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Hu WT, Bergren SM, Dychtwald DK, Ma Y, Dong X. Variations in racial and ethnic groups' trust in researchers associated with willingness to participate in research. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2023; 10:466. [PMID: 38650745 PMCID: PMC11034911 DOI: 10.1057/s41599-023-01960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 07/24/2023] [Indexed: 04/25/2024]
Abstract
Low enrollment in U.S. biomedical research by non-White adults has historically been attributed to mistrust, but few studies have simultaneously examined dimensions of trust in three or more racial/ethnic groups. Leveraging the racial/ethnic diversity of New Jersey, we prospectively recruited 293 adults (72% women, 38% older than 54 years of age) between October 2020 and February 2022 to complete two anonymous surveys in English or one of the common languages (e.g., Spanish, Mandarin Chinese). The first consisted of 12 Likert Scale questions related to trust in biomedical researchers (according to safety, equity, transparency), and the second assessed willingness to consider participation in eight common research activities (health-related survey, blood collection, genetic analysis, medication study, etc). Participants self-reported as Hispanic (n=102), Black (n=49), Chinese (n=48), other Asian (n=53), or White (n=41) race/ethnicity. Factor analysis showed three aspects related to trust in researchers: researchers as fiduciaries for research participants, racial/ethnic equity in research, and transparency. Importantly, we observed differences in the relationship between mistrust and willingness to participate. Whereas Chinese respondents' low trust in researchers mediated their low interest in research involving more than health-related surveys, Hispanic respondents' low trust in research equity did not deter high willingness to participate in research involving blood and genetic analysis. We caution that a generic association between trust and research participation should not be broadly assumed, and biomedical researchers should prospectively assess this relationship within each minoritized group to avoid hasty generalization.
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Affiliation(s)
- William T Hu
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | | | - Dana K Dychtwald
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | - Yiming Ma
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | - XinQi Dong
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
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2
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Tielemans LML, van Heugten KD, Hamaker ME, van Walree IC. Preferred and actual involvement of caregivers in oncologic treatment decision-making: A systematic review. J Geriatr Oncol 2023; 14:101525. [PMID: 37198027 DOI: 10.1016/j.jgo.2023.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/04/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Treatment decision-making in cancer is complex and many patients bring their caregiver to appointments to help them make those decisions. Multiple studies show the importance of involving caregivers in the treatment decision-making process. We aimed to explore the preferred and actual involvement of caregivers in the decision-making process of patients with cancer and to see if there are age or cultural background related differences in caregiver involvement. MATERIALS AND METHODS A systematic review of Pubmed and Embase was performed on January 2, 2022. Studies containing numerical data regarding caregiver involvement were included, as were studies describing the agreement between patients and caregivers regarding treatment decisions. Studies assessing solely patients aged younger than 18 years old or terminally ill patients, and studies without extractable data were excluded. Risk of bias was assessed by two independent reviewers using an adapted version of the Newcastle-Ottawa scale. Results were analysed in two separate age groups, one <62 years and one ≥62 years. RESULTS Twenty-two studies with a total of 11,986 patients and 6,260 caregivers were included in this review. A median of 75% of patients preferred caregivers to be involved in decision-making and a median of 85% of caregivers preferred to be involved. With regards to age groups, the preferred involvement of caregivers was more frequent in the younger study populations. With regards to geographical differences, studies performed in Western countries showed a lower preference for caregiver's involvement compared to studies from Asian countries. A median of 72% of the patients reported the caregiver was actually involved in the treatment decision-making and a median of 78% of the caregivers reported they were actually involved. The most important role of caregivers was to listen and provide emotional support. DISCUSSION Patients and caregivers both want caregivers to be involved in the treatment decision-making process and most caregivers are actually involved. An ongoing dialogue between clinicians, patients and caregivers about decision-making is important to meet the individual patient's and caregiver's needs when involved in the decision-making process. Important limitations were a lack of studies in older patients and significant differences in outcome measures among studies.
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Affiliation(s)
- Laura M L Tielemans
- Department of Geriatric Medicine, Elisabeth-Twee Steden Ziekenhuis, Tilburg, the Netherlands.
| | - Kirsten D van Heugten
- Department of Geriatric Medicine, Elisabeth-Twee Steden Ziekenhuis, Tilburg, the Netherlands
| | - Marije E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - Inez C van Walree
- Department of Geriatric Medicine, University Medical Centrum Utrecht, Utrecht, the Netherlands
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3
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Rodriguez DK, Hewage SA, Periyakoil VS. Factors affecting the recruitment of Hispanic/Latinx American older adults in clinical trials in the United States: A scoping review. J Am Geriatr Soc 2023; 71:1974-1991. [PMID: 37013348 PMCID: PMC10258132 DOI: 10.1111/jgs.18264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/21/2022] [Accepted: 01/02/2023] [Indexed: 04/05/2023]
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.
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Affiliation(s)
- Dulce K Rodriguez
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
| | - Sumali A Hewage
- Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Research Center, Stanford University, School of Medicine, Palo Alto, California, USA
| | - Vyjeyanthi S Periyakoil
- 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
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Murong M, Giannopoulos E, Pirrie L, Giuliani ME, Fazelzad R, Bender J, Jones J, Papadakos J. The Experience of Informal Newcomer Cancer Caregivers with Limited Language Proficiency: A Scoping Review. J Immigr Minor Health 2023; 25:436-448. [PMID: 36538206 DOI: 10.1007/s10903-022-01442-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
This scoping review explored what is known about the experiences of informal cancer caregivers (CGs) who are newcomers with limited language proficiency. A literature search was performed in seven databases and the search yielded 11,289 articles. After duplicate removal and title and abstract screening, 216 articles underwent full text review and 57 articles and were synthesized. Most studies (n = 41, 72%) were qualitative and were published in North America (n = 35, 61%). Most CG participants were female (69%) and only 19 studies explicitly identified the CG country of origin. Of those that did, 26% originated from Asia, with most migrating from East Asia. Significant challenges were experienced by newcomer CGs and chief among these were related to communication challenges with HCPs that were exacerbated by a lack of availability of medical interpreters and the complexity of oncology health information. Efforts are needed to better integrate newcomer CGs into cancer care.
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Affiliation(s)
- Mijia Murong
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Eleni Giannopoulos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
| | - Lorraine Pirrie
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Meredith Elana Giuliani
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada.,The Institute for Education Research, University Health Network, Toronto, Canada.,Department of Radiation of Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Rouhi Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jacqueline Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Janet Papadakos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada. .,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. .,The Institute for Education Research, University Health Network, Toronto, Canada.
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Chee W, Yi JS, Im EO. Information Needs of Asian American Breast Cancer Survivors: a Decision Tree Analysis. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1902-1911. [PMID: 34176104 PMCID: PMC9233757 DOI: 10.1007/s13187-021-02059-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Through a decision tree analysis, this study aimed to determine the characteristics of Asian American breast cancer survivors who had higher decreases in their need for information by a technology-based information and coaching/support program compared with their counterparts. This is a part of a larger randomized controlled trial; only the data from 99 Asian American breast cancer survivors were used for this analysis. The measurement scales included the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the Questions on Attitudes, Subjective Norm, Perceived Behavioral Control and Behavioral Intention, and the Supportive Care Needs Survey-Short Form 34. The data analysis was done using t-tests, chi-square tests, repeated measurement analyses, and a decision tree analysis. The information needs scores of all the participants decreased during the 3-month intervention period (p < .005). However, only the intervention group had statistically significant decreases in the information needs scores during the 3 months (dif. = - 8.545; p < .005). Those with low social influence scores and high self-efficacy scores had significantly larger decreases in their information needs scores compared with the average change scores (100%, p < 01). Asian American breast cancer survivors with low social influences and high self-efficacy would highly benefit from a technology-based intervention for their need for information.
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Affiliation(s)
- Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Jee-Seon Yi
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA.
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Abstract
The purpose of this secondary analysis was to determine the clusters of Asian American breast cancer survivors by the severity scores of menopausal symptoms and to explore the characteristics associated with the identified clusters. The data from an ongoing study among 94 survivors were used. The instruments included the Perceived Isolation Scale, the Personal Resource Questionnaire, and the Memorial Symptom Assessment Scale-Short Form. The data analysis was conducted using hierarchical cluster analyses and multinomial logistic analyses. Three clusters were identified: "the cluster with high severity scores of total, psychological, physical, and psychosomatic symptoms (Cluster 1)," "the cluster with moderate severity scores of total, psychological, physical, and psychosomatic symptoms (Cluster 2)," and "the cluster with low severity scores of total, psychological, physical, and psychosomatic symptoms (Cluster 3)." The clusters had significant differences in the level of acculturation, perceived social isolation, and perceived social support (p < 0.05).
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Affiliation(s)
- Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Thakur N, Lovinsky-Desir S, Appell D, Bime C, Castro L, Celedón JC, Ferreira J, George M, Mageto Y, Mainous III AG, Pakhale S, Riekert KA, Roman J, Ruvalcaba E, Sharma S, Shete P, Wisnivesky JP, Holguin F. Enhancing Recruitment and Retention of Minority Populations for Clinical Research in Pulmonary, Critical Care, and Sleep Medicine: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2021; 204:e26-e50. [PMID: 34347574 PMCID: PMC8513588 DOI: 10.1164/rccm.202105-1210st] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Well-designed clinical research needs to obtain information that is applicable to the general population. However, most current studies fail to include substantial cohorts of racial/ethnic minority populations. Such underrepresentation may lead to delayed diagnosis or misdiagnosis of disease, wide application of approved interventions without appropriate knowledge of their usefulness in certain populations, and development of recommendations that are not broadly applicable.Goals: To develop best practices for recruitment and retention of racial/ethnic minorities for clinical research in pulmonary, critical care, and sleep medicine.Methods: The American Thoracic Society convened a workshop in May of 2019. This included an international interprofessional group from academia, industry, the NIH, and the U.S. Food and Drug Administration, with expertise ranging from clinical and biomedical research to community-based participatory research methods and patient advocacy. Workshop participants addressed historical and current mistrust of scientific research, systemic bias, and social and structural barriers to minority participation in clinical research. A literature search of PubMed and Google Scholar was performed to support conclusions. The search was not a systematic review of the literature.Results: Barriers at the individual, interpersonal, institutional, and federal/policy levels were identified as limiting to minority participation in clinical research. Through the use of a multilevel framework, workshop participants proposed evidence-based solutions to the identified barriers.Conclusions: To date, minority participation in clinical research is not representative of the U.S. and global populations. This American Thoracic Society research statement identifies potential evidence-based solutions by applying a multilevel framework that is anchored in community engagement methods and patient advocacy.
