Cancer Clinical Trial Participation: A Qualitative Study of Black/African American Communities' and Patient/Survivors' Recommendations.

IF 3.4 Q2 ONCOLOGY
Linda Kaljee, Sylvester Antwi, Doreen Dankerlui, Donna Harris, Barbara Israel, Denise White-Perkins, Valerie Ofori Aboah, Livingstone Aduse-Poku, Harriet Larrious-Lartey, Barbara Brush, Chris Coombe, La'Toshia Patman, Nayomi Cawthorne, Sophia Chue, Zachary Rowe, Cassandra Mills, Kurt Fernando, Gwendolyn Daniels, Eleanor M Walker, Evelyn Jiagge
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引用次数: 0

Abstract

Background: Black/African Americans experience a disproportionate cancer burden and mortality rates. Racial/ethnic variation in cancer burden reflects systemic and healthcare inequities, cancer risk factors, and heredity and genomic diversity. Multiple systemic, socio-cultural, economic, and individual factors also contribute to disproportionately low Black/African American participation in cancer clinical trials.

Methods: The Participatory Action for Access to Clinical Trials project utilized a community-based participatory research (CBPR) approach inclusive of Black/African American community-based organizations (CBOs), Henry Ford Health (HFH), and the University of Michigan Urban Research Center. The project aims were to understand Black/African Americans' behavioral intentions to participate in cancer clinical trials and to obtain recommendations for improving participation. Audio-recorded focus group data were transcribed, coded, and searches were conducted to identify themes and subthemes. Representative text was extracted from the transcripts.

Results: Six community focus group discussions (70 participants) and six HFH patient/survivor focus group discussions (29 participants) were completed. General themes related to trial participation were identified including: 1) systemic issues related to racism, health disparities, and trust in government, health systems, and clinical research; 2) firsthand experiences with healthcare and health systems; 3) perceived and experienced advantages and disadvantages of clinical trial participation; and 4) recruitment procedures and personal decision-making processes. Specific recommendations on how to address barriers were obtained.

Conclusions: CBPR is effective in bringing communities equitably to the table. To build trust, health systems must provide opportunities for patients and communities to jointly identify factors affecting cancer clinical trial participation, implement recommendations, and address health disparities.

癌症临床试验参与:黑人/非裔美国人社区和患者/幸存者建议的定性研究。
背景:黑人/非裔美国人的癌症负担和死亡率都不成比例。癌症负担的种族/族裔差异反映了系统性和医疗保健不平等、癌症风险因素以及遗传和基因组多样性。多种系统、社会文化、经济和个人因素也是导致黑人/非洲裔美国人参与癌症临床试验的比例过低的原因:临床试验参与行动项目采用了社区参与式研究(CBPR)方法,包括黑人/非洲裔美国人社区组织(CBOs)、亨利福特健康公司(HFH)和密歇根大学城市研究中心(University of Michigan Urban Research Center)。该项目的目的是了解黑人/非裔美国人参与癌症临床试验的行为意向,并获得改善参与情况的建议。对焦点小组的录音数据进行了转录、编码和搜索,以确定主题和次主题。从录音誊本中提取有代表性的文本:共完成了六次社区焦点小组讨论(70 人参与)和六次 HFH 患者/幸存者焦点小组讨论(29 人参与)。确定了与试验参与相关的一般主题,包括1) 与种族主义、健康差异以及对政府、医疗系统和临床研究的信任有关的系统性问题;2) 与医疗保健和医疗系统有关的亲身经历;3) 参与临床试验所感知和体验到的利弊;以及 4) 招募程序和个人决策过程。我们还就如何消除障碍提出了具体建议:CBPR能有效地让社区公平地参与进来。为了建立信任,医疗系统必须为患者和社区提供机会,共同确定影响癌症临床试验参与的因素、实施建议并解决健康差异问题。
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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来源期刊
JNCI Cancer Spectrum
JNCI Cancer Spectrum Medicine-Oncology
CiteScore
7.70
自引率
0.00%
发文量
80
审稿时长
18 weeks
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