Swaby Jordan, Kaninjing Ernie, Ogunsanya Motolani
Department of Health Sciences, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL 32816, USA.
Department of Health Sciences, School of Health & Human Performance, Georgia College and State University, 231 W Hancock St, Milledgeville, GA 31061, USA.
Ecancermedicalscience. 2021 Oct 25;15:1307. doi: 10.3332/ecancer.2021.1307. eCollection 2021.
According to the Food and Drug Administration, African Americans (AAs) have been habitually underrepresented in cancer clinical trials (CCTs). This under-enrolment has contributed to cancer disparities despite the implementation of policies to improve AA accrual. This systematic review aimed to determine (1) Why AAs are participating in CCT at lower rates compared to other ethnic/racial groups and (2) Are there any tools that have definitively improved AA participation or addressed the barriers associated with their lack of participation.
Searches were carried out in PubMed, Project MUSE and EBSCO which were confined to four databases (BASE, PsycINFO, CINAHL and MEDLINE). Literature published between 2010 and 2020 were filtered with the inclusion and exclusion criteria and then a mixed methods appraisal tool was used to check the quality of the articles. Studies were separated into two categories to extract and synthesise data based on the emerging themes.
Frequent reasons for a lack of participation involved provider related issues, family concerns, health literacy and trust among others. Interventions cited as successful in improving AA participation or addressing a barrier often revolved around community-based participatory research and educational CCT videos/tools.
RECOMMENDATIONS/CONCLUSION: Educating AA patients about the biomedical research process, addressing concerns about CCTs, building trust with community members and improving communication with healthcare providers could improve AA participation in CCTs. Future interventions should consider the effect of diversified healthcare teams in addressing trust deficit in CCTs among AAs. Healthcare practitioners seeking to consent AA into CCTs and biomedical research could consider incorporating cultural competence into their practice for effective interaction with this population and to address their questions about biomedical research.
根据美国食品药品监督管理局的数据，非裔美国人（AAs）在癌症临床试验（CCTs）中的代表性一直不足。尽管实施了提高非裔美国人参与率的政策，但这种参与率低的情况仍导致了癌症差异。本系统评价旨在确定：（1）与其他种族/族裔群体相比，为什么非裔美国人参与癌症临床试验的比例较低；（2）是否有任何工具确实提高了非裔美国人的参与率或解决了与他们参与率低相关的障碍。
在PubMed、Project MUSE和EBSCO中进行检索，检索范围限于四个数据库（BASE、PsycINFO、CINAHL和MEDLINE）。对2010年至2020年发表的文献按照纳入和排除标准进行筛选，然后使用混合方法评估工具检查文章质量。根据新出现的主题，将研究分为两类以提取和综合数据。
参与率低的常见原因包括与医疗服务提供者相关的问题、家庭担忧、健康素养和信任等。被认为成功提高非裔美国人参与率或解决障碍的干预措施通常围绕基于社区的参与性研究和教育性癌症临床试验视频/工具。
建议/结论：对非裔美国患者进行生物医学研究过程的教育，解决对癌症临床试验的担忧，与社区成员建立信任并改善与医疗服务提供者的沟通，可以提高非裔美国人参与癌症临床试验的比例。未来的干预措施应考虑多元化医疗团队在解决非裔美国人对癌症临床试验信任不足方面的作用。寻求让非裔美国人参与癌症临床试验和生物医学研究的医疗从业者可以考虑将文化能力纳入其实践中，以便与该人群进行有效的互动并回答他们关于生物医学研究的问题。
