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Sylla L, Patel H, Louella M, Simoni J, Dubé K. Community HIV clinicians' perceptions about HIV cure-related research in the Northwestern United States. HIV Res Clin Pract 2022; 23:61-75. [PMID: 35904107 PMCID: PMC9836364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background: Research on stakeholder perspectives of HIV cure research has involved people with HIV (PWH), who generally cite the importance of HIV clinician advice in making decisions about trial participation. However, there has been little exploration of non-researcher community HIV clinician perspectives, which are clearly critical to the success of HIV cure-related research.Objective: We aimed to learn how community HIV clinicians perceive HIV cure research and identify factors that would lead them to support or discourage HIV cure trial participation by their patients.Methods: We recruited a purposive sample of 12 community HIV clinicians in metro-Seattle, WA to participate in structured interviews. We completed 11 interviews via teleconference and received one written response. We used conventional content analysis to analyze the data.Results: Overall, community HIV clinicians were supportive of patient participation in HIV cure trials. Factors affecting support included knowledge of local trials, ease of referral, patient immune function and health stability, study risks and benefits, burden of study requirements, patient characteristics, patient life stability, potential impact on engagement in care, study communication plans, and beliefs that patients should have the autonomy to decide to participate. Participants had concerns about trials requiring treatment delays or interruptions and HIV transmission risk. While their knowledge of the field was limited, they were interested in learning more about open HIV cure trials.Conclusions: It would benefit the HIV cure research community if those leading HIV cure trials make stronger efforts to engage community clinicians who care for PWH, but are not active researchers, early in the trial design process. Such engagement prior to launching HIV cure trials will improve trial designs, leading to better enrollment and retention within these important studies.
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Affiliation(s)
- Laurie Sylla
- defeatHIV Collaboratory, 1100 Fairview Avenue North, E5-110, Seattle, WA, 98109, USA,University of Washington, School of Medicine, Division of Allergy and Infectious Diseases, Mountain West AIDS Education & Training Center, Mailstop 359932, Seattle, WA 98104
| | - Hursch Patel
- University of North Carolina Chapel Hill, Gillings School of Global Public Health, 4108 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA
| | - Michael Louella
- defeatHIV Collaboratory, 1100 Fairview Avenue North, E5-110, Seattle, WA, 98109, USA
| | - Jane Simoni
- University of Washington, Departments of Psychology and Global Health, 3909 Stevens Way CE, Box 351525, Seattle, WA, USA
| | - Karine Dubé
- University of North Carolina Chapel Hill, Gillings School of Global Public Health, 4108 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA
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Lee E, Wen P. Gender and sex disparity in cancer trials. ESMO Open 2021; 5:e000773. [PMID: 32816862 PMCID: PMC7440710 DOI: 10.1136/esmoopen-2020-000773] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/27/2022] Open
Abstract
The study population within phase III clinical trials leading to approval of new cancer agents should ideally more closely mirror the population who will ultimately receive these agents. Although the number of females participating in clinical trials has increased over the past several decades, females are still under-represented in preclinical studies, in early phase clinical trials and even in some later phase cancer clinical trials. In the USA, this is particularly true for women from minority populations and elderly women. In this review, we review gender and sex disparities in cancer trials, the reasons for these disparities, the barriers to clinical trial enrolment and ways to improve diversity in cancer clinical trials.
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Affiliation(s)
- Eudocia Lee
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - Patrick Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
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Chalela P, Muñoz E, Gallion KJ, Kaklamani V, Ramirez AG. Empowering Latina breast cancer patients to make informed decisions about clinical trials: a pilot study. Transl Behav Med 2018; 8:439-449. [PMID: 29800408 DOI: 10.1093/tbm/ibx083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Minority representation in clinical trials is vital for researchers to assess differential effects in outcomes of therapies on biological and genetic characteristics among groups. This study assessed the effect of Choices, a bilingual multi-component intervention, on perceived understanding of clinical trials, agreement with stages of decision readiness and consideration of clinical trials as a treatment option, among Latina breast cancer patients. This randomized controlled pilot study compared Choices with a control condition providing general clinical trial information to eligible patients. Seventy-seven Latina breast cancer patients were randomly assigned to either Choices (n = 38) or the control (n = 39). Choices included three components: an educational interactive video, a low-literacy booklet, and care coordination by patient navigation (i.e., educational and psychosocial support, coordinating appointments, translating, interacting with the medical team). Choices was more effective than the control in improving perceived understanding of clinical trials (p = .033) and increasing consideration of clinical trials as a treatment option (p = .008). Additionally, intervention participants showed significant changes between baseline and post-intervention on agreement with stages of decision readiness statements (p < .002) than control participants (p > .05); the percentage of intervention women in agreement with preparation to action statements increased from 52.8% at baseline to 86.1% at post-intervention, and those in agreement with ready to action stages rose from 50.0% to 88.9%. Computer-based videos and care coordination provided by patient navigation-specifically tailored to Latinos-are effective strategies to successfully address awareness, and improved decision-making skills to make informed decisions about clinical trial participation.
