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Tzelios C, Velasco M, Saadi A. Latine Immigrant Perspectives on Trust of Clinical Research. HISPANIC HEALTH CARE INTERNATIONAL 2024:15404153241286745. [PMID: 39360372 DOI: 10.1177/15404153241286745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Introduction: Medical mistrust impedes minority group participation in research, but there are few studies assessing determinants of Latine immigrants' trust in the clinical research enterprise. This qualitative study explored Latine immigrants' perspectives of clinical research. Methods: We conducted telephonic interviews with 20 Latine immigrants receiving care at a Federally Qualified Health Center in Los Angeles, California. Interviews were conducted between December 2021 and April 2022, and resultant data were coded using thematic analysis. Results: Six main themes emerged across two domains. First, trust was influenced by perceptions of the investigators' intentions. These perceptions were primarily based on (1) adequacy of information provided about the research, (2) perceived intent of investigators to respect their humanity, and (3) opportunities to share personal experiences. Second, trust was influenced by perceptions of the study's potential impact, including (4) risk of adverse outcomes, including health risks and risk of immigration status exposure, (5) perceived personal benefits, and (6) perceived community-level benefits. Conclusion: Researchers can build trust and promote participation among Latine immigrants by effectively communicating study objectives, risk mitigation efforts, and personal and community benefits. Enhancing the trustworthiness of clinical research can increase the relevance of scientific findings, representing one pathway to achieving health equity.
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Affiliation(s)
| | - Margarita Velasco
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Altaf Saadi
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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Weiss EM, Gray MM, Ko LK, Duenas DM, Oslin E, Kraft SA. Development of the Better Research Interactions for Every Family (BRIEF) intervention to support recruitment for neonatal clinical trials: an intervention mapping guided approach. Trials 2024; 25:610. [PMID: 39267164 PMCID: PMC11395641 DOI: 10.1186/s13063-024-08446-6] [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: 03/27/2024] [Accepted: 09/02/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND Recruitment for neonatal clinical trials can be particularly challenging. Low enrollment rates bias the research population and decrease generalizability of findings. We identified a critical need for an intervention to improve how researchers recruit for neonatal clinical trials. Working within the US neonatal research context, we developed the Better Research Interactions for Every Family (BRIEF) Intervention, which had two overarching goals: to improve the recruitment experience for all parents, focusing on minoritized populations, and to increase participation, focusing on decreasing disparities in research participation. METHODS We used intervention mapping (IM) to guide all steps of intervention development. IM is a planning framework that provides a systematic process and detailed protocol for step-by-step decision-making for intervention development, implementation, and evaluation. RESULTS We performed IM's six steps. In step 1, we convened two stakeholder groups, a parent panel and an expert panel, who provided guidance through development of all BRIEF components. Through a recent systematic review, empirical data collected by our team, and consultations with the panels, we identified key determinants (barriers and facilitators) of low enrollment rates and research team members as change agents. In step 2, we iteratively refined our list of key factors to include and linked determinants of behavior changes to these performance objectives. In step 3, we chose three theories (social cognitive theory, theory of information processing, and the trans-theoretical model), methods from identified practical applications suitable for the population (research team members) and the context (busy research NICU teams). In step 4, we developed and refined the intervention components, including self-guided pre-work and a single in-person session. In step 5, we identified the Darbepoetin plus slow-release intravenous iron trial as our partner study in which to pilot BRIEF. In step 6, we developed a multi-stage evaluation plan that included five distinct levels of outcomes. CONCLUSIONS This manuscript shares our rationale and processes for the creation of a research team member-facing intervention aiming to improve recruitment processes for neonatal clinical trials. Our approach can inform those aiming to improve recruitment for neonatal clinical trials and those who may be considering use of IM within similar contexts.
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Affiliation(s)
- Elliott Mark Weiss
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 4800 Sand Point Way NE, M/S FA.2.113 Neonatology, Seattle, WA, 98105, USA.
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | - Megan M Gray
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 4800 Sand Point Way NE, M/S FA.2.113 Neonatology, Seattle, WA, 98105, USA
| | - Linda K Ko
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Devan M Duenas
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 4800 Sand Point Way NE, M/S FA.2.113 Neonatology, Seattle, WA, 98105, USA
| | - Ellie Oslin
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 4800 Sand Point Way NE, M/S FA.2.113 Neonatology, Seattle, WA, 98105, USA
| | - Stephanie A Kraft
- Department of Bioethics and Decision Sciences, Geisinger College of Health Sciences, Danville, PA, USA
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Brown KK, Thomas SP, Brothers RM, Liao Y. "Lord Knows What's Being Done with My Blood!": Black Women's Perceptions of Biospecimen Donation for Clinical Research in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02015-y. [PMID: 38714639 DOI: 10.1007/s40615-024-02015-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 04/06/2024] [Accepted: 04/28/2024] [Indexed: 05/10/2024]
Abstract
PURPOSE Black women are underrepresented in clinical research and clinical trials. Knowledge gaps lead to biased clinical practice and care. There is a small but growing body of literature on Black women's perceptions about participation when biospecimen donation is sought by researchers. This is the first known study to investigate willingness to participate in clinical research involving biospecimen donation among Black women of reproductive age in the United States. METHODS This cross-sectional study recruited 496 Black women (ages 18-49) from a research crowdsourcing platform. Participants completed a 46-item online survey which asked about their willingness to provide blood samples for clinical health research and reasons for their willingness or for any unwillingness. Descriptive statistics and thematic analysis method were used to analyze the data. RESULTS Less than half (44%) of participants reported willingness to provide blood samples for clinical research. The most common concerns of those expressing unwillingness to provide samples were "fear of blood sample being misused" and "distrust with the health researchers handling the samples." We identified six qualitative themes from the analysis of participants' open-ended responses. The most important factors include a desire for integrity and transparency in research, institutional racism contributing to mistrust, and adequate compensation and clearly defined benefits to participation. CONCLUSIONS The recruitment and engagement of Black women in clinical biospecimen research should involve transparent, trustworthy, and anti-racist practices and informed respect for Black women's autonomy. There is a need to address Black women's concerns about exploitative profits and mistrust of academic and medical institutions.