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8
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Obra JK, Lin B, Đoàn LN, Palaniappan L, Srinivasan M. Achieving Equity in Asian American Healthcare: Critical Issues and Solutions. JOURNAL OF ASIAN HEALTH 2021; 1:e202103. [PMID: 37872960 PMCID: PMC10593109 DOI: 10.59448/jah.v1i1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Equity is a fundamental goal of the US health care system. Asians comprise 6% of the US population, and 60% of the world's population. Less than 1% of National Institutes of Health funding is directed toward Asian health. Asian health outcomes are often worse than non-Hispanic Whites (NHWS) in America. Increasing federal and foundation resources and funding toward Asian health research could illuminate these risks and develop precision interventions to reduce known health disparities. When disaggregated by race/ethnicity, Asian health risks are even more apparent. Here, we discuss critical health outcome differences between the six major Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) comprising 80% of the US Asian population, highlighting demographic, pharmacologic, disease prevalence, and mortality outcomes. We then outline seven critical issues contributing to Asian American health disparities, including aggregated Asian health data, undersampling, invalid extrapolations, underrepresentation in clinical trials, lack of funding and awareness of disparities, and the model minority myth. Building on the successes of national public health initiatives, we propose nine leverage points to improve Asian American health including the following: obtaining disaggregated Asian health data, improved Asian health research (oversampling Asians, improving clinical trial participation, and increasing research funding), stakeholder collaboration (national and with Asian nations), community engagement, providing culturally precise health care, and expansion of the Asian American research ecosystem. Achieving health equity takes deliberate practice and does not occur by accident. By addressing critical issues that perpetuate Asian health disparities, we grow closer to understanding how to effectively improve Asian health and build a nationally unified mindset toward action that emphasizes equitable care for all.
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Affiliation(s)
- Jed Keenan Obra
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Neurobiology, Physiology, and Behavior, University of California Davis; Davis, CA
| | - Bryant Lin
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Medicine, Stanford University School of Medicine; Palo Alto, CA
| | - Lan N. Đoàn
- Department of Population Health, NYU Grossman School of Medicine; New York, NY
| | - Latha Palaniappan
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Medicine, Stanford University School of Medicine; Palo Alto, CA
| | - Malathi Srinivasan
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Medicine, Stanford University School of Medicine; Palo Alto, CA
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9
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Natale P, Saglimbene V, Ruospo M, Gonzalez AM, Strippoli GF, Scholes-Robertson N, Guha C, Craig JC, Teixeira-Pinto A, Snelling T, Tong A. Transparency, trust and minimizing burden to increase recruitment and retention in trials: a systematic review. J Clin Epidemiol 2021; 134:35-51. [PMID: 33515656 DOI: 10.1016/j.jclinepi.2021.01.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/08/2021] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe patient perspectives on recruitment and retention in clinical trials. STUDY DESIGN AND SETTING Systematic review of qualitative studies that reported the perspective of adult patients with any health condition who accepted or declined to participate in clinical trials. RESULTS Sixty-three articles involving 1681 adult patients were included. Six themes were identified. Four themes reflected barriers: ambiguity of context and benefit - patients were unaware of the research question and felt pressured in making decisions; lacking awareness of opportunities - some believed health professionals obscured trials opportunities, or felt confused because of language barriers; wary of added burden - patients were without capacity because of sickness or competing priorities; and skepticism, fear and mistrust - patients feared loss of privacy, were suspicious of doctor's motivation, afraid of being a guinea pig, and disengaged from not knowing outcomes. Two themes captured facilitators: building confidence - patients hoped for better treatment, were supported from family members and trusted medical staff; and social gains and belonging to the community - altruism, a sense of belonging and peer encouragement motivated participation in trials. CONCLUSION Improving the visibility and transparency of trials, supporting informed decision making, minimizing burden, and ensuring confidence and trust may improve patient participation in trials.
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Affiliation(s)
- Patrizia Natale
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
| | - Valeria Saglimbene
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Marinella Ruospo
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Andrea Matus Gonzalez
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Giovanni Fm Strippoli
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Tom Snelling
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Smith AB, Niu AY, Descallar J, Delaney GP, Wu VS, Agar MR, Girgis A. Clinical trials knowledge and attitudes of Vietnamese- and Anglo-Australian cancer patients: A cross-sectional study. Asia Pac J Clin Oncol 2020; 16:e242-e251. [PMID: 32779349 DOI: 10.1111/ajco.13388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/13/2020] [Indexed: 11/27/2022]
Abstract
AIM Low participation in cancer clinical trials by culturally and linguistically diverse (CALD) patients limits access to cutting-edge treatments and generalizability of results. This is the first study exploring trials knowledge/attitudes and their association with trial participation in Vietnamese- and Anglo-Australian cancer patients. METHODS Eligible patients diagnosed with cancer in the past 10 years were invited to complete a self-report questionnaire comprising validated measures of: trials knowledge and attitudes, preferred information amount, preferred decision-making involvement, health literacy, and past and future (i.e. hypothetical) trial participation. Multivariable linear regression evaluated correlates of trials knowledge/attitudes. Multinomial logistic regression estimated the relationship between trials knowledge/attitudes and possible future trial participation. RESULTS Vietnamese-Australian participants (n = 50) had more negative attitudes regarding trials than Anglo-Australians (n = 100; B = -9.28; 95% confidence interval [CI], -17.60 to -0.97; P = 0.029), but similar knowledge (B = -0.91; 95% CI, -2.27 to 0.44; P = 0.18). Future trial participation was associated with positive attitudes (odds ratio [OR] = 1.08; 95% CI, 1.04-1.12; P < 0.001) and greater knowledge (OR = 1.30; 95% CI, 1.04-1.62; P = 0.02), but not Vietnamese background (OR = 0.95; 95% CI, 0.27-3.32; P = 0.93). CONCLUSION Despite poorer attitudes regarding trials in Vietnamese-Australians, Vietnamese background was not associated with less likely future trial participation, suggesting low trial participation by CALD patients may be more due to opportunity barriers. Improving knowledge and attitudes may increase trial participation generally.
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Affiliation(s)
- Allan B Smith
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia
| | - Anita Y Niu
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia
| | - Joseph Descallar
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia
| | - Geoff P Delaney
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Verena S Wu
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia
| | - Meera R Agar
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia.,Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW, Australia.,Clinical Trials Unit, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia
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Im E, Yi J, Kim H, Chee W. A technology‐based information and coaching/support program and self‐efficacy of Asian American breast cancer survivors. Res Nurs Health 2020; 44:37-46. [DOI: 10.1002/nur.22059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/25/2020] [Accepted: 07/19/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Eun‐Ok Im
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia
| | | | | | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia
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12
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Decreasing menopausal symptoms of Asian American breast cancer survivors through a technology-based information and coaching/support program. Menopause 2020; 26:373-382. [PMID: 30461556 DOI: 10.1097/gme.0000000000001249] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE One of the most prevalent and distressing symptoms after breast cancer treatment is menopausal symptoms. Asian American breast cancer survivors have lower quality of life and often receive inadequate management of menopausal symptoms compared to other racial/ethnic groups. Technology-based programs could be a solution to fill the gap in care. The purpose of this study was to test the efficacy of a technology-based information and coaching/support program on menopausal symptoms of Asian American breast cancer survivors. METHODS This study adopted a randomized pretest/post-test group design among 91 Asian American breast cancer survivors (42 in an intervention group who used the program and the American Cancer Society Web site and 49 in a control group who used only the American Cancer Society Web site). The intervention was a theory-driven and culturally tailored intervention program that aimed to provide information and coaching/support using computers and mobile devices. Multiple instruments were used to measure background characteristics and menopausal symptoms at pretest, post 1-month, and post 3 months. An intent-to-treat linear mixed-model growth curve analysis was used to analyze the data. RESULTS The intervention group showed a significant decrease in the distress scores of menopausal symptoms over time: physical (β = -0.07, P = 0.08), psychological (β = -0.13, P = 0.05), psychosomatic (β = -0.17, P = 0.06), and total symptoms (β = -0.19, P = 0.01). Theory-based variables including attitudes, social influences, and self-efficacy partially mediated the impact of the intervention on the distress scores of menopausal symptoms (P < 0.10). CONCLUSIONS The program was effective in alleviating menopausal symptoms of Asian American breast cancer survivors.
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13
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Facilitators of research registry enrollment and potential variation by race and gender. J Clin Transl Sci 2019; 2:234-238. [PMID: 31660225 PMCID: PMC6798442 DOI: 10.1017/cts.2018.326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/26/2022] Open
Abstract
Introduction Little is known about what motivates people to enroll in research registries. The purpose of this study is to identify facilitators of registry enrollment among diverse older adults. Methods Participants completed an 18-item Research Interest Assessment Tool. We used logistic regression analyses to examine responses across participants and by race and gender. Results Participants (N=374) were 58% black, 76% women, with a mean age of 68.2 years. All participants were motivated to maintain their memory while aging. Facilitators of registry enrolled varied by both race and gender. Notably, blacks (estimate=0.71, p<0.0001) and women (estimate=0.32, p=0.03) were more willing to enroll in the registry due to home visits compared with whites and men, respectively. Conclusions Researchers must consider participant desire for maintaining memory while aging and home visits when designing culturally tailored registries.
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Asian Americans are less willing than other racial groups to participate in health research. J Clin Transl Sci 2019; 3:90-96. [PMID: 31660231 PMCID: PMC6802418 DOI: 10.1017/cts.2019.372] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 01/15/2023] Open
Abstract
Background Asian Americans constitute 5% of the U.S. population. Their willingness to participate in research is important to examine because it influences participation rates and the representativeness of study results. Methods A total of 17,339 community members participated from six diverse Clinical and Translational Award (CTSA) sites. Community members were asked about their willingness to volunteer for eight different types of health research, their expectation of monetary compensation for research participation, their trust in research and researchers, their preferred language to receive health information, and their socio-demographic background. We examined Asian Americans' willingness to participate in various types of health research studies and compared their perceptions with other racial/ethnic groups (i.e., Asian n = 485; African-American n = 9516; Hispanic/Latino n = 1889; Caucasian n = 4760; and other minority n = 689). Results Compared to all other racial/ethnic groups, Asian Americans were less willing to participate in all eight types of health research. However, Asian Americans reported a lower amount of fair compensation for research participation than African-Americans and Hispanics/Latinos but were as likely to trust researchers as all other racial/ethnic groups. Conclusion Asian Americans are less willing to participate in health research than other racial/ethnic groups, and this difference is not due to dissatisfaction with research compensation or lower trust in researchers. Lack of trust in research and language barriers should be addressed to improve representativeness and generalizability of all populations in research.
