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Cakici JA, Dimmock D, Caylor S, Gaughran M, Clarke C, Triplett C, Clark MM, Kingsmore SF, Bloss CS. Assessing Diversity in Newborn Genomic Sequencing Research Recruitment: Race/Ethnicity and Primary Spoken Language Variation in Eligibility, Enrollment, and Reasons for Declining. Clin Ther 2023; 45:736-744. [PMID: 37429778 DOI: 10.1016/j.clinthera.2023.06.014] [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: 01/26/2023] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Diagnostic genomic research has the potential to directly benefit participants. This study sought to identify barriers to equitable enrollment of acutely ill newborns into a diagnostic genomic sequencing research study. METHODS We reviewed the 16-month recruitment process of a diagnostic genomic research study enrolling newborns admitted to the neonatal intensive care unit at a regional pediatric hospital that primarily serves English- and Spanish-speaking families. Differences in eligibility, enrollment, and reasons for not enrolling were examined as functions of race/ethnicity and primary spoken language. FINDINGS Of the 1248 newborns admitted to the neonatal intensive care unit, 46% (n = 580) were eligible, and 17% (n = 213) were enrolled. Of the 16 languages represented among the newborns' families, 4 (25%) had translated consent documents. Speaking a language other than English or Spanish increased a newborn's likelihood of being ineligible by 5.9 times (P < 0.001) after controlling for race/ethnicity. The main reason for ineligibility was documented as the clinical team declined having their patient recruited (41% [51 of 125]). This reason significantly affected families who spoke languages other than English or Spanish and was able to be remediated with training of the research staff. Stress (20% [18 of 90]) and the study intervention(s) (20% [18 of 90]) were the main reasons given for not enrolling. IMPLICATIONS This analysis of eligibility, enrollment, and reasons for not enrolling in a diagnostic genomic research study found that recruitment generally did not differ as a function of a newborn's race/ethnicity. However, differences were observed depending on the parent's primary spoken language. Regular monitoring and training can improve equitable enrollment into diagnostic genomic research. There are also opportunities at the federal level to improve access to those with limited English proficiency and thus decrease disparities in representation in research participation.
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Affiliation(s)
- Julie A Cakici
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, USA; School of Public Health, San Diego State University, San Diego, California, USA
| | - David Dimmock
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California, USA
| | - Sara Caylor
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California, USA
| | - Mary Gaughran
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California, USA
| | - Christina Clarke
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California, USA
| | | | - Michelle M Clark
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California, USA
| | - Stephen F Kingsmore
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California, USA
| | - Cinnamon S Bloss
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, USA.
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Gao H, Cao B, Dang N, Gu S, Xu M, Ji B, Shi Y, Liu S, Wang C. Comparison of factors influencing the willingness to donate biospecimens among guardians of children with cancer and adult cancer patients. Cancer Med 2022; 11:1524-1534. [PMID: 35112506 PMCID: PMC8921908 DOI: 10.1002/cam4.4544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 12/03/2022] Open
Abstract
Background This study examined and compared the attitudes and willingness of guardians of children with cancer and adult cancer patients toward donating biospecimens and clinical data for cancer research. Methods We conducted a cross‐sectional study among guardians of children with cancer (Guardian group) from Shanghai Children's Medical Center and adult cancer patients (Adult group) from Shanghai Ninth People's Hospital between February 1, 2019, and January 31, 2020. Participants’ demographic data, willingness, and motivations for biospecimen donation were collected and analyzed. Results Of 670 participants, 90.8% (318/350) in the Guardian group and 88.1% (282/320) in the Adult group completed the questionnaire. Most participants were willing to donate residual tissue samples (92.8% in the Guardian group vs. 79.4% in the Adult group, pψ = 0.032) and clinical data (94.0% vs. 72.3%, pψ < 0.001) for medical research. Logistic regression analysis indicated that only child status (odds ratio [OR] = 0.140, p = 0.02), history of blood donation (OR = 4.467, p = 0.019) in the Guardian group, education (OR = 0.387, p = 0.037), and history of blood donation (OR = 2.556, p = 0.016) in the Adult group were significantly associated with participants’ willingness to donate biospecimens. The primary motivation for donation was helping other patients with cancer (65.4% vs. 24.5%, pψ < 0.001). The major barriers to donation were the potential to cause physical discomfort (61.0% vs. 64.9%, pψ = 0.032). Conclusions Guardians of children with cancer were more willing to donate biospecimens than adult cancer patients in China. It is essential to promote awareness of biospecimens donation, especially in adult cancer patients.