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Affiliation(s)
- Kyrah K Brown
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA.
| | | | - R Mathew Brothers
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
| | - Yue Liao
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
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Weitlauf AS, Miceli A, Vehorn A, Dada Y, Pinnock T, Harris JW, Hine J, Warren Z. Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care. J Autism Dev Disord 2024; 54:931-942. [PMID: 36626007 PMCID: PMC10330934 DOI: 10.1007/s10803-022-05861-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Despite advances in screening and awareness, Black and multiracial families continue to experience challenges when seeking an autism diagnosis for their children. METHODS We surveyed 400 Black and multiracial families of young children with autism from an existing research database in the United States about their retrospective diagnostic experiences. We gathered quantitative and qualitative data and engaged in iterative coding to understand timing and content of first concerns, families' experiences of care providers and systems, and the impact of race and culture on accessing care. RESULTS Families provided examples of early developmental concern and described provider, systemic, and cultural barriers and facilitators to care. Families also provided insight into the influence of culture and made recommendations on how the medical system could better care for Black and multiracial families of children with autism. CONCLUSIONS Results add to a growing body of literature supporting the need for culturally sensitive and accessible care related to developmental monitoring, diagnosis, and follow-up care for Black and multiracial children.
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Affiliation(s)
- Amy S Weitlauf
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Alexandra Miceli
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alison Vehorn
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yewande Dada
- Department of Pediatrics, Meharry Medical College, Nashville, TN, USA
| | - Theodora Pinnock
- Department of Pediatrics, Meharry Medical College, Nashville, TN, USA
| | - Joyce W Harris
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeffrey Hine
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zachary Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
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Hoverd E, Staniszewska S, Dale J, Spencer R, Devrell A, Khan D, Lamouline C, Saleem S, Smith P. Co-producing an online patient public community research hub: a qualitative study exploring the perspectives of national institute for health research (NIHR) research champions in England. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:26. [PMID: 38365835 PMCID: PMC10874083 DOI: 10.1186/s40900-024-00556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Patient and Public Involvement and Engagement (PPIE) should be embedded as part of researchers' everyday practice. However, this can be challenging. Creating a digital presence for PPIE as part of Higher Education Institutes' (HEIs) infrastructure may be one way of supporting this. This can support how information is made available to patients and members of the public, but relatively little is known about how HEIs can best do this. Our aim was to develop a university website for patients and members of the public to learn about ways to get actively involved in research and be able to access the results of health and social care research. METHODS This project involved working as partners with five National Institute for Health and Care Research (NIHR) Research Champions. NIHR Research Champions are volunteers who raise awareness and share experiences about health and social care research. Content of a prototype Patient Public Community Research Hub website was co-produced with the Research Champions, and then 15 NIHR Research Champions from across England were asked for their views about the website. FINDINGS The information collected told us that the Patient Public Community Research Hub was viewed as being beneficial for increasing visibility of PPIE opportunities and sharing the findings of studies though needs further work: to make the information more user-friendly; to improve the methods for directing people to the site and to create new ways of connecting with people. It provides a foundation for further co-development and evaluation. A set of recommendations has been developed that may be of benefit to other HEIs and organisations who are committed to working with patients and members of the public.
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Affiliation(s)
- Eleanor Hoverd
- Academic Primary Care, Warwick Medical School, Warwick University, Gibbet Hill Rd, Coventry, CV4 7AL, England.
| | - Sophie Staniszewska
- Warwick Medical School, Warwick Research in Nursing, Warwick University, Coventry, England
| | - Jeremy Dale
- Academic Primary Care, Warwick Medical School, Warwick University, Gibbet Hill Rd, Coventry, CV4 7AL, England
| | - Rachel Spencer
- Academic Primary Care, Warwick Medical School, Warwick University, Gibbet Hill Rd, Coventry, CV4 7AL, England
| | | | - Dena Khan
- University of Central London, London, England
| | | | | | - Pam Smith
- University of Central London, London, England
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Passmore SR, Gerbitz A, Hancock GR, Evans L, Green-Harris G, Edwards DF, Jackson T, Thomas SB. "My Blood, You Know, My Biology Being out There…": Consent and Participant Control of Biological Samples. J Empir Res Hum Res Ethics 2024; 19:3-15. [PMID: 38192107 PMCID: PMC10957312 DOI: 10.1177/15562646231222665] [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] [Indexed: 01/10/2024]
Abstract
The widespread and persistent underrepresentation of groups experiencing health disparities in research involving biospecimens is a barrier to scientific knowledge and advances in health equity. To ensure that all groups have the opportunity to participate in research and feel welcome and safe doing so, we must understand how research studies may be shaped to promote inclusion. In this study, we explored the decision to participate in hypothetical research scenarios among African American adults (n = 169) that varied on the basis of four attributes (form of consent, reason for research, institutional affiliation and race of the researcher). Findings indicate that participants were largely willing to contribute to biobanks but significantly preferred opportunities where they had control over the use of their biological samples through tiered or study-specific forms of consent. Broad consent procedures, although common and perhaps preferred by participants with high trust in researchers, may amount to an exclusionary practice.
