A Comparison Between Caucasians and African Americans in Willingness to Participate in Cancer Clinical Trials: The Roles of Knowledge, Distrust, Information Sources, and Religiosity (original) (raw)
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Exploring Willingness to Participate in Clinical Trials by Ethnicity
Journal of Racial and Ethnic Health Disparities, 2016
African-Americans and Hispanic-Americans are disproportionately affected by cancer, yet underrepresented in cancer clinical trials. Because of this, it is important to understand how attitudes and beliefs about clinical trials vary by ethnicity. A national, random sample of 860 adults was given an online survey about attitudes toward clinical trials. We examined willingness to participate in clinical trials, attitudes toward clinical trials, trust in doctors, attitudes toward alternative and complementary medicine, and preferred information channels. Results indicate that African-American and Hispanic-American participants have more negative attitudes about clinical trials, more distrust toward doctors, more interest in complementary and alternative medicine, and less willingness to participate in clinical trials than white/non-Hispanics, although specific factors affecting willingness to participate vary. The channels people turn to for information on clinical trials also varied by ethnicity. These results help explain the ethnic disparities in cancer clinical trial enrollment by highlighting some potential underlying causes and drawing attention to areas of importance to these groups.
Cancer Causes & Control, 2021
Aim: Culturally-appropriate, educational programs are recommended to improve cancer clinical trial participation among African Americans and Latinos. This study investigated the effect of a culturally-appropriate, educational program on knowledge, trust in medical researchers, and intent for clinical trial participation among African Americans and Latinos in Middle Tennessee. Method: Trained community health educators delivered a 30-minute presentation with video testimonials to 198 participants in 13 town halls. A pre-post survey design was used to evaluate the intervention among 102 participants who completed both pre-and post-surveys one to two weeks after the session. Results: Paired-sample t-test showed signi cant increases in unadjusted mean scores for knowledge (p < .001), trust in medical researchers (p < .001), and willingness to participate in clinical trials (p = .003) after the town halls in the overall sample. After adjusting for gender and education, all three outcomes remained signi cant for the overall sample
Journal of racial and ethnic health disparities, 2016
Despite years of research aimed at decreasing the cancer mortality rates, the disparity between African-Americans and whites continues to grow. The fundamental psychosocial and belief differences that may mediate these disparities are poorly studied and rarely disentangle race versus specific socioeconomic status (SES) effects. In this study, breast, colon, and lung cancer patients presenting for their first oncology appointment completed a self-administered survey utilizing previously validated instruments regarding psychosocial and belief factors. Results were analyzed by selfidentified race, income, and education. In total, 161 African-American (37 %) and 269 white (63 %) new oncology patients with breast (47 %), colon (16 %), or lung (37 %) cancer enrolled. African-Americans were more likely to be in the US$<20,000 income group (45 vs. 9 %) but 21 % had incomes US$>60,000. Apparent racial differences in health literacy and cancer knowledge were primarily mediated by income and education. Significant racial differences in God's perceived role in their cancer remained after adjustments for income and education with African-Americans more likely to feel that God was in control of their cancer (67 vs. 30 %). These findings suggest the need for a more nuanced understanding of how race and socioeconomic status exert both independent and interrelated effects in the health care setting. Only then can effective interventions that reduce disparities in survival be designed. This study adds further substantive evidence to the crucial importance of God's perceived role in the cancer experience for African-Americans. An important area for future research is to examine whether these racial differences in religious belief are also associated with differences in health-related behavior and medical decision-making.
Is Religiosity Associated with Cancer Screening? Results from a National Survey
Journal of Religion and Health, 2014
This study examined the following: (1) relationships between religiosity-as measured by religious service attendance-and screening for breast, cervical, and colorectal cancers; (2) the potential mediating role of social support; and (3) the potential moderating effect of race/ethnicity. Statistical analyses showed that religiosity was associated with greater utilization of breast, cervical, and colorectal cancer screening. Social support fully mediated the relationship between religiosity and Pap screening, and partially mediated the relationship between religiosity and colorectal screening, but had no effect on the relationship between religiosity and mammography screening. Race/ethnicity moderated the relationship between religiosity and social support in the cervical cancer screening model, such that the positive association between religiosity and social support was stronger for non-Hispanic Blacks than it was for non-Hispanic Whites. These findings have implications for the role of social networks in health promotion and can inform cancer screening interventions in faith-based settings.
