Dana- Farber Cancer Institute, 450 Brookline Avenue, SW-411C, Boston, MA 02215, USA.
University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125, USA.
Contemp Clin Trials. 2023 May;128:107161. doi: 10.1016/j.cct.2023.107161. Epub 2023 Mar 17.
Clinical trials (CTs) test new medical products for safety and effectiveness. Despite federal policy aimed at generating greater inclusivity of people of color (POC) in CTs, disparity in (CT) enrollment persists. Non-Hispanic White patients comprise the majority of CT participants while Black and Hispanic patient participation has declined over the past decade. The scope of Clinical Research Nurses (CRNs) includes recruitment of participants for CTs. The aim of this phenomenological study was to describe adult oncology CRNs' lived experiences of recruiting POC cancer patients to participate in CTs. The first paper for this study identified three major themes regarding how CRNs view their role in caring for POC considering or enrolling onto cancer clinical trials (CCTs): CRNs act as advocates, care coordinators and educators. This paper focuses on two additional major themes regarding how CRNs view the unique needs of POC in clinical research: establishing and maintaining trusting relationships and recruitment infrastructure.
Nineteen nurses participated in semi-structured one-to-one interviews and data analysis was based on Colaizzi's method.
CRNs described a history of past research injustices, disparate access to care, inadequate cultural training, a physician-driven recruitment structure and provider-based implicit biases that hinder POC enrollment in CTs.
Diversity in CCT enrollment requires CRNs to establish trust with POC, advocate for POC when implicit biases are observed and become competent practitioners of culturally sensitive care. Further, meaningful policy change at both federal and organizational levels must occur to ensure equitable access to novel cancer therapies.
临床试验（CTs）旨在测试新的医疗产品的安全性和有效性。尽管联邦政策旨在提高临床试验中有色人种（POC）的包容性，但参与临床试验的差异仍然存在。非西班牙裔白人患者构成了临床试验参与者的大多数，而黑人患者和西班牙裔患者的参与率在过去十年中有所下降。临床研究护士（CRNs）的工作范围包括招募临床试验的参与者。这项现象学研究的目的是描述成人肿瘤学 CRNs 招募 POC 癌症患者参与 CT 的经验。本研究的第一篇论文确定了 CRNs 考虑或参与癌症临床试验（CCTs）时如何看待他们在照顾 POC 方面的角色的三个主要主题：CRNs 充当倡导者、护理协调员和教育者。本文重点关注 CRNs 如何看待临床研究中 POC 的独特需求的另外两个主要主题：建立和维持信任关系和招聘基础设施。
19 名护士参加了半结构化的一对一访谈，数据分析基于科拉齐的方法。
CRNs 描述了过去研究不公正、获得护理机会不均等、文化培训不足、医生主导的招聘结构以及提供者的隐性偏见，这些都阻碍了 POC 参与 CTs。
CCT 参与的多样性要求 CRNs 与 POC 建立信任，在观察到隐性偏见时为 POC 辩护，并成为文化敏感性护理的胜任实践者。此外，联邦和组织层面必须进行有意义的政策变革，以确保公平获得新的癌症疗法。
