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Vanderpool RC, Ng D, Huang G, Dwyer LA, Kueppers G. Disparities in cancer clinical trials information-seeking: Findings from the National Cancer Institute's Cancer Information Service. PATIENT EDUCATION AND COUNSELING 2024; 127:108358. [PMID: 38936161 PMCID: PMC11323059 DOI: 10.1016/j.pec.2024.108358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/03/2024] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To better understand cancer clinical trials (CCT) information-seeking, a necessary precursor to patient and provider engagement with CCT. METHODS Data from the National Cancer Institute's Cancer Information Service (CIS) were used to examine CCT information-seeking patterns over a 5-year period. Descriptive and logistic regression analyses were conducted to examine characteristics of CIS inquiries and their associations with having a CCT discussion. RESULTS Between September 2018 - August 2023, 117,016 CIS inquiries originated from cancer survivors, caregivers, health professionals, and the general public; 27.5 % of these inquiries included a CCT discussion (n = 32,160). Among CCT discussions, 35.5 % originated from survivors, 53.5 % from caregivers, 6.1 % from the public, and 4.9 % from health professionals. Inquiries in Spanish had lower odds of a CCT discussion (OR=.26, [.25-.28]), whereas inquiries emanating from the CIS instant messaging (OR=2.29, [2.22-2.37]) and email (OR=1.24, [1.18-1.30]) platforms were associated with higher odds of discussing CCT compared to the telephone. Individuals who were male, younger, insured, and had higher income and education had significantly higher odds of a CCT discussion while those who were non-Hispanic Black and living in rural locales had significantly lower odds. CONCLUSIONS Disparities in CCT information-seeking may contribute to downstream CCT participation. PRACTICE IMPLICATIONS Quality, language-concordant health information is needed to enable equitable awareness of - and ultimately engagement in - CCT.
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Affiliation(s)
- Robin C Vanderpool
- National Cancer Institute, Behavioral Research Program, Division of Cancer Control and Population Sciences, 9609 Medical Center Dr, Rockville, MD, USA.
| | - Diane Ng
- Westat, 1600 Research Blvd, Rockville, MD, USA
| | - Grace Huang
- Westat, 1600 Research Blvd, Rockville, MD, USA
| | - Laura A Dwyer
- Cape Cox Facilities Services, 7050 Infantry Ridge Rd, Manassas, VA, USA
| | - George Kueppers
- National Cancer Institute, Behavioral Research Program, Division of Cancer Control and Population Sciences, 9609 Medical Center Dr, Rockville, MD, USA
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Vanderpool RC, Huang G, Wilson A, Gordon R, Mollica MA, Maynard CD. Childhood Cancer Information-Seeking: Findings from the National Cancer Institute's Cancer Information Service. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1084-1090. [PMID: 36414856 DOI: 10.1007/s13187-022-02237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 06/02/2023]
Abstract
The benefits of cancer information-seeking may be particularly salient to individuals impacted by childhood cancer, including patients, caregivers, health professionals, and advocates. The purpose of this study was to explore information-seeking patterns for childhood cancer through the National Cancer Institute's Cancer Information Service (CIS), a multi-channel, bilingual resource for cancer information. The study team conducted descriptive analyses on secondary data characterizing 1820 caregivers, health professionals, organizations, and members of the general public who contacted the CIS about childhood cancer between September 2018 and June 2022. Almost 80% of inquiries about childhood cancer were initiated by caregivers, followed by the public, health professionals, and organizations. Although English was the primary language used by individuals to reach the CIS when discussing childhood cancer, there were variations in points of access (i.e., telephone, instant messaging, email, social media) across the four user groups. Most childhood cancer inquiries were about staging and treatment, and the primary cancer sites discussed by CIS users were neurologic or brain, hematologic, and musculoskeletal cancers. Discussion topics included managing and coping with cancer, clinical trials, and treatment side effects. Just over half (54%) of CIS contacts about childhood cancer resulted in a health professional referral. Findings provide direction for the CIS and other public health organizations to deliver, prioritize, and tailor their services to support the information needs of childhood cancer survivors and their families-as well as those who care and advocate for them-who may have a significant need for credible cancer information.