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Abstract
Objective: The purpose of this article is to examine the relationships of illness perception, self-care, self-efficacy, and self-care strategies and their effects on Chinese cancer patients’ quality of life (QOL). Methods: Questionnaires include data on demographic characteristics, illness perception, symptom self-care activity, and QOL. A secondary analysis was conducted on a sample of ethnic Chinese breast-and-colon cancer patients (n = 159) to examine multivariate associations. Descriptive statistics, bivariate correlational analysis, and hierarchical regression analysis were used to analyze quantitative data. Results: The hierarchical regression model explained 43% of variance in QOL. Perceived illness consequence, personal control, and performance functioning status were found to be significant predictors in the model. Comparisons between breast-and-colon cancer patients showed that colon cancer patients significantly perceived higher levels of chronicity and negativity toward cancer than breast cancer patients. Conversely, breast cancer patients had significantly higher level of QOL and efficacy in making decision. Stress and overwork were the common perceived causes of cancer reported by these patients. Conclusions: These findings suggest that improving self-care efficacy and positive personal control can improve Chinese cancer patients’ QOL. Variation in illness perceptions of cancer by different types of cancer should be considered in cancer survivorship planning and patient education.
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Affiliation(s)
- Fang-Yu Chou
- School of Nursing, San Francisco State University, San Francisco, CA, USA
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16
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Chee W, Lee Y, Im EO, Chee E, Tsai HM, Nishigaki M, Yeo SA, Schapira M, Mao JJ. A culturally tailored Internet cancer support group for Asian American breast cancer survivors: A randomized controlled pilot intervention study. J Telemed Telecare 2017; 23:618-626. [PMID: 27486198 PMCID: PMC6186171 DOI: 10.1177/1357633x16658369] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The necessity of culturally competent Internet Cancer Support Groups (ICSGs) for ethnic minorities has recently been highlighted in order to increase its attractiveness and usage. The purpose of this study was to determine the preliminary efficacy of a culturally tailored registered-nurse-moderated ICSG for Asian American breast cancer survivors in enhancing the women's breast cancer survivorship experience. Methods The study included two phases: (a) a usability test and an expert review; and (b) a randomized controlled pilot intervention study. The usability test was conducted among five Asian American breast cancer survivors using a one-month online forum, and the expert review was conducted among five experts using the Cognitive Walkthrough method. The randomized controlled pilot intervention study (a pre-test and post-test design) was conducted among 65 Asian American breast cancer survivors. The data were analysed using content analysis and descriptive and inferential statistics including the repeated ANOVA. Results All users and experts positively evaluated the program and provided their suggestions for the display, educational contents, and user-friendly structure. There were significant positive changes in the support care needs and physical and psychological symptoms ( p < 0.05) of the control group. There were significant negative changes in the uncertainty level of the intervention group ( p < 0.10). Controlling for background and disease factors, the intervention group showed significantly greater improvements than the control group in physical and psychological symptoms and quality of life ( p < 0.10). Discussion The findings supported the positive effects of ICSGs on support care needs, psychological and physical symptoms, and quality of life.
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Affiliation(s)
| | - Yaelim Lee
- Yeouido St. Mary’s Hospital, Seoul, Korea,
| | | | | | - Hsiu-Min Tsai
- Chang Gung University of Science and Technology, Taipei, Taiwan,
| | | | - Seon Ae Yeo
- University of North Caronia, Chapel Hill, NC,
| | | | - Jun James Mao
- Memorial Sloan-Kettering Cancer Center, New York, NY,
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17
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Thornton LR, Amorrortu RP, Smith DW, Mainous AG, Vernon SW, Tilley BC. Exploring Willingness of Elder Chinese in Houston to Participate in Clinical Research. Contemp Clin Trials Commun 2016; 4:33-38. [PMID: 27458608 PMCID: PMC4957552 DOI: 10.1016/j.conctc.2016.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background and objectives Inadequate minority participation in clinical research can threaten the applicability and strength of scientific findings. Previous research suggests that trial participation rates are lowest among Asian Americans, compared to other groups. This study explored barriers to clinical research participation among elder Chinese living in Houston, Texas. Additionally we administered the Trust in Medical Researchers Scale (TIMRS), used previously in researching trust in medical researchers as related to research participation. Design In this mixed methods study, a semi-structured interview, including the TIMRS were administered to 30 adults of Chinese ancestry aged 50 years or older recruited from a Chinese community center. Interviews were conducted in English, Mandarin and Cantonese and independently coded and analyzed using thematic content analysis. TIMRS scores were calculated for participants. Results Participants were 70% female, 70% were 60 or elder, all were foreign born and on average lived in the US for 21.8 years. Participants perceived risks to research participation and preferred language concordant research staff. Interviewees were more willing to participate if they perceived personal and community health-related benefits. The overall TIMRS score was 23.9 (±5.0), lower than the overall TIMRS for Whites in a previous study (P < 0.001). Conclusions The barriers and facilitators to research participation confirmed previous research among Asians. Our participant TIMRS scores were consistent with decreased levels of trust observed in the original TIMRS study for African Americans as compared and lower than Whites. Employing strategies that utilize language concordant staff who build trust with participants may aid in recruiting elder Chinese, especially if the research is personally relevant to those being recruited.
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Affiliation(s)
- Logan R Thornton
- The University of Texas Health Science Center at Houston (UT Health) School of Public Health, Department of Health Promotion and Behavioral Sciences, 1200 Hermann Pressler, Houston TX USA 77030
| | - Rossybelle P Amorrortu
- The University of Texas Health Science Center at Houston (UT Health) School of Public Health, Department of Biostatistics, 1200 Hermann Pressler, Houston TX USA 77030
| | - Daniel W Smith
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 100 Doughty Street, Charleston SC USA 29425
| | - Arch G Mainous
- University of Florida, Department of Health Services Research, Management and Policy, Health Science Center, PO Box 100195 Gainesville FL 32610
| | - Sally W Vernon
- The University of Texas Health Science Center at Houston (UT Health) School of Public Health, Department of Health Promotion and Behavioral Sciences, 1200 Hermann Pressler, Houston TX USA 77030
| | - Barbara C Tilley
- The University of Texas Health Science Center at Houston (UT Health) School of Public Health, Department of Biostatistics, 1200 Hermann Pressler, Houston TX USA 77030
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18
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Factors affecting patient participation in clinical trials in Ireland: A narrative review. Contemp Clin Trials Commun 2016; 3:23-31. [PMID: 29736453 PMCID: PMC5935836 DOI: 10.1016/j.conctc.2016.01.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/11/2016] [Accepted: 01/20/2016] [Indexed: 11/24/2022] Open
Abstract
Objective Clinical trials have long been considered the ‘gold standard’ of research generated evidence in health care. Patient recruitment is an important determinant in the success of the trials, yet little focus is placed on the decision making process of patients towards recruitment. Our objective was to identify the key factors pertaining to patient participation in clinical trials, to better understand the identified low participation rate of patients in one clinical research facility within Ireland. Design Narrative literature review of studies focussing on factors which may act to facilitate or deter patient participation in clinical trials. Studies were identified from Medline, PubMed, Cochrane Library and CINAHL. Results Sixty-one studies were included in the narrative review: Forty-eight of these papers focused specifically on the patient's perspective of participating in clinical trials. The remaining thirteen related to carers, family and health care professional perspectives of participation. The primary factor influencing participation in clinical trials amongst patients was related to personal factors and these were collectively associated with obtaining a form of personal gain through participation. Cancer was identified as the leading disease entity included in clinical trials followed by HIV and cardiovascular disease. Conclusion The vast majority of literature relating to participation in clinical trials emanates predominantly from high income countries, with 63% originating from the USA. No studies for inclusion in this review were identified from low income or developing countries and therefore limits the generalizability of the influencing factors.
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19
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Meropol NJ, Wong YN, Albrecht T, Manne S, Miller SM, Flamm AL, Benson AB, Buzaglo J, Collins M, Egleston B, Fleisher L, Katz M, Kinzy TG, Liu TM, Margevicius S, Miller DM, Poole D, Roach N, Ross E, Schluchter MD. Randomized Trial of a Web-Based Intervention to Address Barriers to Clinical Trials. J Clin Oncol 2015; 34:469-78. [PMID: 26700123 DOI: 10.1200/jco.2015.63.2257] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Lack of knowledge and negative attitudes have been identified as barriers to participation in clinical trials by patients with cancer. We developed Preparatory Education About Clinical Trials (PRE-ACT), a theory-guided, Web-based, interactive computer program, to deliver tailored video educational content to patients in an effort to overcome barriers to considering clinical trials as a treatment option. PATIENTS AND METHODS A prospective, randomized clinical trial compared PRE-ACT with a control condition that provided general clinical trials information produced by the National Cancer Institute (NCI) in text format. One thousand two hundred fifty-five patients with cancer were randomly allocated before their initial visit with an oncologist to PRE-ACT (n = 623) or control (n = 632). PRE-ACT had three main components: assessment of clinical trials knowledge and attitudinal barriers, values assessment with clarification back to patients, and provision of a video library tailored to address each patient's barriers. Outcomes included knowledge and attitudes and preparation for decision making about clinical trials. RESULTS Both PRE-ACT and control interventions improved knowledge and attitudes (all P < .001) compared with baseline. Patients randomly allocated to PRE-ACT showed a significantly greater increase in knowledge (P < .001) and a significantly greater decrease in attitudinal barriers (P < .001) than did their control (text-only) counterparts. Participants in both arms significantly increased their preparedness to consider clinical trials (P < .001), and there was a trend favoring the PRE-ACT group (P < .09). PRE-ACT was also associated with greater patient satisfaction than was NCI text alone. CONCLUSION These data show that patient education before the first oncologist visit improves knowledge, attitudes, and preparation for decision making about clinical trials. Both text and tailored video were effective. The PRE-ACT interactive video program was more effective than NCI text in improving knowledge and reducing attitudinal barriers.