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Affiliation(s)
- Patricia Chalela
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Edgar Muñoz
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Kipling J Gallion
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Virginia Kaklamani
- Cancer Therapy and Research Center, UT Health San Antonio, San Antonio, USA
| | - Amelie G Ramirez
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
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Re-inventing drug development: A case study of the I-SPY 2 breast cancer clinical trials program. Contemp Clin Trials 2017; 62:168-174. [PMID: 28899813 DOI: 10.1016/j.cct.2017.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 09/04/2017] [Accepted: 09/07/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND In this case study, we profile the I-SPY 2 TRIAL (Investigation of Serial studies to Predict Your Therapeutic Response with Imaging And molecular anaLysis 2), a unique breast cancer clinical trial led by researchers at 20 leading cancer centers across the US, and examine its potential to serve as a model of drug development for other disease areas. This multicenter collaboration launched in 2010 to reengineer the drug development process to be more efficient and patient-centered. METHODS We conduct several interviews with the I-SPY leadership as well as a literature review of relevant publications to assess the I-SPY 2 initiative. RESULTS To date, six drugs have graduated from I-SPY 2, identified as excellent candidates for phase 3 trials in their corresponding tumor subtype, and several others have been or are still being evaluated. These trials are also more efficient, typically involving fewer subjects and reaching conclusions more quickly, and candidates have more than twice the predicted likelihood of success in a smaller phase 3 setting compared to traditional trials. CONCLUSIONS We observe that I-SPY 2 possesses several novel features that could be used as a template for more efficient and cost effective drug development, namely its adaptive trial design; precompetitive network of stakeholders; and flexible infrastructure to accommodate innovation.
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Wuensch A, Goelz T, Ihorst G, Terris DD, Bertz H, Bengel J, Wirsching M, Fritzsche K. Effect of individualized communication skills training on physicians' discussion of clinical trials in oncology: results from a randomized controlled trial. BMC Cancer 2017; 17:264. [PMID: 28403837 PMCID: PMC5390387 DOI: 10.1186/s12885-017-3238-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 03/28/2017] [Indexed: 11/18/2022] Open
Abstract
Background Discussing randomized clinical trials (RCTs) with cancer patients is one of the most challenging communication tasks a physician faces. Only two prior Communication Skills Trainings (CSTs) focused on RCTs in oncology have been reported. Their results demonstrated the need for further improvement. We developed and evaluated an enhanced, individually-tailored CST focused on improving physicians’ communication during discussions of RCTs. Methods The CST focused on personal learning goals derived from video pre-assessment that were addressed in a 1.5-day group workshop and one-on-one coaching sessions. Forty physicians were recruited and randomly assigned to intervention and control groups. Video-recorded standardized consultations with actor-patients were utilized. As a primary outcome (1), training success was evaluated by blinded raters using a previously developed checklist. Change in checklist items was evaluated between pre- and post-training assessment and compared against control group results. As a secondary outcome (2), the physicians’ feeling of confidence was assessed by a questionnaire. Results (1) Significant improvements in the intervention group were observed for the score on all items (p = 0.03), for the subgroup of content-specific items (p = 0.02), and for the global rating of communication competence (p = 0.04). The improvement observed for the subgroup of general communication skill items did not achieve significance (p = 0.20). (2) The feeling of confidence improved in nine out of ten domains. Conclusion While the individually-tailored CST program significantly improved the physicians’ discussions of RCTs, specifically related to discussion content, what remains unknown is the influence of such programs in practice on participant recruitment rates. The study was registered retrospectively in 2010/07/22 under DRKS-ID: DRKS00000492. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3238-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander Wuensch
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstr. 8, D-79104, Freiburg, Germany. .,Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Langerstrasse 3, D-81675, Munich, Germany.
