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影响美国临床试验中西班牙裔/拉丁裔美国老年人招募的因素:范围综述。

Factors affecting the recruitment of Hispanic/Latinx American older adults in clinical trials in the United States: A scoping review.

机构信息

Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA.

Veterans Affairs Palo Alto Health Care Center, Palo Alto, California, USA.

出版信息

J Am Geriatr Soc. 2023 Jun;71(6):1974-1991. doi: 10.1111/jgs.18264. Epub 2023 Apr 3.

Abstract

OBJECTIVE

Participation of Hispanic/Latinx American older adults (HLAOA) in clinical trials is fundamental to health equity in aging research. However, information on strategies for the successful recruitment of this population in clinical trials is limited.

DESIGN

This scoping review aims to identify hindering and facilitating factors that impact the recruitment of HLAOA in clinical trials in the United States.

METHODS

Two databases (PubMed, EMBASE) were searched for original research articles from inception until March 2022 reporting on factors that engaged HLAoa (≥65) in clinical trials. One thousand and thirteen studies were scrutinized to identify 31 eligible articles.

RESULTS

Most articles were from cancer clinical trials (14 studies). Hindering factors that impacted the recruitment of HLAoa in clinical trials were related to (i) study design and logistics challenges, (ii) challenges imposed by social determinants of health, (iii) communication barriers, and (iv) patients' mistrust, and (v) family issues. Facilitating factors include (i) effective modes of outreach, (ii) strategic clinical trial design, (iii) incorporating culturally-respectful approaches that are tailored to the participants' sociocultural background, and (iv) bridging language barriers.

CONCLUSIONS

Successful recruitment of HLAOA into clinical trials requires identifying the study question, co-designing the trial design, implementation, and evaluation in respectful collaboration with the Hispanic/Latinx community with careful attention to their needs and minimizing the study burden on this vulnerable population. Factors identified here may guide researchers to better understand the needs of HLAOA and successfully recruit them into clinical trials, leading to more equitable research that increases their representation in clinical research.

摘要

目的

西班牙裔/拉丁裔美国老年人(HLAOA)参与临床试验对于老龄化研究中的健康公平至关重要。然而,关于成功招募这一人群参与临床试验的策略的信息有限。

设计

本范围综述旨在确定影响美国 HLAOA 参与临床试验招募的阻碍和促进因素。

方法

从建库到 2022 年 3 月,我们在两个数据库(PubMed、EMBASE)中搜索了报告影响 HLAoa(≥65 岁)参与临床试验的因素的原始研究文章。共筛选了 1113 篇文章,确定了 31 篇合格文章。

结果

大多数文章来自癌症临床试验(14 项研究)。影响 HLAoa 参与临床试验招募的阻碍因素与以下方面有关:(i)研究设计和后勤挑战,(ii)健康社会决定因素带来的挑战,(iii)沟通障碍,以及(iv)患者的不信任和(v)家庭问题。促进因素包括:(i)有效的外联方式,(ii)战略性临床试验设计,(iii)纳入尊重参与者社会文化背景的文化适宜方法,以及(iv)弥合语言障碍。

结论

成功招募 HLAOA 参与临床试验需要确定研究问题,与西班牙裔/拉丁裔社区进行合作,共同设计试验设计、实施和评估,关注他们的需求,尽量减少研究对这一脆弱人群的负担。这里确定的因素可能指导研究人员更好地了解 HLAOA 的需求,并成功招募他们参与临床试验,从而进行更加公平的研究,增加他们在临床研究中的代表性。

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