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Affiliation(s)
- Neal J Meropol
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Yu-Ning Wong
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Terrance Albrecht
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Sharon Manne
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Suzanne M Miller
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Anne Lederman Flamm
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Al Bowen Benson
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Joanne Buzaglo
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Michael Collins
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Brian Egleston
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Linda Fleisher
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Michael Katz
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Tyler G Kinzy
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Tasnuva M Liu
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Seunghee Margevicius
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Dawn M Miller
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - David Poole
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Nancy Roach
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Eric Ross
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
| | - Mark D Schluchter
- Neal J. Meropol, University Hospitals Case Medical Center Seidman Cancer Center; Neal J. Meropol, Tyler G. Kinzy, Tasnuva M. Liu, Seunghee Margevicius, Dawn M. Miller, and Mark D. Schluchter, Case Comprehensive Cancer Center, Case Western Reserve University; Anne Lederman Flamm, Cleveland Clinic Foundation, Cleveland, OH; Yu-Ning Wong, Suzanne M. Miller, Michael Collins, Brian Egleston, and Eric Ross, Fox Chase Cancer Center, Temple University Health System; Joanne Buzaglo, Cancer Support Community Research and Training Institute; Linda Fleisher, Children's Hospital of Philadelphia; David Poole, University of Pennsylvania Health System, Philadelphia, PA; Terrance Albrecht, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Sharon Manne, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Al Bowen Benson III, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Michael Katz, International Myeloma Foundation, North Hollywood, CA; and Nancy Roach, Fight Colorectal Cancer, Alexandria, VA
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Lee SKC, Knobf MT. Family involvement for breast cancer decision making among Chinese-American women. Psychooncology 2015; 25:1493-1499. [PMID: 26374698 DOI: 10.1002/pon.3989] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 06/20/2015] [Accepted: 08/21/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND To describe family involvement in decision making for primary treatment in Chinese-American women with early-stage breast cancer. METHODS Qualitative data were collected in 2003 from semi-structured questions in interviews with a sample of Chinese-American (ChA) women with breast cancer, who were recruited from the metropolitan New York area. Responses to the questions were written in Chinese immediately during the interview and read back to the subject for accuracy and validation. Content analysis was used to inductively code and analyze the data to generate themes. RESULTS The participants consisted of 123 ChA women with early stage breast cancer with a mean age of 48.7 years (±9.3) and who had lived in the United States a median of 13.6 years. Support and Caring was the major theme that described family involvement in the breast cancer decision-making process. Gathering Information, Being There, Navigating the Health Care System, Maintaining Family Life and Making the Decision described the aspects of family support in the process. The majority of women described the treatment decision making as a collaborative supportive process with the family, but limited English fluency, strong opinions, lack of a shared perspective, distant living proximity and competing work responsibilities of family members were stressful for the women and perceived as non-supportive. CONCLUSIONS Family involvement in health care decision making is culturally embedded in Asian populations. Culturally sensitive patient and family consultation strategies are needed to assist informed treatment decision making in Chinese-American women diagnosed with breast cancer. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shiuyu Katie C Lee
- National Taipei University of Nursing and Health Science, School of Nursing, Taipei, Taiwan
| | - M Tish Knobf
- Yale University, School of Nursing, Orange, CT, USA
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21
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Considerations of Methodological Approaches in the Recruitment and Retention of Immigrant Participants. J Racial Ethn Health Disparities 2015; 3:267-80. [PMID: 27271068 DOI: 10.1007/s40615-015-0139-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 06/05/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aims to identify effective strategies related to recruitment and retention of immigrant survey participants. METHODOLOGY The study used a multi-mode approach in, first, conducting a literature review of recent articles on surveys that either targeted immigrants or included large numbers of immigrants in their samples. Next, six surveys were reviewed that either targeted or included large numbers of immigrants. Finally, expert opinions on immigration were gathered regarding recruitment and retention of immigrant survey participants. RESULTS Although immigrants may be difficult to recruit due to limited English proficiency, mistrust of strangers, and/or high mobility, many of these challenges can be overcome by adopting the same strategies used when surveying ethnically diverse populations (e.g., snowballing versus advertisement, establishing a personal connection with data collectors). Nonetheless, a few practices were identified as most relevant for recruitment and retention of immigrant populations, including involving local community organizations relevant to immigrants, translation of materials tailored to the vernacular language of the various ethnicities, and customizing non-monetary incentives to the specific ethnicity. CONCLUSIONS Based on the reviews and expert interviews, multiple strategies have been shown to be effective in recruiting and retaining immigrant participants.
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Egleston BL, Pedraza O, Wong YN, Dunbrack RL, Griffin CL, Ross EA, Beck JR. Characteristics of clinical trials that require participants to be fluent in English. Clin Trials 2015; 12:618-26. [PMID: 26152834 DOI: 10.1177/1740774515592881] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND/AIMS Diverse samples in clinical trials can make findings more generalizable. We sought to characterize the prevalence of clinical trials in the United States that required English fluency for participants to enroll in the trial. METHODS We randomly chose over 10,000 clinical trial protocols registered with ClinicalTrials.gov and examined the inclusion and exclusion criteria of the trials. We compared the relationship of clinical trial characteristics with English fluency inclusion requirements. We merged the ClinicalTrials.gov data with US Census and American Community Survey data to investigate the association of English-language restrictions with ZIP-code-level demographic characteristics of participating institutions. We used Chi-squared tests, t-tests, and logistic regression models for analyses. RESULTS English fluency requirements have been increasing over time, from 1.7% of trials having such requirements before 2000 to 9.0% after 2010 (p < 0.001 from Chi-squared test). Industry-sponsored trials had low rates of English fluency requirements (1.8%), while behavioral trials had high rates (28.4%). Trials opening in the Northeast of the United States had the highest regional English requirement rates (10.7%), while trials opening in more than one region had the lowest (3.3%, p<0.001). Since 1995, trials opening in ZIP codes with larger Hispanic populations were less likely to have English fluency requirements (odds ratio=0.92 for each 10% increase in proportion of Hispanics, 95% confidence interval=0.86-0.98, p=0.013). Trials opening in ZIP codes with more residents self-identifying as Black/African American (odds ratio=1.87, 95% confidence interval=1.36-2.58, p<0.001 for restricted cubic spline term) or Asian (odds ratio=1.16 for linear term, 95% confidence interval=1.07-1.25, p<0.001) were more likely to have English fluency requirements. ZIP codes with higher poverty rates had trials with more English-language restrictions (odds ratio=1.06 for a 10% poverty rate increase, 95% confidence interval=1.001-1.11, p=0.045). There was a statistically significant interaction between year and intervention type, such that the increase in English fluency requirements was more common for some interventions than for others. CONCLUSION The proportion of clinical trials registered with ClinicalTrials.gov that have English fluency requirements for study inclusion has been increasing over time. English-language restrictions are associated with a number of characteristics, including the demographic characteristics of communities in which the sponsoring institutions are located.
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Affiliation(s)
- Brian L Egleston
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Omar Pedraza
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Yu-Ning Wong
- Medical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Roland L Dunbrack
- Molecular Therapeutics, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | | | - Eric A Ross
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - J Robert Beck
- Office of Academic Programs, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
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Yen GP, Davey A, Ma GX. Factors that affect willingness to donate blood for the purpose of biospecimen research in the Korean American community. Biopreserv Biobank 2015; 13:107-13. [PMID: 25853387 DOI: 10.1089/bio.2014.0028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Biorepositories have been key resources in examining genetically-linked diseases, particularly cancer. Asian Americans contribute to biorepositories at lower rates than other racial groups, but the reasons for this are unclear. We hypothesized that attitudes toward biospecimen research mediate the relationship between demographic and healthcare access factors, and willingness to donate blood for research purposes among individuals of Korean heritage. METHODS Descriptive statistics and bivariate analyses were utilized to characterize the sample with respect to demographic, psychosocial, and behavioral variables. Structural equation modeling with 5000 re-sample bootstrapping was used to assess each component of the proposed simple mediation models. RESULTS Attitudes towards biospecimen research fully mediate associations between age, income, number of years lived in the United States, and having a regular physician and willingness to donate blood for the purpose of research. CONCLUSION Participants were willing to donate blood for the purpose of research despite having neutral feelings towards biospecimen research as a whole. Participants reported higher willingness to donate blood for research purposes when they were older, had lived in the United States longer, had higher income, and had a regular doctor that they visited. Many of the significant relationships between demographic and health care access factors, attitudes towards biospecimen research, and willingness to donate blood for the purpose of research may be explained by the extent of acculturation of the participants in the United States.
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Affiliation(s)
- Glorian P Yen
- 1 Department of Public Health, Temple University , Philadelphia, Pennsylvania
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A Review of Barriers to Minorities’ Participation in Cancer Clinical Trials: Implications for Future Cancer Research. J Immigr Minor Health 2015; 18:447-53. [DOI: 10.1007/s10903-015-0198-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Braun KL, Stewart S, Baquet C, Berry-Bobovski L, Blumenthal D, Brandt HM, Buchwald DS, Campbell JE, Coe K, Cooper LC, Espinoza P, Henry-Tillman R, Hargreaves M, James A, Salmon Kaur J, Viswanath K, Ma GX, Mandelblatt J, Meade C, Ramirez A, Scarinci I, Park Tanjasiri S, Thompson B, Vines AI, Dignan M. The National Cancer Institute's Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned. Prog Community Health Partnersh 2015; 9 Suppl:21-32. [PMID: 26213401 PMCID: PMC4698458 DOI: 10.1353/cpr.2015.0017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities. METHODS Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme. RESULTS Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services. IMPLICATIONS Findings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.
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26
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Fleisher L, Ruggieri DG, Miller SM, Manne S, Albrecht T, Buzaglo J, Collins MA, Katz M, Kinzy TG, Liu T, Manning C, Charap ES, Millard J, Miller DM, Poole D, Raivitch S, Roach N, Ross EA, Meropol NJ. Application of best practice approaches for designing decision support tools: the preparatory education about clinical trials (PRE-ACT) study. PATIENT EDUCATION AND COUNSELING 2014; 96:63-71. [PMID: 24813474 PMCID: PMC4171039 DOI: 10.1016/j.pec.2014.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 03/14/2014] [Accepted: 04/05/2014] [Indexed: 05/20/2023]
Abstract
OBJECTIVE This article describes the rigorous development process and initial feedback of the PRE-ACT (Preparatory Education About Clinical Trials) web-based- intervention designed to improve preparation for decision making in cancer clinical trials. METHODS The multi-step process included stakeholder input, formative research, user testing and feedback. Diverse teams (researchers, advocates and developers) participated including content refinement, identification of actors, and development of video scripts. Patient feedback was provided in the final production period and through a vanguard group (N=100) from the randomized trial. RESULTS Patients/advocates confirmed barriers to cancer clinical trial participation, including lack of awareness and knowledge, fear of side effects, logistical concerns, and mistrust. Patients indicated they liked the tool's user-friendly nature, the organized and comprehensive presentation of the subject matter, and the clarity of the videos. CONCLUSION The development process serves as an example of operationalizing best practice approaches and highlights the value of a multi-disciplinary team to develop a theory-based, sophisticated tool that patients found useful in their decision making process. Practice implications Best practice approaches can be addressed and are important to ensure evidence-based tools that are of value to patients and supports the usefulness of a process map in the development of e-health tools.