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Affiliation(s)
| | - Abigail Gerbitz
- School of Nursing, University of Wisconsin, Madison, WI, USA
| | - Gregory R. Hancock
- Department of Human Development and Quantitative Methodology, College of Education, University of Maryland, College Park, MD, USA
| | - Laura Evans
- Human Development and Family Studies, School of Human Ecology, University of Wisconsin, Madison, WI, USA
| | - Gina Green-Harris
- Center for Community Engagement and Health Partnerships, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Dorothy Farrar Edwards
- School of Nursing, University of Wisconsin, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, USA
- Department of Kinesiology, School of Education, University of Wisconsin, Madison, USA
| | - Tyson Jackson
- School of Nursing, University of Wisconsin, Madison, WI, USA
| | - Stephen B. Thomas
- Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, USA
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
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Henderson C, Scott T, Schinder B, Hager E, Friedman FS, Miller E, Ragavan MI. Shifting the Paradigm From Participant Mistrust to Researcher & Institutional Trustworthiness: A Qualitative Study of Researchers' Perspectives on Building Trustworthiness With Black Communities. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:127-136. [PMID: 36125424 DOI: 10.1177/0272684x221117710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Black communities are deeply underrepresented in research, due, in large part, to research mistrust. It is critical to shift the burden of trust building from communities to researchers and research institutions, which have perpetrated harm against Black communities for centuries. In this study, we examine researchers' perspectives on how to become trustworthy to Black-identifying participants and communities. METHODS We conducted semi-structured interviews with researchers affiliated with our institution's Clinical and Translational Science Institute. Participants were recruited through email and responded to the study team if they wished to participate. Interviews occurred through Zoom, took 60 minutes, and were audio recorded. We used an inductive thematic data analysis approach. RESULTS Sixteen researchers, who were affiliated with medicine, public health, psychology, education, and nursing, participated in this study. Participants agreed that researchers bear the responsibility for building trust and noted how critical it is to address the underrepresentation of Black participants in research through equitable recruitment and that researchers must be transparent and engage in reciprocal research practices. Community-partnered research was highlighted as a way to develop trustworthiness. Finally, participants noted that trustworthiness must also be built at the institutional level, rather than just by individual researchers. DISCUSSION To our knowledge, this is one of the first studies to examine researchers' perspectives on how to build their own trustworthiness, with a specific focus on trust-building with Black communities. Explicit training and resources are needed to build trustworthiness into academic centers.
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Affiliation(s)
| | | | | | - Erricka Hager
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Elizabeth Miller
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Loeb S, Ravenell JE, Gomez SL, Borno HT, Siu K, Sanchez Nolasco T, Byrne N, Wilson G, Griffith DM, Crocker R, Sherman R, Washington SL, Langford AT. The Effect of Racial Concordance on Patient Trust in Online Videos About Prostate Cancer: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2324395. [PMID: 37466938 DOI: 10.1001/jamanetworkopen.2023.24395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Importance Black men have a higher risk of prostate cancer compared with White men, but Black adults are underrepresented in online content about prostate cancer. Across racial groups, the internet is a popular source of health information; Black adults are more likely to trust online health information, yet have more medical mistrust than White adults. Objective To evaluate the association between racial representation in online content about prostate cancer and trust in the content and identify factors that influence trust. Design, Setting, and Participants A randomized clinical trial was conducted from August 18, 2021, to January 7, 2022, consisting of a 1-time online survey. Participants included US men and women aged 40 years and older. Data were analyzed from January 2022 to June 2023. Interventions Participants were randomized to watch the same video script about either prostate cancer screening or clinical trials presented by 1 of 4 speakers: a Black physician, a Black patient, a White physician, or a White patient, followed by a questionnaire. Main Outcomes and Measures The primary outcome was a published scale for trust in the information. χ2 tests and multivariable logistic regression were used to compare trust according to the video's speaker and topic. Results Among 2904 participants, 1801 (62%) were men, and the median (IQR) age was 59 (47-69) years. Among 1703 Black adults, a greater proportion had high trust in videos with Black speakers vs White speakers (72.7% vs 64.3%; adjusted odds ratio [aOR], 1.62; 95% CI, 1.28-2.05; P < .001); less trust with patient vs physician presenter (64.6% vs 72.5%; aOR, 0.63; 95% CI, 0.49-0.80; P < .001) and about clinical trials vs screening (66.3% vs 70.7%; aOR, 0.78; 95% CI, 0.62-0.99; P = .04). Among White adults, a lower proportion had high trust in videos featuring a patient vs physician (72.0% vs 78.6%; aOR, 0.71; 95% CI, 0.54-0.95; P = .02) and clinical trials vs screening (71.4% vs 79.1%; aOR, 0.57; 95% CI, 0.42-0.76; P < .001), but no difference for Black vs White presenters (76.8% vs 73.7%; aOR, 1.11; 95% CI, 0.83-1.48; P = .49). Conclusions and Relevance In this randomized clinical trial, prostate cancer information was considered more trustworthy when delivered by a physician, but racial concordance was significantly associated with trust only among Black adults. These results highlight the importance of physician participation and increasing racial diversity in public dissemination of health information and an ongoing need for public education about clinical trials. Trial Registration ClinicalTrials.gov Identifier: NCT05886751.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, New York
| | - Joseph E Ravenell
- Department of Population Health, New York University Langone Health, New York
| | - Scarlett Lin Gomez
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
| | - Hala T Borno
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
- Trial Library, Inc., San Francisco, California
| | - Katherine Siu
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | - Nataliya Byrne
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | | | | | - Rob Crocker
- Stakeholder Advisory Board, New York, New York
| | | | - Samuel L Washington
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
| | - Aisha T Langford
- Department of Population Health, New York University Langone Health, New York
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Kost RG, Devine RK, Fernands M, Gottesman R, Kandpal M, MacArthur RB, O’Sullivan B, Romanick M, Ronning A, Schlesinger S, Tobin JN, Vaughan R, Neville-Williams M, Krueger JG, Coller BS. Building an infrastructure to support the development, conduct, and reporting of informative clinical studies: The Rockefeller University experience. J Clin Transl Sci 2023; 7:e104. [PMID: 37250985 PMCID: PMC10225266 DOI: 10.1017/cts.2023.521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Clinical trials are a vital component of translational science, providing crucial information on the efficacy and safety of new interventions and forming the basis for regulatory approval and/or clinical adoption. At the same time, they are complex to design, conduct, monitor, and report successfully. Concerns over the last two decades about the quality of the design and the lack of completion and reporting of clinical trials, characterized as a lack of "informativeness," highlighted by the experience during the COVID-19 pandemic, have led to several initiatives to address the serious shortcomings of the United States clinical research enterprise. Methods and Results Against this background, we detail the policies, procedures, and programs that we have developed in The Rockefeller University Center for Clinical and Translational Science (CCTS), supported by a Clinical and Translational Science Award (CTSA) program grant since 2006, to support the development, conduct, and reporting of informative clinical studies. Conclusions We have focused on building a data-driven infrastructure to both assist individual investigators and bring translational science to each element of the clinical investigation process, with the goal of both generating new knowledge and accelerating the uptake of that knowledge into practice.
