutic trial following the intervention increased by 14% (p < .001). Among 31 AIET items, 25 (81%) showed statistically significant and positive change post-intervention. The findings suggest the promising utility of a culturally tailored video intervention for improving black patients’ attitudes regarding clinical trial participation and resultant enrollment. Future efforts should continue to target facilitators of population-specific recruitment, enrollment, and retention in therapeutic and non-therapeutic clinical trials.

Use of Video Education Interventions to Increase Racial and Ethnic Diversity in Cancer Clinical Trials: A Systematic Review

“…Like Wells et al (2013), Du, Mood, Gadgeel, andSimon (2009) and Pelto et al ( 2016) studied BIPOC cancer survivors' perceptions of materials adapted from the National Cancer Institute's Cancer Clinical Trials videos. Other researchers created original videos (Banda et al, 2012;Chalela et al, 2018;Quinn et al, 2013) or studied the outcomes of existing videos (Robinson et al, 2017).…”

“…For cultural sensitivity, videos featured patient narrators that were racially and ethnically congruent with the target population along with healthcare providers and other public servants (Banda et al, 2012;Chalela et al, 2018;Pelto et al, 2016;Robinson et al, 2017). Narrators were chosen to match the language of the intended population.…”

“…Interventions utilized a variety of delivery modes to communicate the culturally sensitive messages. Videos were presented in a clinical research setting (Banda et al, 2012;Chalela et al, 2018;Du et al, 2009;Pelto et al, 2016;Quinn et al, 2013;Robinson et al, 2017) or in a clinical research and home setting (Wells et al, 2013). Participants in Quinn et al (2013) recommended that videos be available both in the clinical and home setting to allow time for reflection with their families.…”

“…noted that 62.5% of the 17 participants within their study also viewed the intervention again at home. Three studies also employed an additional delivery strategy, i.e., clinical trial coordinators who were racially and linguistically congruent with their samples (Banda et al, 2012;Chalela et al, 2018;Robinson et al, 2017). These coordinators facilitated information delivery describing the clinical trial.…”

A pilot study of a culturally-appropriate, educational intervention to increase participation in cancer clinical trials among African Americans and Latinos

“…Few educational interventions on cancer clinical trials have been speci cally designed to target racial/ethnic minorities, including African Americans and Latinos [17][18][19][20][21][22][23][24][25][26][27][28]. Only a handful can be used across both populations [17,26].…”