| | - Tanja Goelz
- Department of Internal Medicine I (Hematology and Oncology), Medical Center - University of Freiburg, Faculty of Medicine, Hugstetterstr. 55, D-79106, Freiburg, Germany.,Center for Pediatrics, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Mathildenstr.1, D-79106, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit (CTU), Medical Center - University of Freiburg, Faculty of Medicine, Elsaesser Str. 2, D-79110, Freiburg, Germany
| | - Darcey D Terris
- Center for Family Research, University of Georgia, 1095 College Station Rd, Athens, GA, 30602, USA
| | - Hartmut Bertz
- Department of Internal Medicine I (Hematology and Oncology), Medical Center - University of Freiburg, Faculty of Medicine, Hugstetterstr. 55, D-79106, Freiburg, Germany
| | - Juergen Bengel
- Institute of Psychology, Department Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Engelbergerstr. 41, D-79106, Freiburg, Germany
| | - Michael Wirsching
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstr. 8, D-79104, Freiburg, Germany
| | - Kurt Fritzsche
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstr. 8, D-79104, Freiburg, Germany
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Geana M, Erba J, Krebill H, Doolittle G, Madhusudhana S, Qasem A, Malomo N, Sharp D. Searching for cures: Inner-city and rural patients' awareness and perceptions of cancer clinical trials. Contemp Clin Trials Commun 2017; 5:72-79. [PMID: 29740623 PMCID: PMC5936702 DOI: 10.1016/j.conctc.2016.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/22/2016] [Accepted: 12/12/2016] [Indexed: 11/25/2022] Open
Abstract
Fewer than 5% of cancer patients participate in clinical trials, making it challenging to test new therapies or interventions for cancer. Even within that small number, patients living in inner-city and rural areas are underrepresented in clinical trials. This study explores cancer patients' awareness and perceptions of cancer clinical trials, as well as their perceptions of patient-provider interactions related to discussing cancer clinical trials in order to improve accrual in cancer clinical trials. Interviews with 66 former and current in inner-city and rural cancer patients revealed a lack of awareness and understanding about clinical trials, as well as misconceptions about what clinical trials entail. Findings also revealed that commercials and television shows play a prominent role in forming inner-city and rural patients' attitudes and/or misconceptions about clinical trials. However, rural patients were more likely to hold unfavorable views about clinical trials than inner-city patients. Patient-provider discussions emerged as being crucial for increasing awareness of clinical trials among patients and recruiting them to trials. Findings from this study will inform communication strategies to enhance recruitment to cancer clinical trials by increasing awareness and countering misconceptions about clinical trials.
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Affiliation(s)
- Mugur Geana
- William Allen White School of Journalism and Mass Communications, The University of Kansas, 1435 Jayhawk Blvd., Lawrence, KS 66045, USA
| | - Joseph Erba
- William Allen White School of Journalism and Mass Communications, The University of Kansas, 1435 Jayhawk Blvd., Lawrence, KS 66045, USA
| | - Hope Krebill
- Midwest Cancer Alliance, 4350 Shawnee Mission Parkway, Fairway, KS 66205, USA
| | - Gary Doolittle
- School of Medicine, The University of Kansas Cancer Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA
| | - Sheshadri Madhusudhana
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
| | - Abdulraheem Qasem
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
| | - Nikki Malomo
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
| | - Denise Sharp
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
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Smith SG, Sestak I, Forster A, Partridge A, Side L, Wolf MS, Horne R, Wardle J, Cuzick J. Factors affecting uptake and adherence to breast cancer chemoprevention: a systematic review and meta-analysis. Ann Oncol 2016; 27:575-90. [PMID: 26646754 PMCID: PMC4803450 DOI: 10.1093/annonc/mdv590] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/29/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Preventive therapy is a risk reduction option for women who have an increased risk of breast cancer. The effectiveness of preventive therapy to reduce breast cancer incidence depends on adequate levels of uptake and adherence to therapy. We aimed to systematically review articles reporting uptake and adherence to therapeutic agents to prevent breast cancer among women at increased risk, and identify the psychological, clinical and demographic factors affecting these outcomes. DESIGN Searches were carried out in PubMed, CINAHL, EMBASE and PsychInfo, yielding 3851 unique articles. Title, abstract and full text screening left 53 articles, and a further 4 studies were identified from reference lists, giving a total of 57. This review was