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Affiliation(s)
- Rhonda G. Kost
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Rita K. Devine
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Mark Fernands
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Riva Gottesman
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Manoj Kandpal
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Robert B. MacArthur
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Barbara O’Sullivan
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Michelle Romanick
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Andrea Ronning
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Sarah Schlesinger
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Jonathan N. Tobin
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
- Clinical Directors Network, Inc. (CDN), New York, NY, USA
| | - Roger Vaughan
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Maija Neville-Williams
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - James G. Krueger
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Barry S. Coller
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
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Coy T, Brinza E, DeLozier S, Gornik HL, Webel AR, Longenecker CT, White Solaru KT. Black men's awareness of peripheral artery disease and acceptability of screening in barbershops: a qualitative analysis. BMC Public Health 2023; 23:46. [PMID: 36609297 PMCID: PMC9821364 DOI: 10.1186/s12889-022-14648-x] [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: 07/26/2022] [Accepted: 11/16/2022] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Peripheral artery disease (PAD) disproportionately burdens Black Americans, particularly Black men. Despite the significant prevalence and high rate of associated morbidity and mortality, awareness of and treatment initiation for PAD remains low in this demographic group. Given the well-established social cohesion among barbershops frequently attended by Black men, barbershops may be ideal settings for health screening and education to improve awareness, early detection, and treatment initiation of PAD among Black men. METHODS A qualitative study involving 1:1 participant interviews in Cleveland, Ohio assessed perspectives of Black men about barbershop-based screening and education about PAD. Inductive thematic analysis was performed to derive themes directly from the data to reflect perceived PAD awareness and acceptability of screening in a barbershop setting. RESULTS Twenty-eight African American/Black, non-Hispanic men completed a qualitative interview for this analysis. Mean age was 59.3 ± 11.2 years and 93% of participants resided in socioeconomically disadvantaged zip codes. Several themes emerged indicating increased awareness of PAD and acceptability of barbershop-based screenings for PAD, advocacy for systemic changes to improve the health of the community, and a desire among participants to increase knowledge about cardiovascular disease. CONCLUSIONS Participants were overwhelmingly accepting of PAD screenings and reported increased awareness of PAD and propensity to seek healthcare due to engagement in the study. Participants provided insight into barriers and facilitators of health and healthcare-seeking behavior, as well as into the community and the barbershop as an institution. Additional research is needed to explore the perspectives of additional stakeholders and to translate community-based screenings into treatment initiation.
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Affiliation(s)
- Tyler Coy
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
| | - Ellen Brinza
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Internal Medicine, University of Colorado, Aurora, CO, USA
| | - Sarah DeLozier
- Clinical Research Center, University Hospitals, Cleveland, OH, USA
| | - Heather L Gornik
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA.
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Allison R Webel
- University of Washington School of Nursing, Seattle, WA, USA
| | - Christopher T Longenecker
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- School of Medicine and Department of Global Health, University of Washington, Seattle, WA, USA
| | - Khendi T White Solaru
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Chen A, Demaestri S, Schweiberger K, Sidani J, Wolynn R, Chaves-Gnecco D, Hernandez R, Rothenberger S, Mickievicz E, Cowden JD, Ragavan M. Inclusion of Non-English-Speaking Participants in Pediatric Health Research: A Review. JAMA Pediatr 2023; 177:81-88. [PMID: 36315130 PMCID: PMC10854994 DOI: 10.1001/jamapediatrics.2022.3828] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Importance The inclusion of non-English-speaking (NES) participants in pediatric research is an essential step to improving health equity for these populations. Although some studies have shown lack of progress in NES research participation in the past decade, few have examined NES inclusivity in pediatric research or details about the practices that researchers have used to communicate with NES participants. Objective To assess how frequently NES families were included in pediatric research, how rates of inclusion changed over time, what languages were included, and methodological details about oral and written communication with NES participants. Evidence Review In this review, all original investigation articles published in JAMA Pediatrics, Pediatrics, and The Journal of Pediatrics between January 2012 and November 2021 were screened. Eligible articles, which included those based in the US and with human participants, were reviewed to determine whether they included or excluded NES participants or whether or not there was specific mention of language. A second-round review was conducted on the subset of articles that included NES participants to determine methodological details (eg, languages included, type of study, region where the study was located, and oral and written communication practices with NES participants). Findings Of the 8142 articles screened, 5008 (62%) met inclusion criteria; of these, 469 (9%) included NES participants. The most common language was Spanish (350 [75%]); 145 articles (31%) reported non-English or other language without specification. A total of 230 articles (49%) reported the number of NES participants, and 61 (13%) specified the methods used to determine whether participants preferred a language other than English. In all, 101 (22%) and 136 (29%) articles specified how oral and written communication occurred with NES participants, respectively. Conclusions and Relevance This review of 3 pediatric journals provides preliminary evidence suggesting exclusion of NES communities from pediatric research from 2012 to 2021 and highlights an opportunity to provide more methodological detail about communication with NES participants. Best practices for improving inclusivity of NES participants are needed to guide researchers toward improved methods and more relevant results.