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Affiliation(s)
- Robin C Vanderpool
- Health Communication and Informatics Research Branch, Behavioral Research Program, National Cancer Institute, 9609 Medical Center Dr 3E610, Rockville, MD, 20850, USA.
| | - Grace Huang
- Westat, Public Health and Epidemiology, Rockville, MD, USA
| | - Ashley Wilson
- Westat, Public Health and Epidemiology, Rockville, MD, USA
| | - Rebecca Gordon
- Health Communication and Informatics Research Branch, Behavioral Research Program, National Cancer Institute, 9609 Medical Center Dr 3E610, Rockville, MD, 20850, USA
| | - Michelle A Mollica
- Healthcare Delivery Research Program, National Cancer Institute, Rockville, MD, USA
| | - Candace Deaton Maynard
- Office of Communications and Public Liaison, National Cancer Institute, Rockville, MD, USA
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Heckel L, Heynsbergh NL, Livingston PM. Are cancer helplines effective in supporting caregivers? A systematic review. Support Care Cancer 2019; 27:3219-3231. [PMID: 31098794 PMCID: PMC6660576 DOI: 10.1007/s00520-019-04807-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/07/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The aims of this systematic review were to summarize the profile of caregivers accessing cancer helplines, to evaluate caregiver satisfaction with the helpline service, and to review the evidence base of intervention studies testing the efficacy of community-based cancer helplines in improving caregiver health and well-being. METHODS Four electronic databases (Medline, CINAHL, PsychINFO, and EMBASE) were systematically searched to identify relevant literature, including all articles published in English until May 2018. Reference lists of accepted papers were reviewed for the inclusion of additional potentially relevant articles, gray literature was excluded. RESULTS Forty-five publications met the inclusion criteria for this review. Forty-one papers reported on the proportion of caregivers accessing cancer helplines. Twenty-six studies described demographic and clinical characteristics of caregivers and eight reported on call characteristics. Reasons for contacting the service were stated in 21 studies and caregiver satisfaction with the helpline service was assessed in 12 articles. Fourteen studies investigated specific topics of interest (e.g., prevalence of sleep problems, distress screening, or clinical trial participation). Two randomized controlled trials examined the efficacy of cancer helplines in improving caregiver outcomes, with findings showing interventions to be effective in reducing distress and unmet needs, and in increasing positive adjustment. CONCLUSIONS There is limited scientific evidence regarding the efficacy of cancer helplines to improve caregivers' health and well-being. More intervention studies are needed to examine the benefits of cancer helplines to this study population to ensure structured referral pathways can be established.
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Affiliation(s)
- Leila Heckel
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
| | - Natalie L Heynsbergh
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia.
| | - Patricia M Livingston
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
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Burro R, Savardi U, Annunziata MA, De Paoli P, Bianchi I. The effects of presenting oncologic information in terms of opposites in a medical context. Patient Prefer Adherence 2018; 12:443-459. [PMID: 29628757 PMCID: PMC5877498 DOI: 10.2147/ppa.s147091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND An extensive body of literature has demonstrated that many patients who have been asked to participate in clinical trials do not fully understand the informed consent forms. A parallel independent study has demonstrated that opposites have a special status in human cognitive organization: they are common to all-natural languages and are intuitively and naturally understood and learnt. PURPOSE The study investigates whether, and how, the use of opposites impacts on doctor-patient communication: does using the terms "small-large" to describe a nodule (ie, bipolar communication) rather than speaking in terms of centimeters (ie, unipolar communication) affect a patient's understanding of the situation? And is it better to speak of "common-rare" side effects (ie, bipolar communication) instead of the number of people who have suffered from particular side effects (ie, unipolar communication)? METHODS Two questionnaires were created and used, one presenting the information in terms of opposites (ie, bipolar communication) and another using unipolar communication. RESULTS The participants' perception of their situation (in terms of feeling healthy-ill, being at high-low risk, and their treatment requiring high-low commitment) varied in the two conditions. Moreover, self-reported levels of understanding and satisfaction with how the information was communicated were higher when opposites were used. LIMITATIONS Since this is the first study that addresses the merits of using bipolar structures versus unipolar structures in doctor-patient communication, further work is needed to consolidate and expand on the results, involving not only simulated but also real diagnostic contexts. CONCLUSION The encouraging results imply that further testing of the use of opposites in informed consent forms and in doctor-patient communication is strongly advisable.
