Knowledge and Access to Information on Recruitment of Underrepresented Populations to Cancer Clinical Trials: Evidence Report/Technology Assessment, Number 122

Ford, Jean G.; Howerton, Mollie; Bolen, Shari; Gary, Tiffany L.; Lai, Gilda; Tilburt, Jon C.; Gibbons, Michael; Baffi, Charlie; Wilson, Renée F; Feuerstein, Carolyn J; Tanpitukpongse, Peter; Powe, Neil R.; Bass, Eric B

doi:10.1037/e439572005-001

Cited by 73 publications

(106 citation statements)

References 91 publications

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“…One caveat is that the trend toward a gender bias may have been an indirect effect of having more breast and gynecologic studies open for accrual during the period of our data collection. Nevertheless, increasing participation by cancer patients representative of the diverse American population has been identified as a national research goal, in light of evidence demonstrating the under-representation of specific populations in cancer clinical trials [4,[28][29][30][31]. This study was limited to a small and rather homogeneous sample, but even evidence of a trend toward recommending trials to some patient subgroups and not others warrants extending this research to a more diverse population.…”

Section: Discussionmentioning

confidence: 99%

Oncologists’ recommendations of clinical trial participation to patients

Eggly

Albrecht

Harper

et al. 2008

Patient Education and Counseling

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Objective-To describe the frequency, context and type of oncologists' recommendations to patients that they participate in a clinical trial and to analyze the relationship between recommendations and patients' decisions to participate.Methods-Data included 38 video recorded outpatient interactions during which 15 oncologists invited 38 patients to participate in clinical trials. We described the frequency, context, and type of oncologists' recommendations and analyzed the relationship between these factors and patient decisions to participate and socio-demographic characteristics.Results-Sixty-eight percent (n = 26) of the 38 interactions included an explicit recommendation. Most recommendations were unprompted by patients and/or companions and were tailored to individual patients. A significant relationship was found between recommendations and patients' decisions to participate. Positive trends were found between receiving a recommendation and being female and having higher education.Conclusion-Oncologists routinely make recommendations to patients during the presentation of clinical trials. These recommendations may influence patients' decisions and may occur more frequently with some demographic groups.Practice Implications-Oncologists should be aware of the potential influence of their recommendations when discussing clinical trials with patients.

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Section: Discussionmentioning

confidence: 99%

Oncologists’ recommendations of clinical trial participation to patients

Eggly

Albrecht

Harper

et al. 2008

Patient Education and Counseling

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“…This, in turn, may lead to the decision to accept or refuse participation in the trial. 6 In addition, there are several factors that are barriers to or promoters of clinical trial awareness. Awareness involves a person's knowledge and beliefs about clinical trials in general; a person's attitudes and beliefs regarding cancer, the medical profession, and medical research; a person's belief in his/her ability to participate in a clinical trial; the organizational environment, which involves the physical and psychosocial environment in which the information is being disseminated as well as the trial is being conducted; and finally, the role of health literacy as it relates to a person's ability to understand the risks and benefits of clinical trial participation.…”

Section: Methodsmentioning

confidence: 99%

“…Other factors that may influence whether underrepresented populations agree to enroll in a trial include trust in the physician, quality of life, advanced disease, no-cost treatment, financial incentives, personal experience with cancer, and altruism. 6 This article addresses the barriers and promoters of underrepresented patient awareness, opportunity, and the decision to accept or refuse trial participation as they relate to healthcare providers (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, provider knowledge, attitudes, and beliefs about clinical trials and their patients' abilities to enroll in the trials may influence their disseminating information about the trials. 6 The third main component of the conceptual framework involves acceptance/refusal of trial participation among underrepresented populations. The decision to accept or refuse enrollment in a clinical trial is based on many factors, which often involves a decisional balance.…”

Section: Methodsmentioning

confidence: 99%

“…6 In brief, we identified potentially relevant articles through the following methods: 1) an electronic keyword search of multiple databases, including MEDLINE (Fig. 2).…”

Section: Search Strategymentioning

confidence: 99%

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Provider roles in the recruitment of underrepresented populations to cancer clinical trials

Howerton

Gibbons

Baffi

et al. 2007

Cancer

Self Cite

150

127

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BACKGROUND.Providers play a vital role in the successful recruitment of underrepresented patients to cancer clinical trials because they often introduce the opportunity of clinical trials. The purpose of the current systematic review was to describe provider‐related factors influencing recruitment of underrepresented populations to cancer clinical trials.METHODS.To find original studies on the recruitment of underrepresented populations to cancer clinical trials, electronic databases from January 1966 to December 2005 were searched; hand‐searched titles in 34 journals from January 2003 to January 2006; and reference lists were examined of eligible articles. Title and abstract reviews were conducted to identify relevant studies. Potential articles were then abstracted using a structured instrument and a serial review process by 2 investigators.RESULTS.Eighteen studies were eligible for review: 13 targeted healthcare providers, 3 targeted patients/participants, and 2 targeted both providers and patients. The study designs included randomized controlled trial, concurrent controlled trial, case‐control, descriptive, and qualitative. A lack of available protocols and/or a lack of provider awareness about clinical trials prevented providers from discussing the opportunity of clinical trials in 2 studies. In 14 studies, patient accrual was affected by provider attitudinal barriers relating to patient adherence to the study protocol, patient mistrust of research, patient costs, data collection costs, and/or patient eligibility. Providers' communication methods were barriers in 5 studies and promoters in 1 study.CONCLUSIONS.A heterogeneous body of evidence suggests that several provider‐related factors influence recruitment of underrepresented groups to clinical trials. Future recruitment efforts should address these factors. Cancer 2007;109:465–476. © 2007 American Cancer Society.

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