An educational video to increase clinical trials enrollment among breast cancer patients

Abstract

Only 3% of women with breast cancer participate in cancer clinical trials nationwide. The lack of awareness about clinical trials is a significant barrier towards clinical trials participation. A study was conducted at a large urban Comprehensive Cancer Center to test (1) the effectiveness of an 18-min educational video on improving attitudes toward clinical trials and trials enrollment among new breast cancer patients seen at the Karmanos Cancer Institute, and (2) to assess racial differences in attitudes regarding clinical trials. Participants were randomized to either the educational intervention prior to their first oncology clinic appointment or to standard care. A baseline and 2-week post-intervention survey to assess attitudes toward clinical trials participation was completed by participants. Of 218 subjects recruited, 196 (55% white vs. 45% African American (AA)) eligible patients were included in the analysis. A small increase in therapeutic clinical trial enrollment was observed in the intervention arm but was not statistically significant (10.4% vs. 6.1%; P = 0.277). The intervention also did not result in a clear improvement in patients’ attitudes toward clinical trials at posttest. However, a lower enrollment rate for the AA women was noted after adjusting for stage (OR = 0.282, P = 0.049). Significantly more negative scores were noted in 3 out of the 5 baseline attitudinal scales for AA women. The educational video did not significantly increase enrollment in breast cancer clinical trials. The findings that AA women had significantly more negative attitudes toward clinical trials than white women may partially explain the racial disparity in enrollment. An educational video remains a simple and cost-effective way to educate patients. Future studies should focus on designing a new educational video to specifically target cultural and attitudinal barriers in the AA population to more effectively change attitudes and increase trial enrollment.

Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity Program

“…Previous efforts to improve clinical trial enrollment have included interventions involving informational booklets and videos aimed at educating patients about the benefits and risks of clinical trials [38][39][40]. Others have tried to increase trial enrollment by improving the informed consent process [41].…”

“…Others have tried to increase trial enrollment by improving the informed consent process [41]. While these efforts improve patients' understanding of clinical trials, they have been largely unsuccessful at increasing clinical www.TheOncologist.com trial participation [39][40][41]. Studies involving minority-based community clinical oncology programs have shown promise as a way to facilitate clinical trial participation among racial minorities and other underserved populations [42].…”

Effects of a Brief Multimedia Psychoeducational Intervention on the Attitudes and Interest of Patients With Cancer Regarding Clinical Trial Participation: A Multicenter Randomized Controlled Trial

“…Two previous studies directly evaluated this possibility; in both studies, the same 18-minute educational video served as the intervention. 7,8 One study found that among 126 patients with lung cancer who had not previously participated in a clinical trial, the video had a significant positive impact on likelihood of participating but not on attitudes. 8 The other study found that among 196 patients with breast cancer who had not previously participated in a clinical trial, the video had no significant effects on either outcome.…”

Participation in Cancer Clinical Trials as Viewed by Chinese Patients and Their Families

“…Several studies supported our findings. Two publications that focused on an educational video designed to increase clinical trial enrollment observed that the video did not significantly increase enrollment [23,24]. Similarly, cancer patients who did not understand chemotherapy were found to accept it for a small chance of clinical benefit, while doctors, who understood the therapy very well, were unwilling to do so [25].…”