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Affiliation(s)
- Annie Chen
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Kelsey Schweiberger
- Division of General Academic Pediatrics; University of Pittsburgh, Pittsburgh, PA
| | - Jaime Sidani
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Riley Wolynn
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Diego Chaves-Gnecco
- Division of General Academic Pediatrics; University of Pittsburgh, Pittsburgh, PA
| | - Raquel Hernandez
- Johns Hopkins All Children’s Hospital Institute for Clinical and Translational Research, St. Petersburg, FL
| | - Scott Rothenberger
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Erin Mickievicz
- Division of General Academic Pediatrics; University of Pittsburgh, Pittsburgh, PA
| | - John D. Cowden
- Kansas City University; Kansas City, MO
- Division of General Academic Pediatrics, Children’s Mercy Kansas City, Kansas City, MO
| | - Maya Ragavan
- Division of General Academic Pediatrics; University of Pittsburgh, Pittsburgh, PA
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12
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Stallings SC, Cunningham-Erves J, Frazier C, Ichimura JS, Hurd TC, Jurinsky J, Acquaye A, Dalton JS, Wilkins CH. Development and Validation of the Perceptions of Research Trustworthiness Scale to Measure Trust Among Minoritized Racial and Ethnic Groups in Biomedical Research in the US. JAMA Netw Open 2022; 5:e2248812. [PMID: 36580334 PMCID: PMC9856656 DOI: 10.1001/jamanetworkopen.2022.48812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Historically, trust in biomedical research has been lower among minoritized racial and ethnic groups who are underrepresented in and excluded from research, with the same groups experiencing worse health outcomes. Unfortunately, instruments that measure trust may not capture components of trust relevant to minoritized racial and ethnic groups. OBJECTIVE To develop and validate a scale to measure trust in biomedical research among minoritized racial and ethnic groups. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, community-based survey study compared trust and distrust in biomedical research among Black, Latino, and White subgroups in the US using the Perceptions of Research Trustworthiness (PoRT) scale. The scale was developed between March 22, 2016, and September 19, 2018, as part of this study, and its structure, reliability, and validity were examined during pilot (n = 381) and validation (n = 532) phases between February 4, 2019, and July 27, 2021. Convenience samples of adult participants (aged ≥18 years) were recruited locally (Nashville, Tennessee, and San Antonio, Texas) and nationally through the ResearchMatch and Cint online platforms. MAIN OUTCOMES AND MEASURES Overall and individual item Trust and Distrust subscale scores were compared. Overall Trust and Distrust scores were compared by race and ethnicity using a Kruskal-Wallis H test and individual item scores were compared using independent samples t test. RESULTS Of the 532 participants in the scale validation study, 144 (27.1%) were Black, 90 (16.9%) were Latino, and 282 (53.0%) were White. Participants had a median age of 43 years (range, 18-90 years), 352 (66.2%) were women, and 198 (37.2%) had educational attainment levels less than a college degree. Factor analysis of the 18-item PoRT scale revealed a 2-factor structure with two 9-item PoRT subscales (Trust and Distrust), which demonstrated high internal consistency (Cronbach α = 0.72 and 0.87, respectively). Mean (SD) Trust subscale scores were lower among Black (34.33 [2.02]) and Latino (34.55 [1.97]) participants compared with White participants (36.32 [1.81]; P < .001). Mean (SD) Distrust subscale scores were higher among Black (21.0 [2.15]) and Latino (20.53 [2.21]) participants compared with White participants (18.4 [2.03]; P < .001). Individual item results showed that Black and Latino participants were less trusting and more distrusting than White individuals on items related to risks, harms, secrecy, confidentiality, and privacy. CONCLUSIONS AND RELEVANCE These findings suggest that the PoRT scale incorporates trust and trustworthiness concepts relevant among Black and Latino individuals and may allow more precise assessment of trust in research among these groups.
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Affiliation(s)
- Sarah C. Stallings
- Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Meharry-Vanderbilt Alliance, Nashville, Tennessee
| | | | - Carleigh Frazier
- Public Health Department, University of California, Merced, Visalia
| | | | - Thelma C. Hurd
- Department of Surgery, University of Texas Health Science Center, San Antonio
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Jordan Jurinsky
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Amber Acquaye
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee
| | | | - Consuelo H. Wilkins
- Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Meharry-Vanderbilt Alliance, Nashville, Tennessee
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13
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Dermody TS, Ettinger A, Savage Friedman F, Chavis V, Miller E. The Pittsburgh Study: Learning with Communities About Child Health and Thriving. Health Equity 2022; 6:338-344. [PMID: 35651357 PMCID: PMC9148643 DOI: 10.1089/heq.2021.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic has highlighted structural inequities that are barriers to thriving for children in neighborhoods with concentrated disadvantage. Health systems are increasingly addressing health-related social needs. The “Pittsburgh Study” is a longitudinal, community-partnered study focused on child and adolescent thriving and racial equity. This initiative will elucidate critical influences on childhood health and thriving, evaluate developmentally appropriate interventions to improve outcomes from birth to high school, and establish a child health data hub. Integration of community members into scientific inquiry, rapid data-to-action cycles, and workforce development are strategies health systems may consider to enhance child health equity.
