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Lee N, Hong Y, Kirkpatrick CE, Hu S, Lee S, Hinnant A. COVID-19 vaccination communication: Effects of vaccine conspiracy beliefs and message framing among black and white participants. Vaccine 2024; 42:3197-3205. [PMID: 38631951 PMCID: PMC11206173 DOI: 10.1016/j.vaccine.2024.04.001] [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: 02/03/2023] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The importance of vaccination in combating the COVID-19 pandemic is widely acknowledged. The aim of this study was (1) to understand how one's vaccine conspiracy beliefs would influence their public health news processing, (2) to examine how specific public health news features (i.e., news frame) would influence message processing, and (3) to examine if there were any differences between Black and White participants in their message processing. METHODS A nationwide online experiment (N = 821) with a 3 (vaccine conspiracy beliefs: high vs. moderate vs. low) × 2 (participants' race: Black vs. White) × 2 (news frames: gain vs. loss) mixed-factorial design was conducted in the United States. RESULTS Participants' level of vaccine conspiracy beliefs was predictive of their responses to outcome measures. Additionally, Black participants reported higher perceived message effectiveness, more favorable attitudes toward the message, and higher vaccination intentions than White participants. Furthermore, health news that emphasized vaccination benefits produced more favorable attitudes than those emphasizing losses associated with non-vaccination, especially for White participants. Lastly, participants reported more favorable attitudes toward gain-framed health news regardless of their vaccine conspiracy beliefs. CONCLUSION It is crucial for health officials to work to find effective media message strategies to combat COVID-19 vaccine conspiracy theories and misinformation. Furthermore, this study supports the significance of health organizations' ongoing efforts to tailor public health messaging to specific racial groups, as evidenced by considerable variations in perceptions among Black and White Americans.
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Affiliation(s)
- Namyeon Lee
- Department of Mass Communication, University of North Carolina at Pembroke, Pembroke, NC 28372, USA.
| | - Yoorim Hong
- Strategic Communication, School of Journalism, University of Missouri, Columbia, MO 65201, USA.
| | - Ciera E Kirkpatrick
- Advertising & Public Relations, College of Journalism & Mass Communications, University of Nebraska-Lincoln, Lincoln, NE 68588, USA.
| | - Sisi Hu
- School of Journalism and Strategic Media, University of Arkansas, Fayetteville, AR 72701, USA.
| | - Sungkyoung Lee
- Strategic Communication, School of Journalism, University of Missouri, Columbia, MO 65201, USA.
| | - Amanda Hinnant
- Journalism Studies, School of Journalism, University of Missouri, Columbia, MO 65201, USA.
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Hong Y, Lee N, Kirkpatrick CE, Hu S, Lee S, Hinnant A. "Trust Me, I'm a Doctor." How TikTok Videos from Different Sources Influence Clinical Trial Participation. HEALTH COMMUNICATION 2024:1-12. [PMID: 38699819 DOI: 10.1080/10410236.2024.2346680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
This study experiments with TikTok videos to promote clinical trial participation. More specifically, it examines how short-form video sources (doctors vs. prior volunteers for clinical trials) influence perceived source credibility, self-efficacy, and behavioral intention to participate in clinical trials. Findings from this online experiment (N = 396) showed that doctor sources led to greater behavioral intention through enhancing source credibility compared to prior volunteer sources. Alternatively, prior volunteer sources increased behavioral intention via enhanced self-efficacy for participants with low trust in doctors. These findings contribute to the understanding of how short-form video sources act as heuristic cues, leading to persuasion outcomes. Overall, we recommend featuring doctors when using video-based messages to promote clinical trial participation. Also, this study emphasizes the need for health communication practitioners to consider prior volunteers as spokespersons when targeting populations with low baseline trust in doctors.