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Affiliation(s)
- Linda Fleisher
- Children's Hospital of Philadelphia, USA; Fox Chase Cancer Center/Temple University Health System, USA.
| | | | | | | | - Terrance Albrecht
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, USA
| | | | | | | | - Tyler G Kinzy
- University Hospitals Case Medical Center Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, USA
| | - Tasnuva Liu
- University Hospitals Case Medical Center Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, USA
| | | | | | | | - Dawn M Miller
- University Hospitals Case Medical Center Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, USA
| | - David Poole
- Fox Chase Cancer Center/Temple University Health System, USA
| | | | | | - Eric A Ross
- Fox Chase Cancer Center/Temple University Health System, USA
| | - Neal J Meropol
- University Hospitals Case Medical Center Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, USA
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Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, Liedke PER, Pramesh CS, Badovinac-Crnjevic T, Sheikine Y, Chen Z, Qiao YL, Shao Z, Wu YL, Fan D, Chow LWC, Wang J, Zhang Q, Yu S, Shen G, He J, Purushotham A, Sullivan R, Badwe R, Banavali SD, Nair R, Kumar L, Parikh P, Subramanian S, Chaturvedi P, Iyer S, Shastri SS, Digumarti R, Soto-Perez-de-Celis E, Adilbay D, Semiglazov V, Orlov S, Kaidarova D, Tsimafeyeu I, Tatishchev S, Danishevskiy KD, Hurlbert M, Vail C, St Louis J, Chan A. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15:489-538. [PMID: 24731404 DOI: 10.1016/s1470-2045(14)70029-4] [Citation(s) in RCA: 322] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement.
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Affiliation(s)
- Paul E Goss
- Harvard Medical School, Boston, MA, USA; Avon Breast Cancer Center of Excellence, Massachusetts General Hospital, Boston, MA, USA.
| | | | - Brittany L Lee-Bychkovsky
- Harvard Medical School, Boston, MA, USA; Department of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA; International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Lei Fan
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Junjie Li
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Yanin Chavarri-Guerra
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pedro E R Liedke
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Oncologia Hospital de Clínicas de Porto Alegre and Instituto do Cancer Mãe de Deus, Porto Alegre, Rio Grande do Sul, Brazil
| | - C S Pramesh
- Department of Surgical Oncology/Clinical Research, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Tanja Badovinac-Crnjevic
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; University Hospital Zagreb, Department of Oncology, Zagreb, Croatia
| | - Yuri Sheikine
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Zhu Chen
- State Key Lab of Medical Genomics, Shanghai Institute of Hematology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You-lin Qiao
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiming Shao
- Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Daiming Fan
- Fourth Military Medical University, State Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, Xi'an, Shaanxi Province, China
| | - Louis W C Chow
- Organisation for Oncology and Translational Research, Hong Kong, China; UNIMED Medical Institute, Comprehensive Centre for Breast Diseases, Hong Kong, China
| | - Jun Wang
- Institute of Public Health Economics and Management, Central University of Finance and Economics, Beijing, China
| | - Qiong Zhang
- Department of Economics, School of Economics, Central University of Finance and Economics, Beijing, China
| | - Shiying Yu
- Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gordon Shen
- University of California, Berkeley, CA, USA; Cancer Institute & Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Arnie Purushotham
- King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK
| | - Richard Sullivan
- King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK; Institute of Cancer Policy, King's College London, Guy's Hospital, London, UK
| | - Rajendra Badwe
- Administration, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Shripad D Banavali
- Department of Medical and Pediatric Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Reena Nair
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Lalit Kumar
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Purvish Parikh
- Clinical Research and Education, BSES GH Municipal Hospital, Mumbai, India
| | | | - Pankaj Chaturvedi
- Department of Head and Neck Surgery, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Subramania Iyer
- Amrita Institute of Medical Sciences & Research Centre, Head & Neck/Plastic & Reconstructive Surgery, Kochi, Kerala, India
| | | | | | - Enrique Soto-Perez-de-Celis
- Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Dauren Adilbay
- Astana Oncology Center, Head and Neck Oncology, Astana, Kazakhstan
| | - Vladimir Semiglazov
- Reproductive System Tumors Department, NN Petrov Research Institute of Oncology, St Petersburg, Russia
| | - Sergey Orlov
- Department of Thoracic Oncology, Saint Petersburg Medical University, Saint Petersburg, Russia
| | | | - Ilya Tsimafeyeu
- Russian Society of Clinical Oncology, Kidney Cancer Research Bureau, Moscow, Russia
| | - Sergei Tatishchev
- Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
| | | | - Marc Hurlbert
- Avon Foundation Breast Cancer Crusade, New York, NY, USA
| | - Caroline Vail
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica St Louis
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Arlene Chan
- Breast Cancer Research Centre-Western Australia and Curtin University, Perth, WA, Australia
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Ma GX, Seals B, Tan Y, Wang SY, Lee R, Fang CY. Increasing Asian American participation in clinical trials by addressing community concerns. Clin Trials 2014; 11:328-335. [PMID: 24603005 PMCID: PMC4156927 DOI: 10.1177/1740774514522561] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Asian Americans are underrepresented in clinical trials, but little is known about the factors that contribute to clinical trial participation in this population. Purpose The purpose of this study was to identify knowledge, barriers, facilitators, and cultural influences on participating in clinical trials among three Asian American ethnic groups. Concurrently, we sought to identify mechanisms and messages to facilitate dissemination of information and to identify strategies to promote clinical trial participation in this population. Methods Eight focus groups were conducted (n = 103) with Chinese (four groups), Korean (two groups), and Vietnamese (two groups) Americans. Each group was conducted with a moderator and a translator using a standardized guide. Results Participants discuss the benefits of contributing to science, future generations, and their families by being in clinical trials. Some participants think clinical trials would give hope to those with terminal illnesses. A doctor's recommendation, being sick, and needing more options for treatment are motivators for Asian Americans. Having some guarantee of treatment effectiveness and lack of side effects facilitates participation. Cultural or religious beliefs are not believed to prevent clinical trial participation. Limitations This qualitative, two-site study included three Asian American ethnic groups and is not meant to establish prevalence of beliefs. Conclusion Asian Americans need more information about clinical trials and their benefits to science and the larger community. Health-care providers can play pivotal roles in enhancing recruitment of Asian Americans. Basing recruitment goals on percentage representation in most US geographic areas does not provide sufficient numbers to allow for analysis of minorities like Asian American groups. The discovery of important group-specific harms and benefits depends on greater participation of racial/ethnic subgroups.
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Affiliation(s)
- Grace X. Ma
- Center for Asian Health, Temple University, Philadelphia, PA
- Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA
| | - Brenda Seals
- Center for Asian Health, Temple University, Philadelphia, PA
| | - Yin. Tan
- Center for Asian Health, Temple University, Philadelphia, PA
| | - Sylvia. Y. Wang
- Center for Asian Health, Temple University, Philadelphia, PA
| | - Richard Lee
- Asian Community Health Coalition, Philadelphia, PA
| | - Carolyn. Y. Fang
- Fox Chase Cancer Center, Cancer Prevention and Control Program, Philadelphia, PA
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Wang JHY, Sheppard VB, Liang W, Ma GX, Maxwell AE. Recruiting Chinese Americans into cancer screening intervention trials: strategies and outcomes. Clin Trials 2014; 11:167-77. [PMID: 24567288 DOI: 10.1177/1740774513518849] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cancer is the leading cause of death among Asian Americans. While Asian Americans are the fastest growing minority population in the United States, they are underrepresented in cancer research and report poor adherence to cancer screening guidelines. PURPOSE This study utilized data from two large randomized intervention trials to evaluate strategies to recruit first-generation Chinese American immigrants from community settings and Chinese American physician practices. Findings will inform effective strategies for promoting Asian American participation in cancer control research. METHODS Chinese Americans who were non-adherent to annual mammography screening guidelines (Study 1 with 664 immigrant women > 40 years of age) and to colorectal cancer screening guidelines (Study 2 with 455 immigrants > 50 years of age) were enrolled from the greater Washington DC, New York City (NYC), and Philadelphia (PA) areas. Both studies trained bilingual staff to enroll Chinese-speaking participants with the aid of linguistically appropriate fliers and brochures to obtain consent. Study 1 adopted community approaches and worked with community organizations to enroll participants. Study 2 randomly selected potential participants through 24 Chinese American primary-care physician offices, and mailed letters from physicians to enroll patients, followed by telephone calls from research staff. The success of recruitment approaches was assessed by yield rates based on number of participants approached, ineligible, and consented. RESULTS Most participants (70%) of Study 1 were enrolled through in-person community approaches (e.g., Chinese schools, stores, health fairs, and personal networks). The final yield of specific venues differed widely (6% to 100%) due to various proportions of ineligible subjects (2%-64%) and refusals (0%-92%). The Study 2 recruitment approach (physician letter followed by telephone calls) had different outcomes in two geographic areas, partially due to differences in demographic characteristics in the DC and NYC/PA areas. The community approaches enrolled more recent immigrants and uninsured Chinese Americans than the physician and telephone call approach (p < .001). Enrollment cost is provided to inform future research studies. LIMITATIONS Our recruitment outcomes might not be generalizable to all Chinese Americans or other Asian American populations because they may vary by study protocols (e.g., length of trials), target populations (i.e., eligibility criteria), and available resources. CONCLUSIONS Use of multiple culturally relevant strategies (e.g., building trusting relationships through face-to-face enrollment, use of bilingual and bicultural staff, use of a physician letter, and employing linguistically appropriate materials) was crucial for successfully recruiting a large number of Chinese Americans in community and clinical settings. Our data demonstrate that substantial effort is required for recruitment; studies need to budget for this effort to ensure the inclusion of Asian Americans in health research.
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Affiliation(s)
- Judy Huei-yu Wang
- aDepartment of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
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George S, Duran N, Norris K. A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders. Am J Public Health 2014; 104:e16-31. [PMID: 24328648 PMCID: PMC3935672 DOI: 10.2105/ajph.2013.301706] [Citation(s) in RCA: 945] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2013] [Indexed: 11/04/2022]
Abstract
To assess the experienced or perceived barriers and facilitators to health research participation for major US racial/ethnic minority populations, we conducted a systematic review of qualitative and quantitative studies from a search on PubMed and Web of Science from January 2000 to December 2011. With 44 articles included in the review, we found distinct and shared barriers and facilitators. Despite different expressions of mistrust, all groups represented in these studies were willing to participate for altruistic reasons embedded in cultural and community priorities. Greater comparative understanding of barriers and facilitators to racial/ethnic minorities' research participation can improve population-specific recruitment and retention strategies and could better inform future large-scale prospective quantitative and in-depth ethnographic studies.