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Affiliation(s)
- Hongxiang Gao
- Department of Pediatric General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Baige Cao
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Nan Dang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Song Gu
- Department of Pediatric General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Xu
- Department of Pediatric General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Ji
- Department of Operating Room, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqi Shi
- Clinical Research Center for Cell Therapy, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Pediatric Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congrong Wang
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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Fox L, Wylie H, Haire A, Green S, Kibaru J, Van Hemelrijck M. "Something Good Has to Come Out of the Horror": A Qualitative Examination of Cancer Survivors' Attitudes Towards Participation in Research During the First Year of the COVID-19 Pandemic. Front Public Health 2021; 9:741188. [PMID: 34778175 PMCID: PMC8585927 DOI: 10.3389/fpubh.2021.741188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The first year of the COVID-19 pandemic has been highly disruptive for people with cancer. Furthermore, it has been shown that accrual to cancer trials dropped substantially in 2020. Building on findings from a previous pilot survey, the present study used qualitative methods to gain insights into attitudes towards participation in research studies amongst people who have experienced cancer, in the context of the first year of the COVID-19 pandemic. Materials and Methods: We interviewed 13 participants from the UK, who were purposively sampled, including a broad sample of cancer types, and a mixture of individuals who have and have not taken part in research previously. Participants underwent semi-structured interviews (median interview duration: 47 min) and were asked open-ended questions about their attitude towards and experiences with COVID-19, and their attitude towards research participation. In addition to this, prompts were used to ask participants about concerns that were highlighted by our previous quantitative work on this topic, such as concerns about being older or having to travel to participate. Interview transcripts were analysed using a framework analysis approach. Results: Our findings suggest that cancer patient decision-making about research participation during an infectious disease pandemic may be a function of a basic cost-benefit analysis, which considers the benefit of taking part, either personally to themselves or to wider society. The benefit may then be weighed by the patient against the risk of being infected, which may be influenced by trust in the relevant clinicians/researchers; familiarity with the study location; provision of detailed information on safety protocols for infectious disease; and, in particular, the availability of safe transport to and from the study location. Discussion: Some cancer patients say that they would be less likely to participate in a research study in the middle of an infectious disease pandemic due to an increased risk to themselves. Patients' perceived risk to themselves from participating may be ameliorated via the provision of certain practical solutions that can be considered at the study protocol design stage, such as safe travel, information, and the use of staff and study sites familiar to the patient.
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Affiliation(s)
- Louis Fox
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
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Barrett NJ, Ingraham KL, Bethea K, Hwa-Lin P, Chirinos M, Fish LJ, Randolph S, Zhang P, Le P, Harvey D, Godbee RL, Patierno SR. Project PLACE: Enhancing community and academic partnerships to describe and address health disparities. Adv Cancer Res 2020; 146:167-188. [PMID: 32241388 DOI: 10.1016/bs.acr.2020.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Achieving cancer health equity is a national imperative. Cancer is the second leading cause of death in the United States and in North Carolina (NC), where the disease disproportionately impacts traditionally underrepresented race and ethnic groups, those who live in rural communities, the impoverished, and medically disenfranchised and/or health-disparate populations at high-risk for cancer. These populations have worse cancer outcomes and are less likely to be participants in clinical research and trials. It is critical for cancer centers and other academic health centers to understand the factors that contribute to poor cancer outcomes, the extent to which they impact the cancer burden, and develop effective interventions to address them. Key to this process is engaging diverse stakeholders in the development and execution of community and population health assessments, and the subsequent programs and interventions designed to address the need across the catchment area. This chapter describes the processes and lessons learned of the Duke Cancer Institute's (DCI) long standing community partnerships that led to Project PLACE (Population Level Approaches to Cancer Elimination), a National Cancer Institute (NCI)-funded community health assessment reaching 2315 respondents in 7 months, resulting in a community partnered research agenda to advance cancer equity within the DCI catchment area. We illustrate the application of a community partnered health assessment and offer examples of strategic opportunities, successes, lessons learned, and implications for practice.
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Affiliation(s)
- Nadine J Barrett
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States; Department of Family Medicine and Community Health, Duke School of Medicine, Durham, NC, United States; Duke Clinical and Translational Science Institute, Duke University School of Medicine, Durham, NC, United States.