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Affiliation(s)
- Yoorim Hong
- Strategic Communication, School of Journalism, University of Missouri
| | - Namyeon Lee
- Department of Mass Communication, University of North Carolina at Pembroke
| | - Ciera E Kirkpatrick
- Advertising & Public Relations, College of Journalism & Mass Communications, University of Nebraska-Lincoln
| | - Sisi Hu
- Advertising, School of Journalism and Strategic Media, University of Arkansas
| | - Sungkyoung Lee
- Strategic Communication, School of Journalism, University of Missouri
| | - Amanda Hinnant
- Journalism Studies, School of Journalism, University of Missouri
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Lee N, Hong Y, Hu S, Kirkpatrick CE, Lee S, Hinnant A. Exploring the Strategic Use of TikTok for Clinical Trial Recruitment: How audiences' Prior Short-Form Video Usage Influences Persuasive Effects. JOURNAL OF HEALTH COMMUNICATION 2024; 29:294-306. [PMID: 38590176 DOI: 10.1080/10810730.2024.2339237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Guided by the elaboration likelihood model and framing theory, this study explores the potential of short-form video platforms (e.g. TikTok), for targeted clinical trial recruitment. An online experiment compared doctor vs. peer-led videos addressing logistical or psychological barriers to participation, mimicking common TikTok communication tactics. Results indicate that high (vs. low) TikTok users are more persuaded by recruitment messages, and they exhibit stronger intentions to participate in clinical trials. Although doctor-sourced messages generate greater credibility and a more favorable message attitude, peer-sourced messages may be more effective in increasing participation intention. Lastly, doctor-sourced videos that address logistical barriers and peer-sourced videos that discuss psychological barriers result in higher self-efficacy for clinical trial participation. This study contributes to the growing body of research on new media's role in health communication and provides insights into how to strategically utilize TikTok and other short-form video platforms for clinical trial recruitment.
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Affiliation(s)
- Namyeon Lee
- Department of Mass Communication, University of North Carolina at Pembroke, Pembroke, North Carolina, USA
| | - Yoorim Hong
- Strategic Communication, School of Journalism, University of Missouri, Columbia, Missouri, USA
| | - Sisi Hu
- School of Journalism and Strategic Media, University of Arkansas, Fayetteville, Arkansas, USA
| | - Ciera E Kirkpatrick
- Advertising & Public Relations, College of Journalism & Mass Communications, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Sungkyoung Lee
- Strategic Communication, School of Journalism, University of Missouri, Columbia, Missouri, USA
| | - Amanda Hinnant
- Journalism Studies, School of Journalism, University of Missouri, Columbia, Missouri, USA
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Lee S, Lee N, Kirkpatrick CE. Effects of Communication Source and Racial Representation in Clinical Trial Recruitment Flyers. HEALTH COMMUNICATION 2023; 38:790-802. [PMID: 34530661 PMCID: PMC8924020 DOI: 10.1080/10410236.2021.1976361] [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] [Indexed: 06/13/2023]
Abstract
The current study was designed to examine effective message strategies that can be employed in designing mediated communication messages to improve clinical trial research participation. In the study, a total of 300 participants completed an online experiment in which they responded to five different clinical trial recruitment advertisements whose information sources varied in their credentials and race. Overall, peer-featured ads in which previous clinical trial participants communicated their prior experience in clinical trial participation, compared to expert-featured ads in which medical doctors communicated information about clinical trials, led to higher message and topic relevance, higher message credibility, more favorable attitudes toward clinical trials, and higher intentions to participate in future clinical trials. Further, there was a statistically significant interaction among source credentials, racial match (between source and participant), and participant's race on message and topic relevance such that both White and Black participants rated ads from racially mismatched peers highly effective (greater message and topic relevance); however, for doctor featured ads, White participants reported higher message and topic relevance for racially matched (White doctor) ads, and Black participants reported higher message and topic relevance for racially mismatched (White doctor) ads. We discuss theoretical and practical implications.