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Affiliation(s)
- Terence S. Dermody
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Institute of Infection, Inflammation, and Immunity, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anna Ettinger
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Val Chavis
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Community and Population Health, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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14
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Price JL, Bruce MA, Adinoff B. Addressing Structural Racism in Psychiatry With Steps to Improve Psychophysiologic Research. JAMA Psychiatry 2022; 79:70-74. [PMID: 34613345 DOI: 10.1001/jamapsychiatry.2021.2663] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE The American Medical Association has acknowledged the public health threat posed by racism in medicine. While clinicians in psychiatry have echoed the sentiment, the research community has largely been silent. Current understanding of the biological domains that underlie psychiatric disorders was historically established by studying White populations, often leaving widely used treatments ineffective for Asian, Black, Hispanic, Indigenous, and other racial and ethnic minority individuals. This article addresses how undersampling of racial and ethnic minority individuals has led to overgeneralized physiological findings, the implications for development of psychiatric treatments, and steps to improve service to racially diverse communities. OBSERVATIONS Three primary observations regarding differences associated with race and ethnicity have been addressed in the existing psychiatric research: misdiagnosis, medication nonadherence, and treatment efficacy and expression of adverse effects. While cultural factors have been discussed as potential factors associated with these differences, a lack of understanding of physiologic systems may be foundational to each of these issues. Recent evidence points to race differences in psychophysiological measures, likely attributed to factors including the lived experience of racism as opposed to inherent biological differences. This mounting evidence supports a reassessment of existing work to examine potential divergent patterns within racial and ethnic groups. The following strategies may improve understanding of the influence of racism on physiology, allowing clinicians to better address psychiatric symptoms and improve existing treatment approaches. Thus, psychiatric researchers need to (1) understand the historic and current terminology for race and ethnicity and use appropriate terms and categories as defined by sociologists, population health experts, and databases while respecting individuals' right to self-identify, (2) refine research questions, and (3) reexamine research data to determine whether patterns observed in largely White populations can extend to other groups. To appropriately implement these steps, researchers must accept the discomfort that accompanies growth, invite scientists from diverse backgrounds to participate, and use resources to increase diversity in recruitment of study participants. This will require a commitment from funding agencies to provide adequate support to recruit and investigate large, diverse samples. CONCLUSIONS AND RELEVANCE To create more suitable medical treatments and improve the quality of care received by those with psychiatric conditions, further discussion is needed surrounding the physiologic toll that racism has had on multiple generations of racial and ethnic minority groups and how that may alter responsivity to biobehavioral interventions. To better inform psychiatric research, the resources provided must be expanded, basic physiologic studies should be replicated with more diverse samples and adequate analyses, and psychiatry scientists must reconsider approaches to clinical research.
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Affiliation(s)
- Julianne L Price
- Department of Kinesiology and Health, Center of Alcohol and Substance Use Studies, Rutgers University, New Brunswick, New Jersey
| | - Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, Texas
| | - Bryon Adinoff
- Anschutz Medical Campus, University of Colorado, Denver
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15
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Aldrighetti CM, Niemierko A, Van Allen E, Willers H, Kamran SC. Racial and Ethnic Disparities Among Participants in Precision Oncology Clinical Studies. JAMA Netw Open 2021; 4:e2133205. [PMID: 34748007 PMCID: PMC8576580 DOI: 10.1001/jamanetworkopen.2021.33205] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Precision oncology is revolutionizing cancer care, allowing for personalized treatments to improve outcomes. Cancer research has benefitted from well-designed studies incorporating precision medicine objectives, but it is unclear if these studies are representative of the diverse cancer population. OBJECTIVE To evaluate racial and ethnic representation in breast, prostate, lung, and colorectal cancer studies incorporating precision oncology objectives in the Clinicaltrials.gov registry and compare with the incidence of these cancer types in racial and ethnic minority groups in the US population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study identified US-based breast, prostate, lung, and colorectal cancer studies incorporating precision oncology objectives for reporting of race and ethnicity. The Surveillance, Epidemiology, and End Results and US Census databases were used to determine cancer incidence by race and ethnicity, linked with cancer type and median year of enrollment for each trial. Data were collected and analyzed between December 2020 and April 2021. MAIN OUTCOMES AND MEASURES The expected number of participants per study by each racial and ethnic group was calculated based on the corresponding US-based proportion. Under- and overrepresentation was defined as the ratio of the actual number of enrolled cases to the expected number of cases for each trial by cancer type. Ratios above 1 indicated overrepresentation while a ratio below 1 indicated underrepresentation. Random-effects meta-analysis of representation ratios of individual trials was performed to weigh each individual study. RESULTS Of 93 studies encompassing 5867 enrollees with race and ethnicity data; 4826 participants (82.3%) were non-Hispanic White, 587 (10.0%) were Black, and 238 (4.1%) were Asian. Per observed-to-expected ratios, White participants were overrepresented in all studies, with a ratio of 1.35 (95% CI, 1.30-1.37), as well as Asian participants, with a ratio of 1.46 (95% CI, 1.28-1.66), while Black participants (ratio, 0.49; 95% CI, 0.45-0.54), Hispanic participants (ratio, 0.24; 95% CI, 0.20-0.28), and American Indian and Alaskan Native participants (ratio, 0.43; 95% CI, 0.24-0.78) were underrepresented. By individual cancer site, White participants were consistently overrepresented in all studies, while Black and Hispanic participants were underrepresented. CONCLUSIONS AND RELEVANCE This analysis found that precision oncology studies for breast, lung, prostate, and colorectal cancers vastly underrepresent racial and ethnic minority populations relative to their cancer incidence in the US population. It is imperative to increase diversity among enrollees so that all individuals may benefit from cancer research breakthroughs and personalized treatments.