African American women's perceptions of cancer clinical trials
Cancer Medicine, 2014
Cancer clinical trials are important for resolving cancer health disparities for several reasons; however, clinical trial participation among African Americans is significantly lower than Caucasians. This study engaged focus groups of 82 female African American cancer survivors or cancer caregivers, including those in better resourced, more urban areas and less resourced, more rural areas. Informed by an integrated conceptual model, the focus groups examined perceptions of cancer clinical trials and identified leverage points that future interventions may use to improve enrollment rates. Study findings highlight variation in community knowledge regarding cancer clinical trials, and the importance of community education regarding clinical trials and overcoming historical stigma associated with clinical research specifically and the health care system more generally. Study participants commented on the centrality of churches in their communities, and thus the promise of the church as loci of such education. Findings also suggested the value of informed community leaders as community information sources, including community members who have a previous diagnosis of cancer and clinical trial experience. The sample size and location of the focus groups may limit the generalizability of the results. Since the women in the focus groups were either cancer survivors or caregivers, they may have different experiences than nonparticipants who lack the close connection with cancer. Trust in the health system and in one's physician was seen as important factors associated with patient willingness to enroll in clinical trials, and participants suggested that physicians who were compassionate and who engaged and educated their patients would build important trust requisite for patient participation in clinical trials.
Annals of Epidemiology, 2002
PURPOSE: The relative absence of racial/ethnic minorities among medical research subjects is receiving considerable attention because of recent government mandates for their inclusion in all human subject research. We examined racial differences in the prevalence of sociocultural barriers as a possible explanation for the underrepresentation of African Americans in medical research studies. METHODS: During 1998-1999, a total of 198 residents of the Detroit Primary Metropolitan Statistical Area (PMSA) participated in a survey that examined impediments to participation in medical research studies. Chi square tests and logistic regression analyses were used to examine the association between race, issues related to trust of medical researchers, and the willingness to participate in medical research studies. RESULTS: Study results indicate that African Americans and whites differ in their willingness to participate in medical research. Racial differences in the willingness to participate in a medical research are primarily due to the lower level of trust of medical research among African Americans. African American respondents were also somewhat less willing to participate if they attribute high importance to the race of the doctor when seeking routine medical care, believed that minorities bear most of the risks of medical research, and if their knowledge of the Tuskegee Study resulted in less trust in medical researchers. CONCLUSION: These data reiterate the need for medical researchers to build trusting relationships with minority communities. Researchers can begin by acknowledging the previous medical abuse of minority research participants, discussing their specific plans to assure the protection of study participants, and explaining the need for the participation of racial/ethnic minorities including studies that specifically target or that are likely to result in disproportionate representation of racial/ethnic minorities among study participants.
Religiosity and cancer screening
Journal of Religion and …, 1999
Churches have been suggested as avenues to reach African-American populations with messages about health because of their strong participation in church activities. Membership in several religious denominations has been associated with healthy lifestyle practices that are associated with lower cancer-incidence rates and better coping strategies among cancer patients. Among African-American women, however, belief in God as their doctor might preempt seeking treatment for cancer. The goal of the present study was to examine the influence of church participation and religious beliefs on the utilization of breast and cervical cancer screening among low-income, predominantly African-American women. A cohort consisting of 290 women was surveyed at baseline and one year later to determine the association between screening rates in the past year and measures of religiosity. The majority of women were members of a church (88%), with fairly regular church attendance (51% reported weekly attendance), and strong beliefs regarding God's influence on their health (e.g. 88% agreed that God was their doctor). Church attendance was the only religious variable related to screening frequency in univariate analyses, with those reporting attending church 1-3 times per month more likely to receive mammography screening (p = .013). Churches can provide avenues to reach African-American women about cancer screening; strong religious beliefs do not, however, appear to keep women from receiving regular screening exams.
Beliefs and Preferences for Medical Research Among African-Americans
Journal of Racial and Ethnic Health Disparities, 2015
Background and Objectives-Numerous factors contribute to underrepresentation of African-Americans in medical research, including beliefs, historical events, structural, and health access obstacles. This study examined beliefs about medical research and the types of study methods preferred among potential African-American research participants. Methods-A sample of 304 African-American participants from the Washington, DC Metropolitan area, completed a survey evaluating beliefs about medical research and preferred research study methods. Multiple Regression analyses were performed to examine how age, gender, and education may influence these beliefs and preferences for research study methods. Results-The beliefs and preferences surveyed did not differ by age, gender, or educational attainment. There was an overwhelmingly favorable belief (90 %) that medical research was necessary and assists in finding a cure for a disease. Most respondents preferred participating in research related to issues with which they were familiar (e.g., diabetes, hypertension) or working with researchers of a similar ethnic background to themselves. Interestingly, though nonsignificant, those with higher levels of educational trended toward the belief that participation in research was risky. Conclusion-The findings of this study indicate that certain beliefs about medical research participation and preferred study methodologies reported by African-Americans did not differ by age, gender, or level of education. This information about African-American's beliefs and preferences regarding medical research should lead to an awareness of potential gains in African-Correspondence to: Gloria E. Cain. Informed Consent All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study. The study protocol was approved by the Howard University Institutional Review Board (IRB).