Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States.
Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, United States.
JMIR Cancer. 2024 Sep 30;10:e56048. doi: 10.2196/56048.
Black/African American adults are underrepresented in oncology clinical trials in the United States, despite efforts at narrowing this disparity.
This study aims to explore differences in how Black/African American oncology patients perceive clinical trials to improve support for the clinical trial participation decision-making process.
As part of a larger randomized controlled trial, a total of 244 adult oncology patients receiving active treatment or follow-up care completed a cross-sectional baseline survey on sociodemographic characteristics, clinical trial knowledge, health literacy, perceptions of cancer clinical trials, patient activation, patient advocacy, health care self-efficacy, decisional conflict, and clinical trial intentions. Self-reported race was dichotomized into Black/African American and non-Black/African American. As appropriate, 2-tailed t tests and chi-square tests of independence were used to examine differences between groups.
Black/African American participants had lower clinical trial knowledge (P=.006), lower health literacy (P<.001), and more medical mistrust (all P values <.05) than non-Black/African American participants. While intentions to participate in a clinical trial, if offered, did not vary between Black/African American and non-Black/African American participants, Black/African American participants indicated lower awareness of clinical trials, fewer benefits of clinical trials, and more uncertainty around clinical trial decision-making (all P values <.05). There were no differences for other variables.
Despite no significant differences in intent to participate in a clinical trial if offered and high overall trust in individual health care providers among both groups, beliefs persist about barriers to and benefits of clinical trial participation among Black/African American patients. Findings highlight specific ways that education and resources about clinical trials could be tailored to better suit the informational and decision-making needs and preferences of Black/African American oncology patients.
尽管美国在努力缩小这一差距，但黑人和非裔美国人在肿瘤学临床试验中的代表性仍然不足。
本研究旨在探讨黑人和非裔美国肿瘤患者对临床试验的看法差异，以改善对临床试验参与决策过程的支持。
作为一项更大的随机对照试验的一部分，共有 244 名接受积极治疗或随访护理的成年肿瘤患者完成了一项关于社会人口特征、临床试验知识、健康素养、对癌症临床试验的看法、患者激活、患者倡导、医疗保健自我效能、决策冲突和临床试验意向的横断面基线调查。自我报告的种族分为黑人/非裔美国人和非黑人/非裔美国人。适当的情况下，使用双侧 t 检验和独立卡方检验来比较组间差异。
与非黑人/非裔美国人参与者相比，黑人/非裔美国参与者的临床试验知识较低（P=.006），健康素养较低（P<.001），医疗不信任度较高（所有 P 值均<.05）。虽然如果提供的话，参加临床试验的意向在黑人/非裔美国人和非黑人/非裔美国参与者之间没有差异，但黑人/非裔美国参与者表示对临床试验的认识较低，对临床试验的益处较少，对临床试验决策的不确定性较大（所有 P 值均<.05）。其他变量没有差异。
尽管在如果提供的话参加临床试验的意向和对个体医疗保健提供者的总体信任方面，黑人/非裔美国人和非黑人/非裔美国参与者之间没有显著差异，但黑人/非裔美国患者中仍然存在对临床试验参与的障碍和益处的信念。研究结果突出了针对黑人和非裔美国肿瘤患者的信息和决策需求和偏好，量身定制临床试验相关教育和资源的具体方法。