prospectively registered with PROSPERO (CRD42014014957). RESULTS Twenty-four articles reporting 26 studies of uptake in 21 423 women were included in a meta-analysis. The pooled uptake estimate was 16.3% [95% confidence interval (CI) 13.6-19.0], with high heterogeneity (I(2) = 98.9%, P < 0.001). Uptake was unaffected by study location or agent, but was significantly higher in trials [25.2% (95% CI 18.3-32.2)] than in non-trial settings [8.7% (95% CI 6.8-10.9)] (P < 0.001). Factors associated with higher uptake included having an abnormal biopsy, a physician recommendation, higher objective risk, fewer side-effect or trial concerns, and older age. Adherence (day-to-day use or persistence) over the first year was adequate. However, only one study reported a persistence of ≥ 80% by 5 years. Factors associated with lower adherence included allocation to tamoxifen (versus placebo or raloxifene), depression, smoking and older age. Risk of breast cancer was discussed in all qualitative studies. CONCLUSION Uptake of therapeutic agents for the prevention of breast cancer is low, and long-term persistence is often insufficient for women to experience the full preventive effect. Uptake is higher in trials, suggesting further work should focus on implementing preventive therapy within routine care.
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Affiliation(s)
- S G Smith
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London Health Behaviour Research Centre, University College London, London, UK
| | - I Sestak
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London
| | - A Forster
- Health Behaviour Research Centre, University College London, London, UK
| | - A Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - L Side
- Institute for Women's Health, University College London, London, UK
| | - M S Wolf
- Division of General Internal Medicine, Northwestern University, Chicago, USA
| | - R Horne
- Centre for Behavioural Medicine, University College London, London, UK
| | - J Wardle
- Health Behaviour Research Centre, University College London, London, UK
| | - J Cuzick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London
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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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Chalela P, Suarez L, Muñoz E, Gallion KJ, Pollock BH, Weitman SD, Karnad A, Ramirez AG. Promoting Factors and Barriers to Participation in Early Phase Clinical Trials: Patients Perspectives. JOURNAL OF COMMUNITY MEDICINE & HEALTH EDUCATION 2014; 4:1000281. [PMID: 25077043 PMCID: PMC4112537 DOI: 10.4172/2161-0711.1000281] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Inclusion of minorities in clinical research is an essential step to develop novel cancer treatments, improve health care overall, understand potential differences in pharmacogenomics and address minorities' disproportionate cancer burden. However, Latinos and other minority groups continue to be critically underrepresented, particularly in early-phase clinical trials (EPCTs). The objective of the present study was to explore barriers and promoting factors influencing patients' decisions to enroll or not in early phase clinical trials (EPCTs) and identify areas for intervention to increase minority enrollment into clinical research. METHODS An interviewer-administered survey was conducted with 100 cancer patients in the predominantly Latino region of South Texas. Exploratory factor analysis was conducted to identify underlying dimensions, and multiple logistic regression assessed significant factors that promote or deter patients enrollment to EPCTs. In addition, a separate subgroup mean analysis assessed differences by enrollment status and race/ethnicity. RESULTS For one standard deviation increase in the importance given to the possibility of symptoms improvement, the predicted odds of refusing enrollment were 3.20 times greater (OR=3.20, 95% CI=1.06-9.71, p 0.040). Regarding barriers, among patients who considered fear/uncertainty of the new treatment a deterrent to enrollment, one standard deviation increase in agreement with these barriers was associated with a 3.60 increase (OR=3.60, 95% CI=1.30-9.97h, p 0.014) in the odds of not being enrolled in an EPCT. In contrast, non-enrolled patients were less likely (OR=0.14, 95% CI=0.05-0.44, p 0.001) to consider fatalistic beliefs as an important barrier. CONCLUSION This study, one of the first to identify South Texas patients' barriers to enroll in EPCTs, highlights potential focal areas to increase participation of both minority and non-minority patients in clinical research. Culturally tailored interventions promoting patient-centered care and bilingual, culturally competent study teams could solve common barriers and enhance Latinos' likelihood of joining clinical trials. These interventions may simultaneously increase opportunities to involve patients and physicians in clinical trials, while ensuring the benefits of participation are equitably distributed to all patients.