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Affiliation(s)
| | - Andrzej Niemierko
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Eliezer Van Allen
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Henning Willers
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Sophia C. Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
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16
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Overcoming Historical Barriers: Enhancing Positive Perceptions of Medical Research Among African Americans Through a Conference-Based Workshop. J Gen Intern Med 2021; 36:2547-2554. [PMID: 34128196 PMCID: PMC8390631 DOI: 10.1007/s11606-021-06736-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND African Americans (AAs) and other racial/ethnic minority groups continue to be underrepresented in medical research and clinical trials. Failure to create more racially diverse research cohorts can exacerbate existing health disparities among these groups. OBJECTIVE To investigate best practices and strategies for enhancing participation of AAs in medical research among attendees of a preconference Institute at a faith-based public health conference. DESIGN Qualitative study using semi-structured interviews. PARTICIPANTS A total of 21 out of 29 attendees (90% AA) of the Institute (72% response rate). APPROACH A culturally tailored preconference Institute was held at the 2017 Healthy Churches 2020 National Conference. The Institute was led by AA researchers focused on underrepresentation of AAs in medical research. Semi-structured interviews were conducted 1-year post-Institute (n=21) and were audio-recorded, transcribed verbatim, and reviewed using thematic analysis. KEY RESULTS The majority of attendees reported that they were more likely to participate in medical research after attending the Institute (75%). Salient learning points reported by attendees demonstrated attainment of the Institute objectives. Key themes emerged describing barriers preventing AAs from participating in medical research including fear/lack of trust, lack of information on research projects, and not being approached to participate. Key themes regarding facilitators for participation in medical research by AAs were clear communication of study objectives and research benefits along with trust in researchers. CONCLUSIONS Attendees' perceptions of participation in medical research were largely positive following their attendance at a conference-based Institute aimed to address the underrepresentation of AAs in medical research. Our culturally tailored approach to disseminating knowledge of the research process could extend to other national conferences prioritizing AAs and other racial/ethnic minority populations to improve research participation.
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17
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Rogers CR, Matthews P, Brooks E, Le Duc N, Washington C, McKoy A, Edmonson A, Lange L, Fetters MD. Barriers to and Facilitators of Recruitment of Adult African American Men for Colorectal Cancer Research: An Instrumental Exploratory Case Study. JCO Oncol Pract 2021; 17:e686-e694. [PMID: 33974818 DOI: 10.1200/op.21.00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Racial and ethnic minorities remain underrepresented in research and clinical trials. Better understanding of the components of effective minority recruitment into research studies is critical to understanding and reducing health disparities. Research on recruitment strategies for cancer-specific research-including colorectal cancer (CRC)-among African American men is particularly limited. We present an instrumental exploratory case study examining successful and unsuccessful strategies for recruiting African American men into focus groups centered on identifying barriers to and facilitators of CRC screening completion. METHODS The parent qualitative study was designed to explore the social determinants of CRC screening uptake among African American men 45-75 years of age. Recruitment procedures made use of community-based participatory research strategies combined with built community relationships, including the use of trusted community members, culturally tailored marketing materials, and incentives. RESULTS Community involvement and culturally tailored marketing materials facilitated recruitment. Barriers to recruitment included limited access to public spaces, transportation difficulties, and medical mistrust leading to reluctance to participate. CONCLUSION The use of strategies such as prioritizing community relationship building, partnering with community leaders and gatekeepers, and using culturally tailored marketing materials can successfully overcome barriers to the recruitment of African American men into medical research studies. To improve participation and recruitment rates among racial and ethnic minorities in cancer-focused research studies, future researchers and clinical trial investigators should aim to broaden recruitment, strengthen community ties, offer incentives, and use multifaceted approaches to address specific deterrents such as medical mistrust and economic barriers.
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Affiliation(s)
- Charles R Rogers
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Phung Matthews
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Ellen Brooks
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Nathan Le Duc
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Chasity Washington
- Population Sciences Department, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Alicia McKoy
- Population Sciences Department, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Al Edmonson
- A Cut Above the Rest Barbershop, Columbus, OH
| | - LaJune Lange
- International Leadership Institute, Minneapolis, MN
| | - Michael D Fetters
- Mixed Methods Program and Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI
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18
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Lee SM, Majumder MA. National Institutes of Mental Health Data Archive: Privacy, Consent, and Diversity Considerations and Options for Improvement. AJOB Neurosci 2021; 13:3-9. [PMID: 33834954 DOI: 10.1080/21507740.2021.1904025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Data sharing is essential to further advance the field of neuropsychiatry. However, it raises significant ethical issues in the domains of privacy, consent, and diversity. We begin by considering the sensitive nature of much neuropsychiatric data. Next, we review relevant policies of the National Institutes of Mental Health (NIMH), a prominent funder in this field. Because data sharing in neuropsychiatry is in its infancy and rapidly evolving, the NIMH policies serve as a helpful starting point for examining ethical considerations related to the collection and distribution of neuropsychiatric data. However, we find gaps in their guidance in each of the three key ethical domains. Finally, we illustrate how examination of lessons and strategies from other contexts where sustained attention has already been given to these ethical issues may add value by suggesting specific opportunities for improvement. In particular, we highlight approaches including a three-tiered data access scheme, use of technology to enhance the data sharing component of the informed consent process, and evidence-based, targeted recruitment of underrepresented populations to support diverse data resources. Assessment of current policy and potentially helpful innovations in other fields is a necessary step in moving the field forward in an ethically responsible manner.