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Affiliation(s)
- Sungkyoung Lee
- Strategic Communication, School of Journalism, University of Missouri
| | - Namyeon Lee
- Department of Mass Communication, University of North Carolina at Pembroke
| | - Ciera Elaine Kirkpatrick
- Advertising and Public Relations, College of Journalism and Mass Communications, University of Nebraska-Lincoln
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Chen L, Zhang D, Hou M. The Influence of Perceived Social Presence on the Willingness to Communicate in Mobile Medical Consultations: Experimental Study. J Med Internet Res 2022; 24:e31797. [PMID: 35544293 PMCID: PMC9133978 DOI: 10.2196/31797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/30/2021] [Accepted: 04/14/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND With the rise of online health care service, there is growing discussion on the relationship between physicians and patients online, yet few researchers have paid attention to patients' perception of social presence, especially its influence on their willingness to communicate (WTC). OBJECTIVE The goal of the research is to investigate the influence of perceived social presence (PSP) on WTC in mobile medical consultations. METHODS Participants living in Yunnan province during the period of middle to high risk of COVID-19 infection were recruited via the internet. They were assigned randomly into 2 groups interacting with a virtual physician presenting high and low levels of social presence and then asked to complete a questionnaire. Based on the theoretical framework, the study puts forward a model evaluating the relationships among participants' PSP, communication apprehension (CA), self-perceived communication competence (SPCC), and willingness to communicate about health (WTCH) in the computer-mediated communication between virtual physicians and patients. RESULTS In total 206 (106 in group 1 and 100 in group 2) valid samples were gathered (from 276 log-ins) and 88.8% (183/206) of them were aged 18 to 44 years, which approximately resembles the age distribution of the main population engaging in online medical consultation in China. Independent t test shows that there is significant difference between the PSP of the 2 groups (P=.04), indicating a successful manipulation of social presence. The total effect of PSP on WTCH is 0.56 (P<.001), among which 74.4% is direct effect (P<.001). Among the indirect effects between PSP and WTCH, the mediating effect of SPCC accounts for 68.8% (P<.001) and the sequential mediating effect of CA→SPCC accounts for 19.2% (P<.001), while the mediating effect of CA alone is not significant (P=.08). CONCLUSIONS This study provides a comprehensible model, demonstrating that PSP is an important antecedent of WTCH, and the sequential mediating effect of CA and SPCC found in this study also proves that in the environment of online mobile medical services, CA cannot affect communication directly. The findings will provide some practical inspiration for the popularization of online medical service, especially for the promotion of online physician-patient communication.
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Affiliation(s)
- Lijuan Chen
- Department of Journalism, School of Humanities, Shanghai University of Finance and Economics, Shanghai, China
| | - Danyang Zhang
- Department of Journalism and Communication, School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Mutian Hou
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, China
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“Send My Information”: Increasing Public Accessibility to Clinical Trials by Facilitating Participant Expression of Interest. J Clin Transl Sci 2022; 6:e26. [PMID: 35321223 PMCID: PMC8922290 DOI: 10.1017/cts.2022.19] [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] [Received: 10/14/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: The process of identifying and connecting with clinical trial study teams can be challenging and difficult for members of the public. The national volunteer community registry, ResearchMatch, and the public clinical trials search tool, Trials Today, work in tandem to bridge this connection by providing a streamlined process for potential participants to identify clinical trials which may be of interest. Methods: Building on the existing infrastructure of ResearchMatch and Trials Today, we created a mechanism by which the public can request that their basic contact information (e.g., email/phone) be securely shared with any actively recruiting clinical trial, including trials with no existing relationship with ResearchMatch. Results: Within the first 2 years of use (July 2019–July 2021), ResearchMatch Volunteers sent 12,251 requests to study teams. On average, 20% of these requests were accepted by the study teams. Conclusions: The utilization of this tool indicates that there is active interest among members of the public to independently contact study teams about trials of interest. Additionally, research teams unaffiliated with ResearchMatch are willing to at minimum accept contact information. This allows ResearchMatch to successfully serve as a medium, connecting members of the public with actively recruiting trials.
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Le W, Chang PY, Chang YW, Chen J. Why Do Patients Move from Online Health Platforms to Hospitals? The Perspectives of Fairness Theory and Brand Extension Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193755. [PMID: 31590419 PMCID: PMC6801564 DOI: 10.3390/ijerph16193755] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 09/26/2019] [Accepted: 09/30/2019] [Indexed: 12/02/2022]
Abstract
Online healthcare services are growing rapidly. Patients can receive health support through communication with online health professionals. However, previous research on eHealth has focused on patients’ online behavioral intentions. The purpose of this study is to investigate the effect of online patient–doctor communication on offline behavioral intentions and to propose a conceptual model for eHealth. We integrate fairness theory and band extension theory to develop a research model. This is further tested by structural equation modeling (SEM), with 279 valid sets of data from patients on the online health platform. Using partial least squares analysis (PLS), the results show that perceived fairness is an important factor affecting online satisfaction and the willingness to ask online doctors, which in turn has a positive impact on the willingness to go to offline doctors. These findings shed light on the research model for eHealth and offer suggestions for improving patients’ online satisfaction, as well as both online and offline behavioral intentions.