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Affiliation(s)
- Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
- Correspondence: Roberto Burro, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 27, 37129 Verona, Italy, Email
| | - Ugo Savardi
- Department of Human Sciences, University of Verona, Verona, Italy
| | | | - Paolo De Paoli
- National Cancer Institute IRCCS ‘Centro di Riferimento Oncologico’ (CRO), Aviano, Italy
| | - Ivana Bianchi
- Department of Humanities (Section Philosophy and Human Sciences), University of Macerata, Macerata, Italy
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Pariera KL, Murphy ST, Meng J, McLaughlin ML. Exploring Willingness to Participate in Clinical Trials by Ethnicity. J Racial Ethn Health Disparities 2016; 4:763-769. [PMID: 27604379 DOI: 10.1007/s40615-016-0280-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 02/02/2023]
Abstract
African-Americans and Hispanic-Americans are disproportionately affected by cancer, yet underrepresented in cancer clinical trials. Because of this, it is important to understand how attitudes and beliefs about clinical trials vary by ethnicity. A national, random sample of 860 adults was given an online survey about attitudes toward clinical trials. We examined willingness to participate in clinical trials, attitudes toward clinical trials, trust in doctors, attitudes toward alternative and complementary medicine, and preferred information channels. Results indicate that African-American and Hispanic-American participants have more negative attitudes about clinical trials, more distrust toward doctors, more interest in complementary and alternative medicine, and less willingness to participate in clinical trials than white/non-Hispanics, although specific factors affecting willingness to participate vary. The channels people turn to for information on clinical trials also varied by ethnicity. These results help explain the ethnic disparities in cancer clinical trial enrollment by highlighting some potential underlying causes and drawing attention to areas of importance to these groups.
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Affiliation(s)
- Katrina L Pariera
- Department of Organizational Sciences and Communication, The George Washington University, 600 21st St NW, Washington, DC, 20052, USA.
| | - Sheila T Murphy
- Department of Communication, Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Jingbo Meng
- Department of Communication, Michigan State University, East Lansing, MI, USA
| | - Margaret L McLaughlin
- Department of Communication, Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
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Morgan SE, Mouton A, Occa A, Potter J. Clinical Trial and Research Study Recruiters' Verbal Communication Behaviors. JOURNAL OF HEALTH COMMUNICATION 2016; 21:765-72. [PMID: 27259754 DOI: 10.1080/10810730.2016.1157654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The lack of accrual to research studies and clinical trials is a persistent problem with serious consequences: Advances in medical science depend on the participation of large numbers of people, including members of minority and underserved populations. The current study examines a critical determinant of accrual: the approach of patients by professional recruiters who request participation in research studies and clinical trials. Findings indicate that recruiters use a number of verbal strategies in the communication process, including translating study information (such as simplifying, using examples, and substituting specific difficult or problematic words), using linguistic reframing or metaphors, balancing discussions of research participation risks with benefits, and encouraging potential participants to ask questions. The identification of these verbal strategies can form the basis of new communication protocols that will help medical and nonmedical professionals communicate more clearly and effectively with patients and other potential participants about research studies and clinical trials, which should lead to increased accrual in the future.
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Affiliation(s)
- Susan E Morgan
- a School of Communication , University of Miami , Coral Gables , Florida , USA
| | - Ashton Mouton
- b Brian Lamb School of Communication , Purdue University , West Lafayette , Indiana , USA
| | - Aurora Occa
- c School of Communication , University of Miami , Coral Gables , Florida , USA
| | - Jonell Potter
- d Miller School of Medicine , University of Miami , Coral Gables , Florida , USA
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Meng J, McLaughlin M, Pariera K, Murphy S. A Comparison Between Caucasians and African Americans in Willingness to Participate in Cancer Clinical Trials: The Roles of Knowledge, Distrust, Information Sources, and Religiosity. JOURNAL OF HEALTH COMMUNICATION 2016; 21:669-677. [PMID: 27175604 DOI: 10.1080/10810730.2016.1153760] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study aims to (a) examine the roles of knowledge, distrust in medical professionals, information sources, and 2 dimensions of religiosity (i.e., religious activity and religious belief) in influencing willingness to participate (WTP) in cancer clinical trials and to (b) compare the results for Caucasians and African Americans in order to inform future recruitment. An online survey was fielded via a Knowledge Networks panel with a nationally representative sample including 478 Caucasians and 173 African Americans. The results showed that distrust in medical professionals was a strong barrier to WTP for both ethnic groups, whereas factual knowledge about trial procedures was not associated with WTP for either ethnic group. Seeking trial information from doctors was positively associated with WTP for Caucasians; seeking trial information from hospitals was positively associated with WTP for African Americans. More interestingly, levels of religious activity negatively predicted WTP for Caucasians but positively predicted WTP for African Americans. Self-reported religious belief was not associated with WTP for either ethnic group. In sum, although distrust is a common barrier to WTP, the influence of preferred information sources and religious activity on WTP varies as a function of ethnicity.
