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关于参与波多黎各乳腺癌临床试验的知识、动机与担忧

Knowledge, Motivations and Concerns about Participation in Breast Cancer Clinical Trials in Puerto Rico.

作者信息

Rivera-Díaz Marinilda, García-Romero Angélica N, Ayala-Marín Alelí M, Vélez-Alamo Camille, Acevedo-Fontánez Adrianna I, Arévalo Mariana, Colón-López Vivian

机构信息

University of Puerto Rico, Rio Piedras Campus.

Alapás Organization.

出版信息

J Health Dispar Res Pract. 2020 Spring;13(1):50-66.

Abstract

BACKGROUND

Clinical trials (CT) in breast cancer have been crucial for new treatment discoveries. While participation in cancer CT is low, minorities are particularly underrepresented. This study aimed to identify factors influencing the participation in CTs based on the experiences of Latina breast cancer survivors in Puerto Rico (PR), especially their CT knowledge, motivations, and concerns.

METHOD

Focus groups (FG) were conducted by two social workers and the University of Puerto Rico/MD Anderson Community Health Educator. Participants were stratified into two subgroups: a) women with CT experience and b) those without CT experience. Seven FG were completed among breast cancer survivors (n=34) at two hospitals located in Caguas and San Juan, PR.

RESULTS

Our findings showed that participants expressed a basic knowledge and understanding of clinical trials. Motivations to participate included a desire to help others, non-monetary incentives to participation, self-benefits, readiness to participate based on the phases of illness, and enhanced relationships with the clinical trial recruitment team. Regardless of their previous experience with CTs, participants expressed concerns about participation including limited of knowledge about trial procedures and results, and lack of transportation, childcare, and support from family.

RECOMMENDATIONS

The barriers and motivations identified for CT participation are modifiable and best targeted using a multidisciplinary approach. Social workers could play a potential role in participant recruitment and retention by clarifying research protocols to potential participants, as well as conducting CT. Our findings can help enhance capacity and training efforts for health professionals involved in CT recruitment and retention in culturally-relevant ways.

摘要

背景

乳腺癌临床试验对于新治疗方法的发现至关重要。尽管参与癌症临床试验的比例较低,但少数族裔的代表性尤其不足。本研究旨在根据波多黎各(PR)拉丁裔乳腺癌幸存者的经历,确定影响参与临床试验的因素,特别是他们对临床试验的了解、动机和担忧。

方法

由两名社会工作者和波多黎各大学/MD安德森社区健康教育工作者进行焦点小组(FG)访谈。参与者被分为两个亚组:a)有临床试验经验的女性和b)没有临床试验经验的女性。在PR卡瓜斯和圣胡安的两家医院,对34名乳腺癌幸存者完成了7次焦点小组访谈。

结果

我们的研究结果表明,参与者表达了对临床试验的基本知识和理解。参与的动机包括帮助他人的愿望、参与的非货币激励、自身利益、根据疾病阶段准备参与以及与临床试验招募团队加强关系。无论之前是否有过临床试验经验,参与者都表达了对参与的担忧,包括对试验程序和结果的了解有限,以及缺乏交通、儿童保育和家人的支持。

建议

确定的参与临床试验的障碍和动机是可以改变的,最好采用多学科方法针对性解决。社会工作者可以通过向潜在参与者阐明研究方案以及开展临床试验,在参与者招募和保留方面发挥潜在作用。我们的研究结果有助于以与文化相关的方式,提高参与临床试验招募和保留工作的卫生专业人员的能力和培训力度。

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