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Affiliation(s)
- Wei Le
- College of Economics and Management, China Jiliang University, Hangzhou 310018, Zhejiang.
- Key Laboratory of Quality Infrastructure Efficacy Research, AQSIQ, Beijing 100028, China.
| | - Po-Ya Chang
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City 112, Taiwan.
| | - Yu-Wei Chang
- Department of Business Management, National Taichung University of Science and Technology, Taichung City 404, Taiwan.
| | - Jiahe Chen
- Department of Computer Science, Hong Kong Baptist University, Hong Kong, China.
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8
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Chang YW, Hsu PY, Wang Y, Chang PY. Integration of online and offline health services: The role of doctor-patient online interaction. PATIENT EDUCATION AND COUNSELING 2019; 102:1905-1910. [PMID: 31279612 DOI: 10.1016/j.pec.2019.04.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study aims to investigate how doctor-patient online interaction affects the integration of online and offline health services. Drawing on justice theory and the stimulus-organism-response (S-O-R) framework, justice perceptions are conceptualized as online health communication in influencing patient experiences and subsequent responses. METHODS Data were collected from 241 online consultation patients. Partial least squares structural equation modeling (PLS-SEM) approach was used to test the research model and 12 hypothesized relationships. RESULTS Distributive justice, procedural justice, and interpersonal justice significantly affect trust, which in turn affects satisfaction and the continued intention to consult. Distributive justice and informational justice significantly affect satisfaction, which in turn affects the continued intention to consult. Finally, the continued intention to consult significantly affects the behavioral intention to visit. CONCLUSION Doctors can attract patients to visit them in physical hospitals by providing good online health services. Before physically visiting doctors, patients can also search for a suitable doctor that meets their needs through online consultations. To the best of our knowledge, this study is the first to integrate online and offline health services. PRACTICE IMPLICATIONS From the perspective of health communication, the understanding of doctor-patient online interaction offers doctors and hospitals guidance to improve doctor-patient relationships.
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Affiliation(s)
- Yu-Wei Chang
- Department of Business Management, National Taichung University of Science and Technology
| | - Ping-Yu Hsu
- Department of Business Administration, National Central University.
| | - Ying Wang
- Department of Gastroenterology, Wenzhou People's Hospital
| | - Po-Ya Chang
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences
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Carmack HJ, Ahmed R. Students' Perceptions of Provider Cultural Competence and Communication with Providers: Predictors of University Health Center Patient Satisfaction. JOURNAL OF HEALTH COMMUNICATION 2019; 24:719-727. [PMID: 31512992 DOI: 10.1080/10810730.2019.1666197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As student populations become more diverse, understanding university health center (UHC) providers' cultural competence is important for providing students with quality care. Student satisfaction with UHC provider care is influenced by a number of factors, including interpersonal communication between patients and providers. The emphasis on culture, however, suggests that providers' cultural competence should also be an important factor. Guided by communication accommodation theory, this study examined the relationships between patients' willingness to communicate with providers, communication apprehension with providers, and perceptions of providers' cultural competence and if they predicted patient satisfaction with UHC care. Results suggest that willingness to communicate, communication apprehension, and some elements of perceived provider cultural competence were significantly related. Willingness to communicate, communication apprehension, and patient-centeredness were predictors of patient satisfaction. These findings have implications for how UHCs can focus on culturally competent care while meeting the healthcare needs of students.