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19
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Griffith DM, Bergner EM, Fair AS, Wilkins CH. Using Mistrust, Distrust, and Low Trust Precisely in Medical Care and Medical Research Advances Health Equity. Am J Prev Med 2021; 60:442-445. [PMID: 33208267 PMCID: PMC7902381 DOI: 10.1016/j.amepre.2020.08.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee; Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee.
| | - Erin M Bergner
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
| | | | - Consuelo H Wilkins
- Office of the Vice President for Health Equity, Vanderbilt University Medical Center, Nashville, Tennessee
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20
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Henderson HJ, Bell S. Black in Cancer: Championing Diversity in Cancer Research and Medicine. Cancer Discov 2021; 11:237-239. [PMID: 33531422 DOI: 10.1158/2159-8290.cd-20-1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Black in Cancer was designed to strengthen networks and highlight Black excellence in cancer research and medicine. Here we expound on our actions to increase the representation of Black people in cancer-related fields.
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Affiliation(s)
- Henry J Henderson
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Sigourney Bell
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England.
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21
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Shelton RC, Adsul P, Oh A, Moise N, Griffith DM. Application of an antiracism lens in the field of implementation science (IS): Recommendations for reframing implementation research with a focus on justice and racial equity. IMPLEMENTATION RESEARCH AND PRACTICE 2021; 2:26334895211049482. [PMID: 37089985 PMCID: PMC9978668 DOI: 10.1177/26334895211049482] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Despite the promise of implementation science (IS) to reduce health inequities, critical gaps and opportunities remain in the field to promote health equity. Prioritizing racial equity and antiracism approaches is critical in these efforts, so that IS does not inadvertently exacerbate disparities based on the selection of frameworks, methods, interventions, and strategies that do not reflect consideration of structural racism and its impacts. Methods Grounded in extant research on structural racism and antiracism, we discuss the importance of advancing understanding of how structural racism as a system shapes racial health inequities and inequitable implementation of evidence-based interventions among racially and ethnically diverse communities. We outline recommendations for explicitly applying an antiracism lens to address structural racism and its manifests through IS. An anti-racism lens provides a framework to guide efforts to confront, address, and eradicate racism and racial privilege by helping people identify racism as a root cause of health inequities and critically examine how it is embedded in policies, structures, and systems that differentially affect racially and ethnically diverse populations. Results We provide guidance for the application of an antiracism lens in the field of IS, focusing on select core elements in implementation research, including: (1) stakeholder engagement; (2) conceptual frameworks and models; (3) development, selection, adaptation of EBIs; (4) evaluation approaches; and (5) implementation strategies. We highlight the need for foundational grounding in antiracism frameworks among implementation scientists to facilitate ongoing self-reflection, accountability, and attention to racial equity, and provide questions to guide such reflection and consideration. Conclusion We conclude with a reflection on how this is a critical time for IS to prioritize focus on justice, racial equity, and real-world equitable impact. Moving IS towards making consideration of health equity and an antiracism lens foundational is central to strengthening the field and enhancing its impact. Plain language abstract There are important gaps and opportunities that exist in promoting health equity through implementation science. Historically, the commonly used frameworks, measures, interventions, strategies, and approaches in the field have not been explicitly focused on equity, nor do they consider the role of structural racism in shaping health and inequitable delivery of evidence-based practices/programs. This work seeks to build off of the long history of research on structural racism and health, and seeks to provide guidance on how to apply an antiracism lens to select core elements of implementation research. We highlight important opportunities for the field to reflect and consider applying an antiracism approach in: 1) stakeholder/community engagement; 2) use of conceptual frameworks; 3) development, selection and adaptation of evidence-based interventions; 4) evaluation approaches; 5) implementation strategies (e.g., how to deliver evidence-based practices, programs, policies); and 6) how researchers conduct their research, with a focus on racial equity. This is an important time for the field of implementation science to prioritize a foundational focus on justice, equity, and real-world impact through the application of an anti-racism lens in their work.
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Affiliation(s)
- Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, USA
| | - Prajakta Adsul
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, USA
| | - April Oh
- Division of Cancer Control and Population Sciences, Implementation
Science Team, National Cancer Institute, Rockville, USA
| | - Nathalie Moise
- Department of Medicine, Columbia University Irving Medical
Center, New York, USA
| | - Derek M. Griffith
- Georgetown University, Racial Justice Institute, Washington,
USA
- Georgetown University, Center for Men’s Health Equity, Washington,
USA
- Department of Health Systems Administration at the School of Nursing
& Health Studies, Georgetown University, Washington, USA
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22
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Abstract
Men's health equity is an area of men's health research and practice that combines the literature on men's health with that of health equity. More research is needed that describes how to intervene to promote men's health equity. This introduction to the American Journal of Men's Health special collection on promoting men's health equity was created to feature research that describes aspects of promising interventions that (a) are population-specific approaches that consider the unique biopsychosocial factors that affect the health of socially defined populations of men; or (b) use a comparative approach to close or eliminate gaps between socially defined groups of men and women and among socially meaningful groups of men that are unnecessary, avoidable, considered unfair and unjust, and yet are modifiable. The dozen papers from across the globe included in the special collection are grouped in three areas: conceptual approaches and reviews; formative research; and evaluation findings. The papers represent a diverse array of populations under the umbrella of men's health and a range of strategies to improve men's health from tobacco cessation to microfinance. The collection features a range of alternative masculinities that emerge from original research by the contributors that are used in novel ways in the interventions. This editorial argues that more qualitative research is needed to evaluate the intended and unintended findings from interventions. This editorial also highlights the benefits that men's health equity can gain from embracing dissemination and implementation science as a tool to systematically design, implement, refine, and sustain interventions.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA.,Department of Medicine, Health and Society, Vanderbilt University, Nashville, TN, USA
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