| | - Kearston L Ingraham
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
| | - Kenisha Bethea
- Duke Clinical and Translational Science Institute, Duke University School of Medicine, Durham, NC, United States
| | - Pao Hwa-Lin
- Chinese Christian Church, Raleigh, NC, United States; Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | | | - Laura J Fish
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
| | | | - Ping Zhang
- Chinese American Friendly Association, Raleigh, NC, United States
| | - Peter Le
- St. Joseph's Primary Care, Raleigh, NC, United States
| | - Demetrius Harvey
- Black Men's Health Initiative, Wilson, NC, United States; Alumni Chapter of Kappa Alpha Psi Fraternity, Inc., Smithfield, NC, United States
| | | | - Steven R Patierno
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, NC, United States
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Barrett NJ, Rodriguez EM, Iachan R, Hyslop T, Ingraham KL, Le GM, Martin K, Haring RC, Rivadeneira NA, Erwin DO, Fish LJ, Middleton D, Hiatt RA, Patierno SR, Sarkar U, Gage-Bouchard EA. Factors associated with biomedical research participation within community-based samples across 3 National Cancer Institute-designated cancer centers. Cancer 2020; 126:1077-1089. [PMID: 31909824 DOI: 10.1002/cncr.32487] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/21/2019] [Accepted: 05/27/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Engaging diverse populations in biomedical research, including biospecimen donation, remains a national challenge. This study examined factors associated with an invitation to participate in biomedical research, intent to participate in biomedical research in the future, and participation in biomedical research and biospecimen donation among a diverse, multilingual, community-based sample across 3 distinct geographic areas. METHODS Three National Cancer Institute-designated cancer centers engaged in community partnerships to develop and implement population health assessments, reaching a convenience sample of 4343 participants spanning their respective catchment areas. Data harmonization, multiple imputation, and multivariable logistic modeling were used. RESULTS African Americans, Hispanic/Latinos, and other racial minority groups were more likely to be offered opportunities to participate in biomedical research compared to whites. Access to care, history of cancer, educational level, survey language, nativity, and rural residence also influenced opportunity, intent, and actual participation in biomedical research. CONCLUSIONS Traditionally underserved racial and ethnic groups reported heightened opportunity and interest in participating in biomedical research. Well-established community partnerships and long-standing community engagement around biomedical research led to a diverse sample being reached at each site and may in part explain the current study findings. However, this study illustrates an ongoing need to establish trust and diversify biomedical research participation through innovative and tailored approaches. National Cancer Institute-designated cancer centers have the potential to increase opportunities for diverse participation in biomedical research through community partnerships and engagement. Additional work remains to identify and address system-level and individual-level barriers to participation in both clinical trials and biospecimen donation for research.
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Affiliation(s)
- Nadine J Barrett
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina.,Department of Community and Family Medicine, Duke School of Medicine, Durham, North Carolina.,Duke Clinical and Translational Science Institute, Duke University School of Medicine, Durham, North Carolina
| | - Elisa M Rodriguez
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Terry Hyslop
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina.,Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Kearston L Ingraham
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Gem M Le
- Center for Vulnerable Populations, Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California
| | | | - Rodney C Haring
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Natalie A Rivadeneira
- Center for Vulnerable Populations, Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California.,Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California
| | - Deborah O Erwin
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Laura J Fish
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | | | - Robert A Hiatt
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, California.,Department of Epidemiology and Biostatistics, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Steven R Patierno
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina.,Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Urmimala Sarkar
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, California
| | - Elizabeth A Gage-Bouchard
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Chen MS, Chow EA, Nguyen TT. The Asian American Network for Cancer Awareness, Research, and Training (AANCART)'s contributions toward reducing Asian American cancer health disparities, 2000-2017. Cancer 2019; 124 Suppl 7:1527-1534. [PMID: 29578598 DOI: 10.1002/cncr.31103] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 10/10/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND In 2000 and in 2 subsequent 5-year cycles, the National Cancer Institute funded grantees on a regional and national basis to address community needs for cancer awareness, research, and training. The Asian American Network for Cancer Awareness, Research and Training (AANCART) is fortunate to have been funded since 2000 to focus on mitigating cancer health disparities facing Asian Americans residing primarily in California and Hawaii. This article highlights AANCART's achievements with respect to the original specific aims and unanticipated outcomes in its most recent funded cycle. METHODS Sources included reports to the National Cancer Institute and peer-reviewed articles as well as the insights of the 3 principal investigators. RESULTS All aims of the original application (infrastructure, outreach, research, and training) were attained or exceeded. Most distinctive was the completion and publication of 8 randomized controlled trials to address Asian American cancer health disparities and its nurture of 14 new and early stage investigators who have been productive in terms of research career trajectories. CONCLUSIONS AANCART is contributing to mitigating Asian American cancer health disparities by catalyzing academic and community collaborations that have resulted in linguistically specific and culturally tailored educational products, scientifically rigorous interventions addressed at cancer risk factors, and nurturing new and early stage Asian American cancer investigators. Cancer 2018;124:1527-34. © 2018 American Cancer Society.
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Affiliation(s)
- Moon S Chen
- Division of Hematology and Oncology, University of California, Davis, School of Medicine, Sacramento, California.,Cancer Control/Cancer Health Disparities, UC Davis Comprehensive Cancer Center, Sacramento, California
| | - Edward A Chow
- Jade Health Care Medical Group, San Francisco, California.,San Francisco Health Commission, San Francisco, California
| | - Tung T Nguyen
- Department of Medicine, University of California, San Francisco, San Francisco, CA
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