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Affiliation(s)
- Heather J Carmack
- Department of Communication Studies, University of Alabama, Tuscaloosa, Alabama, USA
| | - Rukhsana Ahmed
- Department of Communication, University at Albany, State University of New York, Albany, New York, USA
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Cook JA, Campbell MK, Gillies K, Skea Z. Surgeons' and methodologists' perceptions of utilising an expertise-based randomised controlled trial design: a qualitative study. Trials 2018; 19:478. [PMID: 30189868 PMCID: PMC6127897 DOI: 10.1186/s13063-018-2832-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 08/01/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Randomised controlled trials (RCTs) are widely recognised to be the most rigorous way to test new and emerging clinical interventions. When the interventions under study are two different surgical procedures, however, surgeons are required to be trained and sufficiently proficient in the different surgical approaches to take part in such a trial. It is often the case that even where surgeons can perform both trial surgical procedures, they have a preference and/or have more expertise in one of the procedures. The expertise-based trial design, where participating surgeons only provide the procedure in which they have appropriate expertise, has been proposed to overcome this problem. When expertise-based designs should be best used remains unclear; such approaches may be more suited to addressing specific questions. The aim of this qualitative study was to improve understanding about the range of views that surgeons and methodologists have regarding the use of the expertise-based RCT design. METHODS Twelve individual interviews with surgeons and methodologists with experience of surgical trials were conducted. Interviews were semi-structured and conducted face-to-face or by telephone. Interviews were audio-recorded, transcribed and analysed systematically using an interpretive approach. RESULTS Both surgeons and methodologists saw potential advantages in the expertise-based design particularly in terms of surgeons' participation and in trials where the procedures being evaluated were significantly different. The main disadvantages identified were methodological (e.g. the potential for surgeons carrying out one of the trial procedure being systematically different) and operational (e.g. the need to 'transfer' patients between surgeons with potential consequences for the surgeon/patient relationship). CONCLUSION This study suggests that the expertise-based trial design has significant potential to increase surgeon participation in trials in some settings. In other settings the standard design was generally seen as the preferable design. Particularly suitable conditions for an expertise-based design include those where the surgical procedures under evaluation are substantially different, where they are routinely delivered by different health professionals/surgeons with clear proficiencies in each; and contexts in which a multiple-surgeon model is in use and trust between the patient and surgeons can be suitably protected. The standard design was seen by most participants as the default design. Several logistical and methodological concerns remain to be addressed before the expertise-based design is likely to be more widely adopted.
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Affiliation(s)
- Jonathan A Cook
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Rd, Oxford, OX3 7LD, UK. .,Surgical Intervention Trials Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Rd, Oxford, OX3 7LD, UK.
| | - Marion K Campbell
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Zoë Skea
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
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11
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Gruca TS, Hottel WJ, Comstock J, Olson A, Rosenthal GE. Sex and cardiovascular disease status differences in attitudes and willingness to participate in clinical research studies/clinical trials. Trials 2018; 19:300. [PMID: 29843818 PMCID: PMC5975677 DOI: 10.1186/s13063-018-2667-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 05/03/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND While women are under-represented in research on cardiovascular disease (CVD), little is known about the attitudes of men and women with CVD regarding participation in clinical research studies/clinical trials. METHODS Patients with CVD (and/or risk factors) and patients with other chronic conditions from Iowa were recruited from a commercial panel. An on-line survey assessed willingness to participate (WTP) and other attitudes towards aspects of clinical research studies. RESULTS Based on 504 respondents, there were no differences in WTP in patients with CVD compared to patients with other chronic diseases. Across all respondents, men had 14% lower WTP (relative risk (RR) for men, 0.86, 95% CI, 0.72-1.02). Among patients with CVD, there was no significant difference in WTP between women (RR for women = 1) and men (RR for men, 0.96, 95% CI, 0.82-1.14). There were no significant differences based on sex or CVD status for attitudes on randomization, blinding, side effects, conflict of interest, experimental treatments or willingness to talk to one's physician. Women had more favorable attitudes about participants being treated like "guinea pigs" (RR for men, 0.84, 95% CI, 0.73-0.98) and clinical trials being associated with terminally ill patients (RR for men, 0.93, 95% CI, 0.86-1.00). CONCLUSIONS The findings reported here suggest that the observed lower levels of participation by women are due to factors other than a lower WTP or to women having more negative attitudes towards aspects of study participation. Patients with CVD have similar attitudes and WTP as patients with other chronic conditions.
