Abstract B09: Partnering around cancer clinical trials: Preliminary report of an intervention to improve patient-physician communication and clinical trial enrollment of Black and White men with prostate cancer

L. Hamel, L. Penner, E. Heath, D. Lansey, M. Carducci, T. Albrecht, E. Barton, Mark A Manning, Tanina S Foster, Mark R. Wojda, S. Eggly
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Abstract

Background: Few patients, especially racial/ethnic minorities, enroll in clinical trials (CTs) in the United States, in part due to factors related to patient-physician interactions. We describe a theory-based patient intervention to improve communication and enrollment of Black and White men in prostate cancer CTs. We also report on preliminary baseline data comparing Black and White participants9 demographic and social characteristics and their willingness to discuss a CT with a physician. Method: A team of communication scientists, psychologists, and clinicians collaborated to create a theory-based, patient-focused intervention. Theories included the common ingroup identity model, which suggests people from different social groups can better achieve goals when they see themselves as members of the same team, and patient-centered communication, which suggests that patient active participation improves clinical communication. The intervention is in the form of a booklet given to patients prior to meeting with their oncologist. The booklet includes a) encouragement to view the patient and physician as a team and participate actively in clinical interactions, and b) 33 questions about participating in a CT. Preliminary data from one data collection site (Detroit, Michigan) include 72 Black (n=40) and White (n=32) men with prostate cancer who completed baseline measures assessing age; education; income; breadwinner status; marital status; health literacy; perceived economic burden (e.g., how difficult is it for you to live on your total household income right now?); general trust in physicians; group-based medical mistrust (including three subscales--suspicion, perceived racial health care disparities, and perceived health care provider support); and willingness to discuss a CT with a physician. Chi-square and independent samples t-tests were conducted to determine racial differences. Results: Black patients were younger (p=.04), had less education (p=.006) and lower annual incomes (p Discussion: Black and White patients differed in many demographic and social characteristics. Both groups indicated they were very willing to discuss a CT with their physician, although Whites were significantly more willing. This finding suggests the intervention may be especially beneficial for Black patients, who are disproportionately under-represented in CTs. Next steps involve analysis of the effect of the intervention and addition of a physician-focused intervention. Citation Format: Lauren M. Hamel, Louis A. Penner, Elisabeth Heath, Dina Lansey, Michael Carducci, Terrance L. Albrecht, Ellen Barton, Mark Manning, Tanina Foster, Mark Wojda, Susan Eggly. Partnering around cancer clinical trials: Preliminary report of an intervention to improve patient-physician communication and clinical trial enrollment of Black and White men with prostate cancer [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B09.
摘要B09:围绕癌症临床试验的合作:一项改善黑人和白人前列腺癌患者医患沟通和临床试验入组的干预措施的初步报告
背景:在美国,很少有患者,特别是少数种族/民族患者参加临床试验(ct),部分原因是与医患互动相关的因素。我们描述了一种基于理论的患者干预,以改善黑人和白人男性在前列腺癌ct中的交流和登记。我们还报告了初步的基线数据,比较了黑人和白人参与者的人口统计和社会特征,以及他们与医生讨论CT的意愿。方法:一个由沟通科学家、心理学家和临床医生组成的团队合作创建了一个以理论为基础、以患者为中心的干预方法。理论包括常见的群体内认同模型(ingroup identity model)和以患者为中心的沟通模型(patient-centered communication),前者认为来自不同社会群体的人在将自己视为同一团队的成员时可以更好地实现目标。后者认为患者的积极参与可以改善临床沟通。干预的形式是在与肿瘤医生会面之前给患者一本小册子。这本小册子包括a)鼓励将患者和医生视为一个团队,并积极参与临床互动,b)关于参与CT的33个问题。来自一个数据收集点(密歇根州底特律)的初步数据包括72名患有前列腺癌的黑人(n=40)和白人(n=32),他们完成了评估年龄的基线测量;教育;收入;养家糊口状态;婚姻状况;健康知识;感知到的经济负担(例如,你目前靠家庭总收入生活有多困难?)对医生的普遍信任;基于群体的医疗不信任(包括三个子量表——怀疑、感知的种族卫生保健差异和感知的卫生保健提供者支持);并愿意与医生讨论CT。采用卡方检验和独立样本t检验来确定种族差异。结果:黑人患者较年轻(p= 0.04),受教育程度较低(p= 0.006),年收入较低(p)。两组人都表示,他们非常愿意与医生讨论CT,尽管白人明显更愿意。这一发现表明,干预可能对黑人患者特别有益,他们在ct中的代表性不成比例。接下来的步骤包括分析干预的效果和增加以医生为中心的干预。引文格式:Lauren M. Hamel, Louis A. Penner, Elisabeth Heath, Dina Lansey, Michael Carducci, Terrance L. Albrecht, Ellen Barton, Mark Manning, Tanina Foster, Mark Wojda, Susan Eggly。围绕癌症临床试验的合作:改善黑人和白人前列腺癌患者的医患沟通和临床试验入组的干预措施的初步报告[摘要]。见:第十届AACR会议论文集:种族/少数民族和医疗服务不足人群的癌症健康差异科学;2017年9月25-28日;亚特兰大,乔治亚州。费城(PA): AACR;癌症流行病学杂志,2018;27(7增刊):摘要nr B09。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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