Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Clin Trials. 2023 Dec;20(6):708-713. doi: 10.1177/17407745231178790. Epub 2023 Jun 22.
Clinical trials remain a critical component of medical innovation. Evidence suggests that individuals' political ideologies may impact their health behaviors. However, there is a paucity of literature examining the relationship between political ideologies and clinical trial knowledge and participation.
Study data were derived from Health Information National Trends Survey 5 Cycle 4 (n = 3300), which was conducted from February to June 2020. We used participants' characteristics to estimate the prevalence of clinical trial knowledge and participation. We used multivariable logistic regressions to investigate whether political ideology had a significant impact on clinical trial knowledge and participation. Jack-knife replicate weights were applied for population-level estimates.
Most participants were White (64.2%), earned above US$50,000 (62.4%), and lived in urban areas (88.0%). About 59.2% reported having some knowledge of clinical trials, and only 8.9% had ever been invited to participate in clinical trials. A total of 37.0%, 29.5%, and 33.5% of the population endorsed moderate, liberal, and conservative political viewpoints respectively. In the adjusted logistic regression analysis, compared to conservatives, liberals (adjusted odds ratio, 1.92; 95% confidence interval, 1.31-2.80) and moderates (adjusted odds ratio, 1.43; 95% confidence interval, 1.09-1.88) had significantly greater odds of having knowledge of clinical trials. Also, liberals had higher odds of receiving invitations to participate in clinical trials (odds ratio, 1.76; 95% confidence interval, 1.08-2.85; p = 0.023) and greater odds of trial participation (odds ratio, 3.90; 95% confidence interval, 1.47-10.33; p = 0.007) compared to moderates.
The mechanism underlying the higher rates of clinical trial invitations to liberals is unclear and requires further comprehensive investigation. Similarly, further qualitative studies are needed to understand the attributes that promote knowledge and increased likelihood of clinical trial participation among liberals. This will provide crucial insight to help design interventions that further involve conservatives and moderates in clinical trials and scientific enterprise.
临床试验仍然是医学创新的重要组成部分。有证据表明，个人的政治意识形态可能会影响他们的健康行为。然而，目前关于政治意识形态与临床试验知识和参与之间关系的文献很少。
研究数据来自 2020 年 2 月至 6 月进行的健康信息国家趋势调查 5 周期 4（n=3300）。我们使用参与者的特征来估计临床试验知识和参与的流行率。我们使用多变量逻辑回归来研究政治意识形态是否对临床试验知识和参与有显著影响。为了进行人口水平的估计，使用了刀叉重复权重。
大多数参与者是白人（64.2%），收入超过 5 万美元（62.4%），居住在城市地区（88.0%）。约 59.2%的人表示对临床试验有一定的了解，只有 8.9%的人曾被邀请参加临床试验。分别有 37.0%、29.5%和 33.5%的人持温和、自由和保守的政治观点。在调整后的逻辑回归分析中，与保守派相比，自由派（调整后的优势比，1.92；95%置信区间，1.31-2.80）和温和派（调整后的优势比，1.43；95%置信区间，1.09-1.88）更有可能了解临床试验。此外，自由派收到参加临床试验邀请的可能性更高（优势比，1.76；95%置信区间，1.08-2.85；p=0.023），参与试验的可能性也更高（优势比，3.90；95%置信区间，1.47-10.33；p=0.007），而温和派则不然。
自由派收到更多临床试验邀请的机制尚不清楚，需要进一步全面调查。同样，需要进一步进行定性研究，以了解促进自由派了解临床试验和增加参与可能性的属性。这将为帮助设计干预措施提供重要的见解，进一步使保守派和温和派参与临床试验和科学事业。