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Affiliation(s)
| | | | | | | | - Gary E. Rosenthal
- Department of Internal Medicine, Wake Forest University, Winston-Salem, NC USA
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Morgan SE, Occa A, Potter J, Mouton A, Peter ME. "You Need to Be a Good Listener": Recruiters' Use of Relational Communication Behaviors to Enhance Clinical Trial and Research Study Accrual. JOURNAL OF HEALTH COMMUNICATION 2017; 22:95-101. [PMID: 28085636 DOI: 10.1080/10810730.2016.1256356] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Medical and research professionals who discuss clinical trials and research studies with potential participants face an often daunting challenge, particularly when recruiting from minority and underserved populations. This study reports on findings from a focus group study of 63 research coordinators, study nurses, professional recruiters, and other professionals in Indianapolis, IN and Miami, FL who work to recruit from minority and underserved populations. These professionals discussed the importance of creating a sense of connection with potential participants as part of the recruitment and retention process. Building a relationship, however fleeting, involved a number of concrete behaviors, including listening to personal information, expressing empathy, and then providing reciprocal self-disclosures; having repeated contact, usually by working in the same environment over an extended period of time; demonstrating respect through politeness and the use of honorifics; going the extra mile for participants; offering flexibility in scheduling follow-up appointments; and creating a sense of personal and community trust by being truthful. The implications of these findings for clinical trial and research study accrual are discussed.
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Affiliation(s)
- Susan E Morgan
- a School of Communication , University of Miami , Coral Gables , Florida , USA
| | - Aurora Occa
- a School of Communication , University of Miami , Coral Gables , Florida , USA
| | - JoNell Potter
- b Miller School of Medicine , University of Miami , Miami , Florida , USA
| | - Ashton Mouton
- c Brian Lamb School of Communication , Purdue University , West Lafayette , Indiana , USA
| | - Megan E Peter
- d Department of Health Behavior and Policy , Virginia Commonwealth University , Richmond , Virginia , 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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Tanner A, Bergeron CD, Zheng Y, Friedman DB, Kim SH, Foster CB. Communicating Effectively About Clinical Trials With African American Communities: A Comparison of African American and White Information Sources and Needs. Health Promot Pract 2015; 17:199-208. [PMID: 26715695 DOI: 10.1177/1524839915621545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinical trial (CT) participation is low among African Americans (AAs). To better communicate with AAs about the importance of CTs, the purpose of this study was to explore the communication sources and perceived effective communication channels and strategies through which the general public, AAs, and White individuals receive CT information. A quantitative telephone survey was conducted with AAs and Whites in one Southern state (N = 511). The measures assessed CT sources of information, perceived effectiveness of communication channels and strategies, CT understanding, and CT participation. Descriptive and bivariate analyses were used to compare responses overall and by race. AAs reported being exposed to more CT information than Whites. AAs received CT information most often through television, social media, and doctors compared to Whites. Perceived effectiveness of communication strategies and channels varied by race. AAs preferred simple and easy-to-understand CT information distributed through faith-based organizations. Whites preferred to receive CT information through a trustworthy source (e.g., doctor). There were no significant differences between AAs and Whites in their perceived effectiveness of media sources (e.g., Internet). Recommendations are provided to help health promotion practitioners and CT recruiters tailor information and communicate it effectively to potential AA and White CT participants.