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Affiliation(s)
- Sheba George
- Sheba George is with the Center for Biomedical Informatics, Charles R. Drew University of Medicine and Science, and the Department of Community Health Sciences, University of California Los Angeles (UCLA) Fielding School of Public Health, Los Angeles. Nelida Duran is with the Department of Community Health Sciences, UCLA Fielding School of Public Health. Keith Norris is with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles
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Im EO, Rendell MO, Chang SJ, Chee E. Predictors of Quality of Life in Cancer Survivors: White and Asian American Women. WOMEN & THERAPY 2014; 37:282-300. [PMID: 26052175 DOI: 10.1080/02703149.2014.897554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The purpose of this study is to compare the pathways through which multiple contextual factors influence the quality of life in Asian American and White women living with cancer. This is a secondary analysis of the data from 95 Asian American women and 113 White women. The data were analyzed using hierarchical multiple regression analyses and structural equation modeling. Multiple factors explained higher percent of total variances of the quality of life scores in Whites compared with that in Asian Americans.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, The University of Pennsylvania
| | | | - Sun Ju Chang
- School of Nursing, The University of Pennsylvania
| | - Eunice Chee
- School of Engineering, the University of Pennsylvania
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Breast cancer experience and survivorship among Asian Americans: a systematic review. J Cancer Surviv 2013; 8:94-107. [PMID: 24214498 DOI: 10.1007/s11764-013-0320-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 10/11/2013] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Breast cancer is the most common cancer in Asian American women, and the number of Asian American breast cancer survivors is rapidly increasing. Although Asian Americans are one of the fastest growing and most heterogeneous ethnic groups in the United States, limited data exist in regard to their breast cancer experience and survivorship. METHODS A systematic review of the breast cancer experience literature was conducted and included studies of Asian Americans or their subgroups as a major category of study participants. Of the 125 studies reviewed, 10 qualitative studies, 10 quantitative studies, 5 studies that used a mixed-method approach, and 1 intervention study met the criteria for inclusion. RESULTS Qualitatively, Asian Americans reported unmet physical and emotional needs and challenges during survivorship. Quantitative studies consistently found that socioeconomic status, cultural health beliefs, immigration stress, acculturation level, English proficiency, social support, and spirituality associated with Asian American breast cancer patients' health behaviors and health-related quality of life (HRQOL). Studies also revealed significant variation in breast cancer reaction and HRQOL within Asian American subgroups. CONCLUSIONS Although research on Asian American breast cancer experience and survivorship is sparse, we concluded that Asian Americans experience disrupted HRQOL following breast cancer diagnosis and treatment, interwoven with their cultural and socio-ecological system, and that programs focused on improving cancer survivorship outcomes among this ethnic minority group are limited. Most studies have concentrated on the West coast population, and there is significant underrepresentation of longitudinal and intervention studies. Implications for study design, measurement, and future research areas are also included. IMPLICATIONS FOR CANCER SURVIVORS The results highlight a need to understand ethnic differences and to take into account social, cultural, and linguistic factors in breast cancer survivorship experiences among Asian American subgroups as a means to develop culturally relevant and linguistically appropriate interventions designed to improve HRQOL.
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Ma GX, Tan Y, Blakeney NC, Seals BF, Ma XS, Zhai S, Liu A, Tai Y, Michaels M. The impact of a community-based clinical trial educational intervention among underrepresented Chinese Americans. Cancer Epidemiol Biomarkers Prev 2013; 23:424-32. [PMID: 24092627 DOI: 10.1158/1055-9965.epi-13-0773] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Clinical trials are a critical resource for the discovery of new prevention, diagnostic, and treatment methods for cancer. The most effective prevention and treatment modalities are based on previous clinical trial results. However, participation in clinical trials is underrepresented by racial/ethnic minority populations, Asian Americans in particular. Asian Americans are the least represented of any ethnic groups in clinical trials. The purpose of this study is to develop and evaluate a culturally and linguistically appropriate community-based educational intervention to increase knowledge of and intent to participate in cancer clinical trials among underrepresented Chinese Americans. METHODS Community-Based Participatory Research approach was used to guide the development, cultural tailoring, implementation, and evaluation of clinical trial intervention. First, 22 Asian community representatives were recruited as community health educators (CHE) who received 12-hour training on clinical trial education. Second, 262 members were recruited from 11 Chinese community organizations. Of those recruited, a total of 247 eligible Chinese enrolled and participated in the clinical trial education delivered by trained CHEs. Participants completed pretest before and posttest after the intervention. RESULTS Fifteen of 21 measures of clinical trial knowledge showed significant changes post the intervention (P < 0.05). Education remained the sole demographic factor increasing clinical trial knowledge in multivariate analysis. CONCLUSION Clinical trial education should emphasize both benefits to science and the larger Asian community. This community-based clinical trial intervention demonstrated promising results and has potential to enhance recruitment and participation in clinical trial research among the underrepresented Asian Americans. IMPACT Improving clinical trial participation in the fast-growing Asian American population is key to dissemination of health innovations targeted to diminish health disparities.
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Affiliation(s)
- Grace X Ma
- Authors' Affiliations: Center for Asian Health, Department of Public Health, College of Health Professions, School of Medicine, Temple University; Asian Health Trilogy, Philadelphia, Pennsylvania; Education Network to Advance Cancer Clinical Trials (NACCT), Bethesda, Maryland; and Boston University School of Public Health, Boston, Massachusetts
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Limkakeng A, Phadtare A, Shah J, Vaghasia M, Wei DY, Shah A, Pietrobon R. Willingness to participate in clinical trials among patients of Chinese heritage: a meta-synthesis. PLoS One 2013; 8:e51328. [PMID: 23349672 PMCID: PMC3547937 DOI: 10.1371/journal.pone.0051328] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Accepted: 11/01/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Subjects of Chinese heritage have been found to participate in clinical research at lower rates than other groups despite growing in numbers as a population. While much research has examined research participants' motivation, there has not been a comprehensive synthesis of this information with respect to participants of Chinese descent. We sought to identify the factors that promote and hinder participation in clinical research among participants of Chinese heritage. METHODOLOGY/PRINCIPAL FINDINGS We conducted a systematic review of the literature in Pubmed, OpenJGATE, SCIRUS, and COCHRANE databases and performed a meta-synthesis of retrieved articles. We extracted qualitative data, such as quotes to identify emerging themes. We identified five studies that met our selection criteria. Of them, only one (1/5) was conducted in China while other studies involved Chinese emigrants in USA (3/5) and Singapore (1/5). Participants from China were similar to emigrants with regard to factors that either promoted or decreased research participation. Four studies reported data exclusively on Chinese subjects. Three of the five studies involved qualitative interviews while the others were conducted using a survey design. Six themes favoring research participation were identified: Personal Benefit to Participants, Financial Incentives, Participant Sense of Altruism, Family or Physician Recommendations, Advertisements, and Convenience to the Participant. Five factors were seen as a barrier to participation in clinical trials: Mistrust of Researchers, Language Barrier, Lack of Financial and Other Support, Cultural and Social Barriers, Lack of Knowledge about Clinical Trials. CONCLUSIONS/SIGNIFICANCE Chinese heritage clinical research participants value personal benefit, financial incentives, the ability to help others, recommendations of others, advertisements, and convenience when considering clinical research participation. In addition, the establishment of trust and addressing knowledge deficits are important factors to them. Investigators seeking to optimize enrolment in these populations should incorporate these findings into their study design and subject handouts.
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Affiliation(s)
- Alexander Limkakeng
- Division of Emergency Medicine, Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Amruta Phadtare
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Jatin Shah
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Meenakshi Vaghasia
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | | | - Anand Shah
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ricardo Pietrobon
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
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Lee CI, Bassett LW, Leng M, Maliski SL, Pezeshki BB, Wells CJ, Mangione CM, Naeim A. Patients' willingness to participate in a breast cancer biobank at screening mammogram. Breast Cancer Res Treat 2012; 136:899-906. [PMID: 23129174 DOI: 10.1007/s10549-012-2324-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 10/26/2012] [Indexed: 10/27/2022]
Abstract
To characterize patients' willingness to donate a biospecimen for future research as part of a breast cancer-related biobank involving a general screening population. We performed a prospective cross-sectional study of 4,217 women aged 21-89 years presenting to our facilities for screening mammogram between December 2010 and October 2011. This HIPAA-compliant study was approved by our institutional review board. We collected data on patients' interest in and actual donation of a biospecimen, motivators and barriers to donating, demographic information, and personal breast cancer risk factors. A multivariate logistic regression analysis was performed to identify patient-level characteristics associated with an increased likelihood to donate. Mean patient age was 57.8 years (SD 11.1 years). While 66.0 % (2,785/4,217) of patients were willing to donate blood or saliva during their visit, only 56.4 % (2,378/4,217) actually donated. Women with a college education (OR = 1.27, p = 0.003), older age (OR = 1.02, p < 0.001), previous breast biopsy (OR = 1.23, p = 0.012), family history of breast cancer (OR = 1.23, p = 0.004), or a comorbidity (OR = 1.22, p = 0.014) were more likely to donate. Asian-American women were significantly less likely to donate (OR = 0.74, p = 0.005). The major reason for donating was to help all future patients (42.3 %) and the major reason for declining donation was privacy concerns (22.3 %). A large proportion of women participating in a breast cancer screening registry are willing to donate blood or saliva to a biobank. Among minority participants, Asian-American women are less likely to donate and further qualitative research is required to identify novel active recruitment strategies to insure their involvement.
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Affiliation(s)
- Christoph I Lee
- Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA 98109-1023, USA.
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Wells KJ, Quinn GP, Meade CD, Fletcher M, Tyson DM, Jim H, Jacobsen PB. Development of a cancer clinical trials multi-media intervention: clinical trials: are they right for you? PATIENT EDUCATION AND COUNSELING 2012; 88:232-240. [PMID: 22525803 DOI: 10.1016/j.pec.2012.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 03/15/2012] [Accepted: 03/27/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe processes used to develop a multi-media psycho-educational intervention to prepare patients for a discussion about cancer clinical trials (CTs). METHODS Guided by a Steering Committee, formative research was conducted to develop an informative and engaging tool about cancer CTs. Twenty-three patients and caregivers participated in formative in-depth interviews to elicit information about perceptions of cancer CTs to inform production of a new media product. RESULTS Formative research revealed participants had concerns about experimentation, held beliefs that cancer CTs were for patients who had no other treatment options, and wanted a balance of information about pros and cons of CT participation. The value of physicians as credible spokespersons and the use of patients as role-models were supported. Using iterative processes, the production team infused the results into creation of a multimedia psycho-educational intervention titled Clinical Trials: Are they Right for You? CONCLUSION An intervention, developed through an iterative consumer-focused process involving multiple stakeholders and formative research, may result in an engaging informative product. PRACTICE IMPLICATIONS If found to be efficacious, Clinical Trials: Are they Right for You? is a low-cost and easily disseminated multimedia psycho-educational intervention to assist cancer patients with making an informed decision about cancer CTs.
