Kathryn E. Lancaster PhD, Angela T. Estadt PhD, Madison N. Enderle MPH, Todd P. Korthuis MD, April M. Young PhD
{"title":"“我厌倦了看到我的朋友死去”：在美国农村吸毒人群中参与临床试验的障碍和促进因素","authors":"Kathryn E. Lancaster PhD, Angela T. Estadt PhD, Madison N. Enderle MPH, Todd P. Korthuis MD, April M. Young PhD","doi":"10.1111/jrh.70009","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Participation in clinical trials among people who use drugs (PWUD) in rural areas remains disproportionately low compared to those in urban communities. Our objective was to describe the barriers and facilitators to clinical trial participation among this understudied and underserved population.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted semi-structured in-depth interviews among rural PWUD in Kentucky, Ohio, and Oregon. Using the Ickovics and Meisler framework, we classified factors associated with participation in clinical trials among rural PWUD into five categories: the individual, trial and intervention characteristics, participant-trial staff relationship, clinical trial setting, and features of the disease. We used inductive qualitative analysis methods to identify salient themes.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Thirty-five rural participants (median age: 39, 51% men) completed in-depth interviews. Facilitators for rural clinical trial participation were mainly situated within the individual, trial and intervention characteristics, and clinical trial setting. Individual characteristics, such as altruistic motivations to help their communities and peers, as well as trial and intervention characteristics like visit reminders and resource assistance, were the most frequently noted facilitators of clinical trial participation. In contrast, participation barriers were mainly related to participant-trial staff relationships and disease features. Judgmental and untrustworthy trial staff, along with involvement in the criminal legal system, were obstacles to clinical trial participation.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Individual, intrapersonal, and logistical factors described by rural PWUD must be addressed to enhance the participation and retention of this population in clinical trials. Successful clinical trial participation may contribute to equitable access to essential health services by PWUD in rural communities.</p>\n </section>\n </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"“I'm tired of seeing my friends die”: Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States\",\"authors\":\"Kathryn E. Lancaster PhD, Angela T. Estadt PhD, Madison N. Enderle MPH, Todd P. Korthuis MD, April M. Young PhD\",\"doi\":\"10.1111/jrh.70009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>Participation in clinical trials among people who use drugs (PWUD) in rural areas remains disproportionately low compared to those in urban communities. Our objective was to describe the barriers and facilitators to clinical trial participation among this understudied and underserved population.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We conducted semi-structured in-depth interviews among rural PWUD in Kentucky, Ohio, and Oregon. Using the Ickovics and Meisler framework, we classified factors associated with participation in clinical trials among rural PWUD into five categories: the individual, trial and intervention characteristics, participant-trial staff relationship, clinical trial setting, and features of the disease. We used inductive qualitative analysis methods to identify salient themes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Findings</h3>\\n \\n <p>Thirty-five rural participants (median age: 39, 51% men) completed in-depth interviews. Facilitators for rural clinical trial participation were mainly situated within the individual, trial and intervention characteristics, and clinical trial setting. Individual characteristics, such as altruistic motivations to help their communities and peers, as well as trial and intervention characteristics like visit reminders and resource assistance, were the most frequently noted facilitators of clinical trial participation. In contrast, participation barriers were mainly related to participant-trial staff relationships and disease features. Judgmental and untrustworthy trial staff, along with involvement in the criminal legal system, were obstacles to clinical trial participation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Individual, intrapersonal, and logistical factors described by rural PWUD must be addressed to enhance the participation and retention of this population in clinical trials. 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“I'm tired of seeing my friends die”: Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States
Purpose
Participation in clinical trials among people who use drugs (PWUD) in rural areas remains disproportionately low compared to those in urban communities. Our objective was to describe the barriers and facilitators to clinical trial participation among this understudied and underserved population.
Methods
We conducted semi-structured in-depth interviews among rural PWUD in Kentucky, Ohio, and Oregon. Using the Ickovics and Meisler framework, we classified factors associated with participation in clinical trials among rural PWUD into five categories: the individual, trial and intervention characteristics, participant-trial staff relationship, clinical trial setting, and features of the disease. We used inductive qualitative analysis methods to identify salient themes.
Findings
Thirty-five rural participants (median age: 39, 51% men) completed in-depth interviews. Facilitators for rural clinical trial participation were mainly situated within the individual, trial and intervention characteristics, and clinical trial setting. Individual characteristics, such as altruistic motivations to help their communities and peers, as well as trial and intervention characteristics like visit reminders and resource assistance, were the most frequently noted facilitators of clinical trial participation. In contrast, participation barriers were mainly related to participant-trial staff relationships and disease features. Judgmental and untrustworthy trial staff, along with involvement in the criminal legal system, were obstacles to clinical trial participation.
Conclusions
Individual, intrapersonal, and logistical factors described by rural PWUD must be addressed to enhance the participation and retention of this population in clinical trials. Successful clinical trial participation may contribute to equitable access to essential health services by PWUD in rural communities.
期刊介绍：
The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.
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