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Affiliation(s)
| | | | - Yue Zheng
- University of South Carolina, Columbia, SC, USA
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Tanner A, Kim SH, Friedman DB, Foster C, Bergeron CD. Promoting clinical research to medically underserved communities: current practices and perceptions about clinical trial recruiting strategies. Contemp Clin Trials 2014; 41:39-44. [PMID: 25542611 DOI: 10.1016/j.cct.2014.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/15/2014] [Accepted: 12/16/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Although clinical trials have the potential to provide the most advanced medical treatments and screening options, accrual rates remain low among medically underserved populations. Strategies to enhance clinical trial recruitment are frequently undertaken without developing, implementing, and evaluating communication and educational activities. This study assesses the current clinical trial recruiting efforts taking place at academic medical centers in a southeastern state and explores principal investigators' attitudes and beliefs about how to successfully recruit for clinical trials, in the general population, and in African American and rural communities. METHODS An online survey was used to collect responses from clinical trial principal investigators working in a southeastern state's five main academic medical centers. Respondents were asked about their experience with recruitment and recruiting strategies, in general, and in the African American and rural communities. RESULTS Respondents said that it was most difficult to find rural residents to participate in clinical trials (M=3.60, SD=.93), followed by the general public (M=3.30, SD=.99) and African American residents (M=3.15, SD=.99). Investigators most often reported personally recruiting their patients (M=3.50, SD=1.34) and through local doctors (M=2.80, SD=1.20). Principal investigators rarely recruit through faith-based organizations (M=1.74, SD=1.05), or by using radio (M=1.62, SD=.90), or television ads (M=1.42, SD=.75). CONCLUSION Clinical trial investigators rarely communicate about clinical research outside of the medical setting or partner with community organizations or local doctors to reach individuals in medically underserved communities. Study implications describe the importance of educating research teams about how best to promote clinical trial awareness and knowledge.
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Affiliation(s)
- Andrea Tanner
- School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, United States.
| | - Sei-Hill Kim
- School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, United States
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States
| | | | - Caroline D Bergeron
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
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Tanner A, Kim SH, Friedman DB, Foster C, Bergeron CD. Barriers to medical research participation as perceived by clinical trial investigators: communicating with rural and african american communities. JOURNAL OF HEALTH COMMUNICATION 2014; 20:88-96. [PMID: 25204763 DOI: 10.1080/10810730.2014.908985] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Clinical trials help advance public health and medical research on prevention, diagnosis, screening, treatment, and quality of life. Despite the need for access to quality care in medically underserved areas, clinical trial participation remains low among individuals in rural and African American communities. This study assessed clinical trial research in South Carolina's five main academic medical centers, focusing specifically on clinical trial investigators' perceived barriers to recruitment in the general population and in rural and African American communities. Online survey responses (N = 119) revealed that it was most difficult for investigators to recruit from rural areas and that rural residents were least likely to be represented in medical research, behind both the general public and African Americans. Barriers focusing on communication or awareness proved to be the biggest hurdles to finding potential participants in both the general public and rural communities. Psychological barriers to recruitment were perceived to be most prevalent in African American communities. Study findings provide important insights from the perspective of the clinical trial investigator that will aid in the development of effective communication and education strategies for reaching rural and African American residents with information about clinical trials.
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Affiliation(s)
- Andrea Tanner
- a School of Journalism and Mass Communications , University of South Carolina , Columbia , South Carolina , USA
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18
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How are we communicating about clinical trials? Contemp Clin Trials 2014; 38:275-83. [DOI: 10.1016/j.cct.2014.05.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 11/22/2022]
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Banda DR, Libin AV, Wang H, Swain SM. A pilot study of a culturally targeted video intervention to increase participation of African American patients in cancer clinical trials. Oncologist 2013; 17:708-14. [PMID: 22639112 DOI: 10.1634/theoncologist.2011-0454] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Barriers to clinical trial participation among African American cancer patients are well characterized in the literature. Attitudinal barriers encompassing fear, distrust, and concerns about ethical misconduct are also well documented. To increase trial accrual, these attitudes must be adequately addressed, yet there remains a lack of targeted interventions toward this end. We developed a 15-minute culturally targeted video designed to impact six specific attitudes of African American cancer patients toward therapeutic trials. We conducted a pilot study to test in the first such intervention to increase intention to enroll. PATIENTS AND METHODS The primary study outcome was self-reported likelihood to participate in a therapeutic trial. Using a mixed methods approach, we developed the Attitudes and Intention to Enroll in Therapeutic Clinical Trials (AIET) instrument, a 30-item questionnaire measuring six attitudinal barriers to African American trial participation. We enrolled 108 eligible active treatment patients at a large urban cancer institute. McNemar's test for matched pairs was used to assess changes in attitudes and likelihood to enroll in a clinical trial at baseline and immediately after the video. Pre- and post-video AIET summative scores were analyzed by paired t-test for each attitudinal barrier. RESULTS Patients' likelihood of enrolling in a clinical trial significantly increased post-video with 36% of the sample showing positive changes in intention [McNemar's χ(2) = 33.39, p < .001]. Paired t-tests showed significant changes in all six attitudinal barriers measured via AIET summative scores from pre- to post-video. CONCLUSION These data suggest utility of our video for increasing African American participation in clinical trials.
