McCaskill-Stevens W, Pinto H, Marcus A C, Comis R, Morgan R, Plomer K, Schoentgen S
Division of Cancer Prevention, National Cancer Institute/National Institutes of Health, Rockville, MD 20852, USA.
J Clin Oncol. 1999 Mar;17(3):1029-39. doi: 10.1200/JCO.1999.17.3.1029.
Minority accrual onto clinical trials is of significant interest to cooperative oncology study groups. The Eastern Cooperative Oncology Group (ECOG) conducted a study to identify barriers and solutions to African American accrual onto clinical trials.
We hypothesize that the National Medical Association (NMA) might provide insight into ways to increase minority participation and that ECOG might facilitate that participation. Four sites were selected in which NMA chapters existed and ECOG main institutions with less than half of the corresponding percentage of minorities in their communities entered trials for 1992. Fifteen workshops were conducted using discussions and open-ended, self-administered questionnaires.
Seventy percent of NMA physicians cited mistrust of the research centers, fear of losing patients, and a lack of respect from ECOG institutions as the most important barriers to minority cancer patient referrals, compared with 30% for ECOG physicians. Sixty-nine percent of NMA and 43% of ECOG physicians cited a lack of information about specific trials. Nearly half of NMA physicians (47%) cited a lack of minority investigators as a barrier, compared with 4% of ECOG physicians. Solutions by both groups were improved communication (73%) and culturally relevant educational materials (40%). ECOG physicians cited more minority outreach staff as a potential solution (22% v 6%). NMA physicians cited increased involvement of referring physicians (44% v4%).
NMA physicians who serve a significant sector of the African American population demonstrated a willingness to participate and work with a cooperative group effort to increase participation of minority patients and investigators.
少数族裔参与临床试验是肿瘤协作研究组非常关注的问题。东部肿瘤协作组(ECOG)开展了一项研究,以确定非裔美国人参与临床试验的障碍及解决办法。
我们假设美国医学协会(NMA)可能会为增加少数族裔参与度提供思路,且ECOG可能会促进这种参与。选择了四个设有NMA分会且ECOG主要机构所在社区少数族裔比例低于相应比例一半的地点,这些机构在1992年进入试验的情况。通过讨论和开放式自填问卷进行了15次研讨会。
70%的NMA医生认为对研究中心的不信任、担心失去患者以及得不到ECOG机构的尊重是少数族裔癌症患者转诊的最重要障碍,而ECOG医生的这一比例为30%。69%的NMA医生和43%的ECOG医生提到缺乏关于具体试验的信息。近一半的NMA医生(47%)认为缺乏少数族裔研究人员是一个障碍,而ECOG医生的这一比例为4%。两组提出的解决办法都是改善沟通(73%)和提供与文化相关的教育材料(40%)。ECOG医生提到增加少数族裔外联工作人员是一个潜在解决办法(22%对6%)。NMA医生提到增加转诊医生的参与度(44%对4%)。
为大量非裔美国人服务的NMA医生表现出愿意参与并与协作组共同努力,以增加少数族裔患者和研究人员的参与度。