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Affiliation(s)
- Kristen J Wells
- University of South Florida, College of Medicine, Tampa FL 33612, USA.
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Harun A, Harrison JD, Young JM. Interventions to improve patient participation in the treatment process for culturally and linguistically diverse people with cancer: a systematic review. Asia Pac J Clin Oncol 2012; 9:99-109. [PMID: 22897920 DOI: 10.1111/j.1743-7563.2012.01531.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Disparities in cancer outcomes for people from culturally and linguistically diverse (CALD) groups are well known. Improving CALD patients' active participation in treatment processes holds potential to improve outcomes, but little is known of effective strategies to facilitate this. This systematic review investigated interventions to improve three aspects of participation in cancer care among CALD groups, namely involvement in decision-making, communication with health providers and treatment adherence. A comprehensive search of electronic bibliographic databases was conducted to identify intervention studies that reported outcomes relevant to patient participation for CALD groups. Two reviewers independently critically appraised the studies and abstracted data. Of 10,278 potential articles, seven met the inclusion criteria, including three randomized controlled, three non-randomized and one mixed-method experimental studies. Interventions included the use of patient navigators, videos and decision aids. The impact on patient participation was varied. The effect of a decision aid and patient navigator interventions on communication with health providers was positive. While the use of a decisions aid successfully facilitated shared decision-making and patients' perception of treatment adherence, the use of patient navigators was ineffective. A computer support system was found to improve general patient participation; however little clarification of what this involved was provided. This systematic review identified few rigorous evaluations of interventions to improve treatment participation for CALD people with cancer, highlighting the lack of a robust evidence base to improve this crucial aspect of care. The development and evaluation of interventions for diverse populations remains a priority.
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Affiliation(s)
- Aisha Harun
- Surgical Outcomes Research Centre, Sydney Local Health Sydney Local Health District and Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
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Miller SM, Hudson SV, Egleston BL, Manne S, Buzaglo JS, Devarajan K, Fleisher L, Millard J, Solarino N, Trinastic J, Meropol NJ. The relationships among knowledge, self-efficacy, preparedness, decisional conflict, and decisions to participate in a cancer clinical trial. Psychooncology 2012; 22:481-9. [PMID: 22331643 DOI: 10.1002/pon.3043] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 01/04/2012] [Accepted: 01/14/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cancer clinical trials (CCTs) are important tools in the development of improved cancer therapies; yet, participation is low. Key psychosocial barriers exist that appear to impact a patient's decision to participate. Little is known about the relationship among knowledge, self-efficacy, preparation, decisional conflict, and patient decisions to take part in CCTs. OBJECTIVE The purpose of this study was to determine if preparation for consideration of a CCT as a treatment option mediates the relationship between knowledge, self-efficacy, and decisional conflict. We also explored whether lower levels of decisional conflict are associated with greater likelihood of CCT enrollment. METHOD In a pre-post test intervention study, cancer patients (N = 105) were recruited before their initial consultation with a medical oncologist. A brief educational intervention was provided for all patients. Patient self-report survey responses assessed knowledge, self-efficacy, preparation for clinical trial participation, decisional conflict, and clinical trial participation. RESULTS Preparation was found to mediate the relationship between self-efficacy and decisional conflict (p = 0.003 for a test of the indirect mediational pathway for the decisional conflict total score). Preparation had a more limited role in mediating the effect of knowledge on decisional conflict. Further, preliminary evidence indicated that reduced decisional conflict was associated with increased clinical trial enrollment (p = 0.049). CONCLUSIONS When patients feel greater CCT self-efficacy and have more knowledge, they feel more prepared to make a CCT decision. Reduced decisional conflict, in turn, is associated with the decision to enroll in a clinical trial. Our results suggest that preparation for decision-making should be a target of future interventions to improve participation in CCTs.
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Affiliation(s)
- S M Miller
- Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
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Lu Q, Zheng D, Young L, Kagawa-Singer M, Loh A. A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors. Health Psychol 2012; 31:548-51. [PMID: 22229930 DOI: 10.1037/a0026834] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Little attention has been focused on Asian American breast cancer survivor's psychological needs. No outcome-based psychosocial interventions have been reported to target at this population. Expressive writing interventions have been previously shown to improve health outcomes among non-Hispanic White breast cancer populations. This pilot study aimed to test the cultural sensitivity, feasibility, and potential health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors. METHODS Participants (N = 19) were asked to write about their deepest thoughts and feelings, their coping efforts, and positive thoughts and feelings regarding their experience with breast cancer each week for 3 weeks. Health outcomes were assessed at baseline, 3, and 6 months after the intervention. A Community-Based Participatory Research Approach (CBPR) is used. RESULTS Expressive writing was associated with medium and large effect sizes (η(p)² = 0.066∼0.208) in improving multiple health outcomes (quality of life, fatigue, posttraumatic stress, intrusive thoughts, and positive affect) at follow-ups. Participants perceived the study to be valuable. The study yielded high compliance and completion rates. CONCLUSION Expressive writing is associated with long-term improvement of health outcomes among Chinese breast cancer survivors and has the potential to be utilized as a support strategy for minority cancer survivors. In addition, CBPR is valuable in improving feasibility and cultural sensitivity of the intervention in understudied populations. Future studies employing randomized, controlled trial designs are warranted.
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Affiliation(s)
- Qian Lu
- Department of Psychology, University of Houston, Houston, TX 77204-5022, USA.
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Stepan KA, Gonzalez AP, Dorsey VS, Frye DK, Pyle ND, Smith RF, Throckmorton TA, Villejo LA, Cantor SB. Recommendations for enhancing clinical trials education: a review of the literature. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:64-71. [PMID: 20862574 DOI: 10.1007/s13187-010-0160-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study aims to apply the evidence-based practice (EBP) process to determine the factors that influence patients' understanding of, participation in, and satisfaction with clinical trials, the informed consent process, and treatment decisions and to make recommendations for improving clinical trials education. Beginning with evidence retrieval, the authors identified key search terms and searched MEDLINE--Ovid, MEDLINE--PubMed, and the Cumulative Index to Nursing and Allied Health Literature to identify articles published between July 2001 and July 2006 that highlighted clinical trials education. The articles were reviewed for clinical trials patient education information, clinician methods of communicating clinical trial information to patients, and patient satisfaction with the clinical trials process, including the informed consent process. As a result, practice changes were recommended for the patient/family, staff/community, and institution. From the literature review, 81 articles were identified. Recurring themes included decision-making, patient education, staff education, and pediatrics. Most articles focused on methods and strategies aimed at improving education at the patient/family, staff/community, and institutional levels. The issues surrounding clinical trial education are complex due to multiple variables interfering with poor patient understanding of, participation in, and satisfaction with clinical trial treatment decisions. On the basis of our findings, we recommend that clinicians involved in educating patients, families, staff, and communities about clinical trials have an awareness of and understanding for very complex issues.
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Affiliation(s)
- Karen A Stepan
- Patient Education Office, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 21, Houston, TX 77030, USA.
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Shah JY, Phadtare A, Rajgor D, Vaghasia M, Pradhan S, Zelko H, Pietrobon R. What leads Indians to participate in clinical trials? A meta-analysis of qualitative studies. PLoS One 2010; 5:e10730. [PMID: 20505754 PMCID: PMC2873955 DOI: 10.1371/journal.pone.0010730] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 04/05/2010] [Indexed: 11/19/2022] Open
Abstract
Background With the globalization of clinical trials, large developing nations have substantially increased their participation in multi-site studies. This participation has raised ethical concerns, among them the fear that local customs, habits and culture are not respected while asking potential participants to take part in study. This knowledge gap is particularly noticeable among Indian subjects, since despite the large number of participants, little is known regarding what factors affect their willingness to participate in clinical trials. Methods We conducted a meta-analysis of all studies evaluating the factors and barriers, from the perspective of potential Indian participants, contributing to their participation in clinical trials. We searched both international as well as Indian-specific bibliographic databases, including Pubmed, Cochrane, Openjgate, MedInd, Scirus and Medknow, also performing hand searches and communicating with authors to obtain additional references. We enrolled studies dealing exclusively with the participation of Indians in clinical trials. Data extraction was conducted by three researchers, with disagreement being resolved by consensus. Results Six qualitative studies and one survey were found evaluating the main themes affecting the participation of Indian subjects. Themes included Personal health benefits, Altruism, Trust in physicians, Source of extra income, Detailed knowledge, Methods for motivating participants as factors favoring, while Mistrust on trial organizations, Concerns about efficacy and safety of trials, Psychological reasons, Trial burden, Loss of confidentiality, Dependency issues, Language as the barriers. Conclusion We identified factors that facilitated and barriers that have negative implications on trial participation decisions in Indian subjects. Due consideration and weightage should be assigned to these factors while planning future trials in India.
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Affiliation(s)
- Jatin Y. Shah
- Graduate Medical School, Duke-National University of Singapore, Singapore, Singapore
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
| | - Amruta Phadtare
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
- Kalpavriksha Healthcare and Research, Thane, India
| | - Dimple Rajgor
- Graduate Medical School, Duke-National University of Singapore, Singapore, Singapore
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
| | - Meenakshi Vaghasia
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
- Kalpavriksha Healthcare and Research, Thane, India
| | - Shreyasee Pradhan
- Graduate Medical School, Duke-National University of Singapore, Singapore, Singapore
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
| | - Hilary Zelko
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Ricardo Pietrobon
- Graduate Medical School, Duke-National University of Singapore, Singapore, Singapore
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
- * E-mail:
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Edrington J, Sun A, Wong C, Dodd M, Padilla G, Paul S, Miaskowski C. A Pilot Study of Relationships Among Pain Characteristics, Mood Disturbances, and Acculturation in a Community Sample of Chinese American Patients With Cancer. Oncol Nurs Forum 2010; 37:172-81. [DOI: 10.1188/10.onf.172-181] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Li JY, Yu CH, Jiang Y. Participation in Cancer Clinical Trials as Viewed by Chinese Patients and Their Families. Oncology 2010; 79:343-8. [DOI: 10.1159/000323325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 10/18/2010] [Indexed: 11/19/2022]
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Kim JW, Kim SJ, Chung YH, Kwon JH, Lee HJ, Chung YJ, Kim YJ, Oh DY, Lee SH, Kim DW, Im SA, Kim TY, Heo DS, Bang YJ. Cancer patients' awareness of clinical trials, perceptions on the benefit and willingness to participate: Korean perspectives. Br J Cancer 2008; 99:1593-9. [PMID: 19002181 PMCID: PMC2584950 DOI: 10.1038/sj.bjc.6604750] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
To understand patients' perceptions of clinical trials (CTs) is the principal step in the enrolment of patients to CTs. However, these perceptions in eastern countries are very rare. From 12 February 2007 to 13 April 2007, we consecutively distributed the questionnaire to 842 cancer patients who initiated a first cycle of chemotherapy regardless of each treatment step in the Seoul National University Hospital. Younger age, higher educational degree, higher economic status, and possession of private cancer insurance were related with significantly higher awareness of CTs (P=0.001, P=0.006, P=0.002, and P=0.009, respectively). However, unlike awareness, perceptions on benefits of CTs were not changed according to age, educational degree, and economic status (P=0.709, P=0.920, and P=0.847, respectively). Willingness was also not changed according to age, educational degree, economic status, and private cancer insurance (P=0.381, P=0.775, P=0.887, and P=0.392, respectively). Instead, males and heavily treated patients had more positive perceptions on benefits (P=0.002 and P=0.001, respectively) and more willingness to participate in CTs (OR=1.17, 1.14–2.75: OR=1.59, 1.01–2.51, respectively). In summary, cancer patients' awareness of CTs, perceptions on the benefit in CTs, and willingness to participate are differently influenced by diverse medical and social conditions. This information would be very helpful for investigators to properly conduct CTs in eastern cancer patients.
