Use of Video Education Interventions to Increase Racial and Ethnic Diversity in Cancer Clinical Trials: A Systematic Review

Abstract

Background: Less than 5% of eligible adult cancer survivors participate in cancer clinical trials. Survivors identifying as Black, Indigenous, and people of color (BIPOC) are less likely to participate in clinical trials compared to those identifying as non-Hispanic White. Common barriers to BIPOC participation are lack of knowledge, lack of access, and mistrust. These barriers are all factors in the disparities observed in BIPOC cancer-related morbidity and mortality. Clinical trials need adequate BIPOC representation to garner generalizable findings that can reduce or eliminate cancer disparities associated with the social construct of race.Aim: This systematic review examined the use of video education interventions to impact BIPOC survivor participation in clinical trials.Methods: Web of Science, Embase, PubMed, Cochrane, PsycInfo, and CINAHL databases were queried for articles that described or tested video interventions aimed at increasing adult, BIPOC survivor clinical trial participation. Two authors independently screened articles for inclusion, appraised quality, and abstracted relevant data. All authors synthesized the data into themes through discussion and consensus. Results: The search yielded 2,512 articles. Seven selected articles described six distinct interventions. Although the six interventions reduced barriers to participation in clinical trials, their findings varied on Black and Hispanic survivors' readiness to enroll and participate in trials. Four themes emerged: (a) cultural sensitivity is needed in video development and delivery; (b) video content should be aimed to educate and change attitudes about clinical trials; (c) video interventions are feasible and acceptable; and (d) video interventions affect outcomes on intention or actual enrollment. Linking Evidence to Action: Video interventions are well-received by BIPOC survivors and may improve representation in clinical trials. Yet, video interventions are underutilized. More studies are needed to establish best practices for video interventions aimed at diversifying clinical trial participation as widening cancer disparities and rapidly changing cancer care continue to emerge.

Equitable Representation of Latinos in Clinical Research Is Needed to Achieve Health Equity in Cancer Care

“…51 Educational videos that include peer modeling and narrative messages from individuals who have participated in CTs and that are similar to the population groups they intend to reach can create a sense of commonality and trust in the message compared with strictly informational videos, providing another key strategy that can improve Latino participation in CTs. 17,51 An innovative but not-yet-fully-maximized method to improve recruitment in clinical research is the use of social media platforms to promote awareness of CTs, dispel misconceptions about clinical research, and enable researchers to engage community members and potential participants in unique ways. 62 Targeted messages on social media platforms can stimulate interest in specific CTs that connect patients, caregivers, and advocates with trial centers' websites.…”

“…Interventions providing decisional support, such as educational videos, and patient navigation (a recognized care coordination strategy) for patients addressing common barriers and facilitating the provision of coordinated patient-centered care, have been effective in improving positive attitudes toward CTs, accrual, and retention, 7,17,49-51 and may be feasible strategies to address low participation rates among Latinos and other under-represented groups.…”

“…19,61 Culturally tailored educational videos on CTs are not only well received by Latinos and other under-represented groups, but also can increase their knowledge and intent to participate in CTs. 51…”

“…2 In particular, culturally tailored CT communications and transparency can promote trust, 48 increase awareness, and improve attitudes, acceptance, and consideration of CTs as a treatment option for cancer, which in turn can enhance recruitment efforts among under-represented groups. 2 Interventions providing decisional support, such as educational videos, and patient navigation (a recognized care coordination strategy) for patients addressing common barriers and facilitating the provision of coordinated patientcentered care, have been effective in improving positive attitudes toward CTs, accrual, and retention, 7,17,[49][50][51] and may be feasible strategies to address low participation rates among Latinos and other under-represented groups.…”

“…19,61 Culturally tailored educational videos on CTs are not only well received by Latinos and other underrepresented groups, but also can increase their knowledge and intent to participate in CTs. 51 Educational videos that include peer modeling and narrative messages from individuals who have participated in CTs and that are similar to the population groups they intend to reach can create a sense of commonality and trust in the message compared with strictly informational videos, providing another key strategy that can improve Latino participation in CTs. 17,51 An innovative but not-yet-fully-maximized method to improve recruitment in clinical research is the use of social media platforms to promote awareness of CTs, dispel misconceptions about clinical research, and enable researchers to engage community members and potential participants in unique ways.…”