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Affiliation(s)
- Jingbo Meng
- a Department of Communication , Michigan State University , East Lansing , Michigan , USA
| | - Margaret McLaughlin
- b Annenberg School for Communication and Journalism , University of Southern California , Los Angeles , California , USA
| | - Katrina Pariera
- c Department of Organizational Sciences and Communication , The George Washington University , Washington , DC , USA
| | - Sheila Murphy
- b Annenberg School for Communication and Journalism , University of Southern California , Los Angeles , California , USA
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Byrne MM, Tannenbaum SL, Glück S, Hurley J, Antoni M. Participation in cancer clinical trials: why are patients not participating? Med Decis Making 2013; 34:116-26. [PMID: 23897588 DOI: 10.1177/0272989x13497264] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Participation in cancer clinical trials is low, particularly in racial and ethnic minorities in some cases, which has negative consequences for the generalizability for study findings. The objective of this study was to determine what factors are associated with patients' participation or willingness to participate and whether these factors vary by race/ethnicity. DESIGN or METHODS . White, Hispanic, and black participants were obtained through the Florida cancer registry and who were diagnosed with breast, lung, colorectal, or prostate cancer (N = 1100). Participants were surveyed via telephone to obtain demographic information, past participation, and willingness to participate in clinical trials, as well as barriers and facilitators to participation. Logistic and Poisson regressions were performed. RESULTS . Respondents were on average 67.4 years old, 42.7% were male, and 50.1% were married. In this population, 7.7% of respondents had participated in a clinical trial, and 36.5% stated that they would be willing to participate. In multivariate models, blacks and Hispanics were equally likely as whites to be willing to participate in cancer trials, but Hispanics were less likely to have participated, and this was especially more likely in non-English-speaking Hispanics compared with English-speaking Hispanics. Notable barriers across race/ethnicity were mistrust and lack of knowledge of clinical trials. Limitations. Cross-sectional design limits cause-and-effect conclusions. CONCLUSIONS . There are racial differences in participation rates but not in willingness to participate. We hypothesize that willingness to participate is not very high because people are uninformed about participating, particularly in non-English-speaking Hispanics. Barriers and facilitators to participation vary by race. Improved understanding of cultural differences that can be addressed by physicians may restore faith, comprehension, and acceptability of clinical trials by all patients.
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Affiliation(s)
- Margaret M Byrne
- Department of Public Health Sciences (MMB), University of Miami Miller School of Medicine, Miami, Florida.,Sylvester Comprehensive Cancer Center (MMB, SLT), University of Miami Miller School of Medicine, Miami, Florida
| | - Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center (MMB, SLT), University of Miami Miller School of Medicine, Miami, Florida
| | - Stefan Glück
- Department of Medicine (SG, JH), University of Miami Miller School of Medicine, Miami, Florida
| | - Judith Hurley
- Department of Medicine (SG, JH), University of Miami Miller School of Medicine, Miami, Florida
| | - Michael Antoni
- Department of Psychology, Universityof Miami, Miami, Florida (MA)
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Vanderpool RC, Kornfeld J, Mills L, Byrne MM. Rural-urban differences in discussions of cancer treatment clinical trials. PATIENT EDUCATION AND COUNSELING 2011; 85:e69-e74. [PMID: 21458194 PMCID: PMC3162073 DOI: 10.1016/j.pec.2011.01.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 01/06/2011] [Accepted: 01/20/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Compare the characteristics of rural and urban callers to NCI's Cancer Information Service (CIS), and explore the association of geographic location and discussion of cancer clinical trials. METHODS Using CIS call data from 2006 to 2008, we assigned a rural or urban designation to caller ZIP codes using Rural-Urban Commuting Area Codes. Calls which discussed clinical trials were analyzed using univariate and multivariate analyses. RESULTS The CIS received 227,579 calls from 2006 to 2008 where geographic location could be determined. Overall, 10.3% of calls included a discussion of clinical trials; there were significantly more discussions among urban dwellers than rural individuals (10.5% versus 9.4%, respectively). Multivariate regression analyses supported the univariate findings. In addition, compared to other callers, patients (OR 5.58 [95% CI: 4.88, 6.39]) and family and friends (6.26 [5.48, 71.5]) were significantly more likely to discuss clinical trials. CONCLUSION Urban callers were more likely than their rural counterparts to discuss cancer treatment trials, placing individuals living in rural areas at a disadvantage in learning about and communicating with their providers about possible participation in clinical trials. PRACTICE IMPLICATIONS Through its multiple access points, the CIS can serve as an important source of clinical trials information for rural cancer patients, family members, and providers.
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Affiliation(s)
- Robin Cline Vanderpool
- Department of Health Behavior, University of Kentucky College of Public Health, Lexington, KY, USA.
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