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Affiliation(s)
- J W Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Abstract
Chinese immigrants to North America have substantially higher rates of chronic hepatitis B infection than the general population. One area for strategic development in the field of health education is the design and evaluation of English-as-a-Second language (ESL) curricula. The theoretical perspective of the Health Behavior Framework, results from a community-based survey of Chinese Canadian immigrants with limited English proficiency, and findings from focus groups of ESL instructors as well as Chinese ESL students were used to develop a hepatitis B ESL educational module. This research was conducted in Vancouver, BC. Survey data showed that less than three-fifths of the respondents had been tested for hepatitis B, and documented some important hepatitis B knowledge deficits. Further, only about one-quarter had ever received a physician recommendation for hepatitis B serologic testing. The ESL curriculum aims to both promote hepatitis B testing and improve knowledge, and includes seven different ESL exercises: Warm-up, vocabulary cards, information-gap, video, jigsaw, guided discussion, and problem/advice cards. Our quantitative and qualitative methods for curriculum development could be replicated for other health education topics and in other limited English speaking populations.
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Paskett ED, Reeves KW, McLaughlin JM, Katz ML, McAlearney AS, Ruffin MT, Halbert CH, Merete C, Davis F, Gehlert S. Recruitment of minority and underserved populations in the United States: the Centers for Population Health and Health Disparities experience. Contemp Clin Trials 2008; 29:847-61. [PMID: 18721901 PMCID: PMC2642621 DOI: 10.1016/j.cct.2008.07.006] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 07/22/2008] [Accepted: 07/28/2008] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The recruitment of minority and underserved individuals to research studies is often problematic. The purpose of this study was to describe the recruitment experiences of projects that actively recruited minority and underserved populations as part of The Centers for Population Health and Health Disparities (CPHHD) initiative. METHODS Principal investigators and research staff from 17 research projects at eight institutions across the United States were surveyed about their recruitment experiences. Investigators reported the study purpose and design, recruitment methods employed, recruitment progress, problems or challenges to recruitment, strategies used to address these problems, and difficulties resulting from Institutional Review Board (IRB) or Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements. Additionally, information was collected about participant burden and compensation. Burden was classified on a three-level scale. Recruitment results were reported as of March 31, 2007. RESULTS Recruitment attainment ranged from 52% to 184% of the participant recruitment goals. Commonly reported recruitment problems included administrative issues, and difficulties with establishing community partnerships and contacting potential participants. Long study questionnaires, extended follow-up, and narrow eligibility criteria were also problematic. The majority of projects reported difficulties with IRB approvals, though few reported issues related to HIPAA requirements. Attempted solutions to recruitment problems varied across Centers and included using multiple recruitment sites and sources and culturally appropriate invitations to participate. Participant burden and compensation varied widely across the projects, however, accrual appeared to be inversely associated with the amount of participant burden for each project. CONCLUSION Recruitment of minority and underserved populations to clinical trials is necessary to increase study generalizbility and reduce health disparities. Our results demonstrate the importance of flexible study designs which allow adaptation to recruitment challenges. These experiences also highlight the importance of involving community members and reducing participant burden to achieve success in recruiting individuals from minority and underserved populations.
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Affiliation(s)
- Electra D Paskett
- College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
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Wenzel L, Bowen D, Habbal R, Leighton N, Vu T, Anton-Culver H. Testing targeted approaches to enhance Cancer Genetics Network minority recruitment within Asian populations. ACTA ACUST UNITED AC 2008; 11:234-40. [PMID: 18417971 DOI: 10.1159/000116884] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Asian Americans have been underrepresented in cancer research. The purpose of this study was to evaluate the efficacy of a multiple arm recruitment approach in improving Asian recruitment into the Cancer Genetics Network (CGN). METHODS 1,096 potential participants, identified through cancer registries located at University of California, Irvine (UCI) and Fred Hutchinson Cancer Research Center (FHCRC), were randomly assigned to receive one of four recruitment approaches. RESULTS A 6.2% gain in Asian participation into the CGN was achieved over a 2-year period at FHCRC and UCI, which contributed a 2% CGN-wide increase in overall Asian enrollment. Site-specific differences in recruitment success by study arm were observed. CONCLUSION Novel recruitment approaches can assist in improving recruitment of Asian populations into cancer genetic research studies.
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Affiliation(s)
- Lari Wenzel
- Center for Health Policy Research, University of California, Irvine, CA 92697, USA.
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Chou FY, Dodd M, Abrams D, Padilla G. Symptoms, self-care, and quality of life of Chinese American patients with cancer. Oncol Nurs Forum 2008; 34:1162-7. [PMID: 18024342 DOI: 10.1188/07.onf.1162-1167] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the cancer symptom experience, self-care strategies, and quality of life (QOL) among Chinese Americans during outpatient chemotherapy. DESIGN Descriptive, exploratory cohort study. SETTING An outpatient infusion unit at a public urban county medical center. SAMPLE 25 Chinese-speaking patients with cancer completed the study. Participants were first-generation immigrants with low levels of acculturation; 88% could not read English; 64% had an annual household income of less than $20,000. METHODS Participants completed a basic demographics data sheet, the Suinn-Lew Acculturation Scale, the Memorial Symptom Assessment Scale and Self-Care Diary weekly for three weeks, and the Multidimensional QOL Scale-Cancer and Short-Form 36 Health Survey at the start and end of one chemotherapy cycle. Study instruments were translated into Chinese. MAIN RESEARCH VARIABLES Symptoms, self-care, QOL, and acculturation. FINDINGS Participants reported experiencing about 14 symptoms weekly. Lack of energy, hair loss, dry mouth, sleep difficulty, and loss of appetite were reported most frequently. On average, about two self-care strategies per symptom were reported and were low to moderate in effectiveness. About 20% of the sample listed Chinese medicine as part of their self-care strategies. A moderate level of QOL was reported. CONCLUSIONS Using translated standardized questionnaires can be a feasible method of data collection in studies with non-English-speaking patients. However, having well-trained, bilingual data collectors is important. More attention to long-term cancer self-management in minority patients with cancer is needed. IMPLICATIONS FOR NURSING Further research is needed with larger samples, more efficient community-based recruitment strategies, and the development and testing of culturally sensitive interventions.
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Affiliation(s)
- Fang-Yu Chou
- The School of Nursing, San Francisco State University, California, USA.
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Eggly S, Albrecht TL, Harper FWK, Foster T, Franks MM, Ruckdeschel JC. Oncologists' recommendations of clinical trial participation to patients. PATIENT EDUCATION AND COUNSELING 2008; 70:143-148. [PMID: 17983722 PMCID: PMC2248277 DOI: 10.1016/j.pec.2007.09.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Accepted: 09/22/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To describe the frequency, context and type of oncologists' recommendations to patients that they participate in a clinical trial and to analyze the relationship between recommendations and patients' decisions to participate. METHODS Data included 38 video recorded outpatient interactions during which 15 oncologists invited 38 patients to participate in clinical trials. We described the frequency, context, and type of oncologists' recommendations and analyzed the relationship between these factors and patient decisions to participate and socio-demographic characteristics. RESULTS Sixty-eight percent (n=26) of the 38 interactions included an explicit recommendation. Most recommendations were unprompted by patients and/or companions and were tailored to individual patients. A significant relationship was found between recommendations and patients' decisions to participate. Positive trends were found between receiving a recommendation and being female and having higher education. CONCLUSION Oncologists routinely make recommendations to patients during the presentation of clinical trials. These recommendations may influence patients' decisions and may occur more frequently with some demographic groups. PRACTICE IMPLICATIONS Oncologists should be aware of the potential influence of their recommendations when discussing clinical trials with patients.
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Affiliation(s)
- Susan Eggly
- Program in Communication and Behavioral Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
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Chen MS, Shinagawa SM, Bal DG, Bastani R, Chow EA, Ho RCS, Jones L, McPhee SJ, Senie R, Taylor V, Kagawa-Singer M, Stewart S, Koh HK, Li FP. Asian American Network for Cancer Awareness, Research, and Training's legacy. The first 5 years. Cancer 2007; 107:2006-14. [PMID: 16977597 DOI: 10.1002/cncr.22160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Asian American Network for Cancer Awareness, Research, and Training (AANCART) is the first special populations network for Asian Americans on a national basis and includes collaborating organizations from Boston, New York, Houston, Seattle, San Francisco, Los Angeles, Hawaii, and Sacramento (where it is headquartered at the University of California, Davis). NCI funding of AANCART in 2000 brought together investigators and leaders from 9 cities across 6 states to establish an infrastructure for addressing cancer awareness, research, and training. Since 2000, AANCART has conducted needs assessments, held community awareness activities and trainings, trained trainees, sponsored National Asian American Cancer Control Academies, and produced presentations, publications, and grants. All specific aims have been attained, including the establishment of an infrastructure to promote Asian American cancer awareness, research, and training in 4 targeted regions; the establishment of partnerships to promote accrual to clinical trials, training, and pilot studies; and the formulation and successful implementation of grant-funded research to reduce the cancer burden among Asian Americans. AANCART's first 5 years have increased cancer awareness, trained special populations scientists, and advanced the field of Asian American cancer control research. Cancer 2006. (c) 2006 American Cancer Society.
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Affiliation(s)
- Moon S Chen
- Asian American Network for Cancer Awareness, Research, and Training (AANCART), Department of Public Health Sciences, University of California-Davis, Sacramento, California 95817, USA.
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