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Affiliation(s)
- Deliya R Banda
- Medstar Health Research Institute, Hyattsville, Maryland, USA.
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A Pilot Study of a Culturally Targeted Video Intervention to Increase Participation of African American Patients in Cancer Clinical Trials. Oncologist 2012. [DOI: 10.1634/theoncologist.2012-0454] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Parreco LK, DeJoice RW, Massett HA, Padberg RM, Thakkar SS. Power of an effective clinical conversation: improving accrual onto clinical trials. J Oncol Pract 2012; 8:282-6. [PMID: 23277764 DOI: 10.1200/jop.2011.000478] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2011] [Indexed: 11/20/2022] Open
Abstract
The National Cancer Institute (NCI) is actively transforming clinical trials to revitalize the clinical trials system and improve patient accrual. For more than 30 years, NCI has provided information and communication resources about cancer clinical trials. The Institute supports a clinical trials Web site (www.cancer.gov/clinicaltrials) that receives nearly a half million page views a month. In addition, NCI's Cancer Information Service (800-4-CANCER, chat and e-mail) responds to 1,750 clinical trial inquiries every month. Although these numbers suggest that a high volume of clinical trial information is being exchanged between NCI, the public, and providers, most patients decide whether to participate in clinical trials during the patient-provider interaction.
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Byrne MM, Kornfeld J, Vanderpool R, Belanger M. Discussions of cancer clinical trials with the National Cancer Institute's Cancer Information Service. JOURNAL OF HEALTH COMMUNICATION 2011; 17:319-337. [PMID: 22150169 PMCID: PMC4753796 DOI: 10.1080/10810730.2011.626500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Clinical trials are essential for the development of new and effective treatments for cancer; however, participation rates are low. One reason for this is lack of knowledge about clinical trials. This study assessed how often clinical trials are discussed on calls to National Cancer Institute's Cancer Information Service (CIS). The authors quantitatively analyzed 283,094 calls to the CIS (1-800-4-CANCER) over 3 years (2006-2008). They calculated descriptive statistics and multivariate regressions to determine whether specific caller characteristics are associated with the presence of a clinical trials discussion. In addition, 2 focus groups were conducted with CIS information specialists (n=12) to provide insight into the findings. The authors found that approximately 9.3% of CIS calls discussed clinical trials, with higher percentages for patients (12.5%) and family members (15.4%). Calls with Hispanics, Blacks, and Spanish speakers were less likely to include a conversation. For all cancers, patients who are in treatment or experiencing a recurrence were statistically significantly more likely to discuss clinical trials. CIS information specialists reported callers' limited knowledge of clinical trials. The CIS has the unique ability to make a substantial effect in educating patients about clinical trials as an option in cancer treatment and care.
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Affiliation(s)
- Margaret M Byrne
- Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
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Miller JD, Kotowski MR, Comis RL, Smith SW, Silk KJ, Colaizzi DD, Kimmel LG. Measuring cancer clinical trial understanding. HEALTH COMMUNICATION 2011; 26:82-93. [PMID: 21218302 DOI: 10.1080/10410236.2011.527624] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Researchers, practitioners, and participants in cancer clinical trials must have a clear understanding of clinical trials if participation in them is to be solicited ethically and effectively. A valid and reliable measure of cancer clinical trial understanding did not exist prior to a 2005 study conducted for the Coalition of Cooperative Cancer Groups. This report outlines a measure derived from that study, discusses the rationale for its component items, examines its psychometric properties, and demonstrates the relationship of this measure to the enrollment decision. Data from national samples of cancer survivors and the general public demonstrate the measure's validity and reliability. Results are discussed as they relate to patient understanding of clinical trials, informed decision making, and health communication processes.
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Affiliation(s)
- Jon D Miller
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48823, USA.
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