Tarn Derjung M, Liu Ruey-Ying, Pun Ting, Schwartz Janice B
Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Sociology, National Chengchi University, Taipei, Taiwan.
J Gen Intern Med. 2025 Feb;40(2):393-401. doi: 10.1007/s11606-024-09162-2. Epub 2024 Nov 4.
Older adults with multimorbidity are underrepresented in clinical trials, with enrollment of Asians particularly low.
Understand perspectives of US Chinese older adults regarding clinical trial participation.
Focus group interviews analyzed using thematic analysis.
Community/senior centers, academic health systems in Northern and Southern California, and a nationwide registry of Asian Americans/Pacific Islanders.
Mandarin- and English-speaking Chinese adults aged ≥ 65 years with multimorbidity.
Themes related to barriers and facilitators of enrollment in clinical trials of medications.
We conducted 12 focus groups: 7 with non-US-born and 5 with US-born Chinese older adults (n = 83 total). Mean age was 74 years (SD = 5.9), 43 (51.8%) were female, and 47 (56.6%) Mandarin-speaking. US-born participants had greater educational attainment than non-US-born participants. Participants took a mean of 6.1 prescriptions (SD = 1.5). Barriers to participation in clinical trials of medications included lack of awareness of/exposure for patients and community-based Chinese physicians, preference for natural/traditional medicine, risk aversion and safety concerns, desire for privacy, and inconvenience. Trusted influences included physicians, hospitals/health systems, Asian/Chinese community centers, and family (for non-US-born participants). Suggestions to enhance participation included using language and culturally concordant materials/personnel, educating community-based Chinese physicians about clinical trials, involving patient-trusted physicians in recruitment, promoting trials on conditions common in Chinese people or for an existing condition, and financial incentives. US-born participants expressed greater understanding and willingness to join trials. All groups attributed low clinical trial enrollment to non-US-born Chinese adults.
Chinese older adults perceived obstacles to clinical trial participation that could be mitigated by involving trusted physicians in recruitment, using language and culturally concordant materials/staff, and educating patients and community-based physicians. Recognition of differences in attitudes among US- and non-US-born Chinese people may be important to tailoring recruitment strategies.
患有多种疾病的老年人在临床试验中的代表性不足，亚洲人的入组率尤其低。
了解美国华裔老年人对参与临床试验的看法。
采用主题分析法对焦点小组访谈进行分析。
社区/老年中心、加利福尼亚州北部和南部的学术医疗系统，以及全美亚太裔美国人登记处。
年龄≥65岁、患有多种疾病、说普通话和英语的华裔成年人。
与药物临床试验入组的障碍和促进因素相关的主题。
我们开展了12个焦点小组：7个针对非美国出生的华裔老年人，5个针对美国出生的华裔老年人（共83人）。平均年龄为74岁（标准差=5.9），43人（51.8%）为女性，47人（56.6%）说普通话。美国出生的参与者的教育程度高于非美国出生的参与者。参与者平均服用6.1种药物（标准差=1.5）。参与药物临床试验的障碍包括患者和社区华裔医生缺乏认识/接触机会、偏爱天然/传统药物、风险规避和安全担忧、对隐私的渴望以及不便。可信赖的影响因素包括医生、医院/医疗系统、亚裔/华裔社区中心和家人（针对非美国出生的参与者）。提高参与率的建议包括使用语言和文化协调的材料/人员、对社区华裔医生进行临床试验教育、让患者信任的医生参与招募、推广针对中国人常见疾病或现有疾病的试验以及提供经济激励。美国出生的参与者表示对参与试验有更高的理解和意愿。所有小组都将临床试验入组率低归因于非美国出生的华裔成年人。
华裔老年人认为参与临床试验存在障碍，通过让可信赖的医生参与招募、使用语言和文化协调的材料/工作人员以及对患者和社区医生进行教育，可以缓解这些障碍。认识到美国出生和非美国出生的华裔在态度上的差异对于制定招募策略可能很重要。
