Improving Ethnic Diversity in Cancer Trials Through Healthcare Interpreter Training

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-08-01 DOI:10.1002/cam4.71071

Suzanne J. Grant, Mayra Ouriques, Abhijit Pal, Sharon Lee, Sheetal Challam, Lindsey Jasicki

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Abstract

Introduction

People with cancer from culturally and linguistically diverse (CALD) backgrounds who are not proficient in English face many challenges in accessing clinical trials. Clinical trials offer opportunities to access cutting-edge therapies for cancer management, with opportunities for longer survival and/or better quality of life. Inequitable access to these clinical trials not only reduces the validity of research findings, but also exacerbates the known disparities in cancer outcomes for these populations. Australia is a migrant majority country, with certain areas having large proportions of people who do not speak English—research has shown that this group has a lower rate of trial participation than those who can speak English. There is no available specific training in cancer clinical trials or research terminology for healthcare interpreters (HCIs). Research has shown that inadequately trained interpreters are a recognized barrier to clinical trial access for patients who are not proficient in English. This two-phase quality improvement project, including a baseline knowledge survey and subsequent training modules, was undertaken to build workforce capacity for interpreters in cancer clinical trials.

Methods

Phase 1: Subject matter experts and NSW Healthcare Interpreting Services managers codeveloped a survey to identify knowledge and skill gaps. HCIs across NSW (approx. 700) were invited to participate in a survey via an anonymous link (Qualtrics). Phase 2: Training was developed comprising five sections (basic concepts of clinical trials, governance and ethics, phases, informed consent and role of interpreters) using a blend of videos and presentations, interactive polls, and discussions. Pretraining and post-training surveys were conducted to assess learnings. Statistical analysis used descriptive statistics and t-tests.

Results

In Phase 1, 133 interpreters responded to an initial online survey (response rate of 19%). The majority (71%) had been working as interpreters for more than 10 years. Clinical trial interpreting experience was limited; 34% had never interpreted for a clinical trial. Mean knowledge accuracy for clinical trial concepts was 68%, with uncertainty/lack of knowledge around randomization, clinical trial phases, and uncertainty around governance/ethics and clinical trial sponsors. In Phase 2, 92 interpreters attended in-person or online training. Training increased mean accuracy in knowledge items about cancer clinical trials from 74% prior to training to 91% after the training. Confidence in understanding clinical trial terminology increased from 20% to 62% after training.

Conclusion

Training for HCIs improved knowledge and confidence in understanding cancer clinical trial principles and terminology, building competency to provide better service to people from CALD backgrounds. The training modules developed will be made available online for statewide interpreter access. Future evaluation should track the impact on CALD trial participation to assess long-term outcomes.

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通过医疗口译培训改善癌症试验中的种族多样性

来自不同文化和语言背景（CALD）的癌症患者，如果不精通英语，在进入临床试验时面临许多挑战。临床试验为获得癌症管理的尖端疗法提供了机会，有机会延长生存期和/或提高生活质量。这些临床试验的不公平获取不仅降低了研究结果的有效性，而且还加剧了这些人群在癌症结局方面的已知差异。澳大利亚是一个以移民为主的国家，在某些地区有很大比例的人不会说英语——研究表明，这一群体的试验参与率低于那些会说英语的人。没有针对医疗口译员（hci）的癌症临床试验或研究术语的专门培训。研究表明，对于英语不熟练的患者来说，训练不足的口译员是临床试验准入的公认障碍。这一质量改进项目分两阶段进行，包括基线知识调查和随后的培训模块，目的是建设癌症临床试验口译人员的工作能力。方法：第一阶段：主题专家和新南威尔士州医疗口译服务经理共同制定了一项调查，以确定知识和技能差距。横跨新南威尔士州的hci（约）。700)被邀请通过匿名链接（Qualtrics）参与一项调查。第二阶段：培训包括五个部分（临床试验的基本概念、治理和伦理、阶段、知情同意和口译员的作用），采用视频和演示、互动式民意调查和讨论相结合的方式。通过训练前和训练后的调查来评估学习情况。统计分析采用描述性统计和t检验。在第一阶段，133名口译员回应了最初的在线调查（回复率为19%）。大多数人（71%）从事口译工作超过10年。临床试验口译经验有限；34%的人从未为临床试验做过口译。临床试验概念的平均知识准确性为68%，存在随机化、临床试验阶段以及治理/伦理和临床试验发起人方面的不确定性/缺乏知识。在第二阶段，92名口译员参加了现场或在线培训。培训将癌症临床试验知识项目的平均准确率从培训前的74%提高到培训后的91%。培训后，理解临床试验术语的信心从20%增加到62%。结论hci培训提高了对癌症临床试验原理和术语的认识和信心，培养了为来自CALD背景的患者提供更好服务的能力。开发的培训模块将在网上提供给全州的口译人员使用。未来的评估应跟踪对CALD试验参与的影响，以评估长期结果。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.