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Affiliation(s)
- Patricia Chalela
- Institute for Health Promotion Research The University of Texas Health Science Center at San Antonio 7411 John Smith Dr., Suite 1000 San Antonio, TX 78229
| | | | - Edgar Muñoz
- Institute for Health Promotion Research The University of Texas Health Science Center at San Antonio 7411 John Smith Dr., Suite 1000 San Antonio, TX 78229
| | - Kipling J Gallion
- Institute for Health Promotion Research The University of Texas Health Science Center at San Antonio 7411 John Smith Dr., Suite 1000 San Antonio, TX 78229
| | - Brad H Pollock
- Department of Epidemiology and Biostatistics The University of Texas Health Science Center at San Antonio 7703 Floyd Curl Ave., Mail Code 7933 San Antonio, TX 78229-3901
| | - Steven D Weitman
- The University of Texas Health Science Center at San Antonio Cancer Therapy & Research Center Institute for Drug Development 7979 Wurzbach Road, Room Z459 San Antonio, Texas 78229
| | - Anand Karnad
- The University of Texas Health Science Center at San Antonio Cancer Therapy & Research Center Institute for Drug Development 7979 Wurzbach Road, Room Z459 San Antonio, Texas 78229
| | - Amelie G Ramirez
- Institute for Health Promotion Research The University of Texas Health Science Center at San Antonio 7411 John Smith Dr., Suite 1000 San Antonio, TX 78229
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Habersack M, Luschin G. Insecurities of women regarding breast cancer research: a qualitative study. PLoS One 2013; 8:e81770. [PMID: 24312584 PMCID: PMC3847121 DOI: 10.1371/journal.pone.0081770] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 10/16/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives Only 1.2%–11% of all potential study participants participate in cancer studies. Low participation rates can result in bias or in a failure to obtain data saturation. Subject-scientific psychology assumes that reasons for acting are based on individual premises. The objective of this study was to render reproducible individual reasons of female breast cancer patients to participate or not participate in breast cancer studies using a qualitative approach. Methods Problem-based interviews were conducted with female breast cancer patients. The selection of interview partners continued until theoretical data saturation was achieved. Results As main arguments against participation emotional overload and too many medication side-effects were stated. Improvement of health-related values, long-term protection and comprehensive follow-up exams were stated as arguments for participation. Trust in the attending physician was mentioned as influencing both participation and non-participation. Conclusions A significant influential factor determining willingness to participate in studies was one's contentment with patient-physician communication. In order to guarantee an adequate patient decision-making process, keeping existing standards for patient briefings is absolutely mandatory.
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Affiliation(s)
- Marion Habersack
- Office of the Vice Rector for Teaching and Studies, Medical University Graz, Graz, Austria
- * E-mail:
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Luschin G, Habersack M, Gerlich IA. Reasons for and against participation in studies of medicinal therapies for women with breast cancer: a debate. BMC Med Res Methodol 2012; 12:25. [PMID: 22405127 PMCID: PMC3329416 DOI: 10.1186/1471-2288-12-25] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 03/11/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A special challenge for research studies of breast cancer among females is low patient participation rates. We compiled this systematic review to identify reasons why women with, or at high risk of, breast cancer do or do not participate in medicinal studies of breast cancer. METHOD A systematic literature search in the databases Cochrane Library, EMBASE, Medline, Pascal Biomed, ACP Journal Club and CINAHL, as well as searches through reference lists of relevant texts, was performed. RESULTS Of 39 relevant full texts, ultimately, nine studies (1 qualitative, 8 quantitative) were included after applying the inclusion criteria. Despite a lack of data material, it was possible to identify various factors influencing women's willingness to participate in medicinal studies and group them into three categories: person-related, study-related, and physician-related. CONCLUSION Reasons for or against participation in studies of medicinal therapies by women with, or at high risk of, breast cancer are multi-dimensional, and should be considered when planning such studies to garner higher participation rates. For a more comprehensive picture of factors that affect participation, further studies in this field are recommended.
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Affiliation(s)
- Gero Luschin
- Medical University Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
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