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Gaillard T, Shambley-Ebron DZ, Vaccaro JA, Neff DF, Padovano CM, Swagger P, Vieira E, Webb F. Intergenerational Influence of African American, Caribbean and Hispanic/Latino Adults Regarding Decision to Participate in Health-Related Research. Res Aging 2024; 46:414-425. [PMID: 38361310 DOI: 10.1177/01640275241229411] [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: 02/17/2024]
Abstract
Introduction: Identifying effective strategies to enroll African American, Caribbean, and Hispanic/Latino adults ≥65 years of age in health research is a public health priority. This study aimed to explore intergenerational influence (IGI) among these populations living throughout Florida. Methods: African American, Caribbean, and Hispanic/Latino adults ≥65 years of age and a trusted family member/friend between 25-64 years participated in virtual listening sessions (LS). Culturally matched facilitators used a semi-structured guide to lead LS that was recorded, transcribed, and uploaded into NVivo©. The constant comparative method was used for analysis. Results: 363 African American, Caribbean, and Hispanic/Latino participated in LS. Five (5) themes relate to IGI emerged: (1) parent-child relationships; (2) family caregiving/parental illness experiences; (3) historical research maltreatment; (4) transfer of cultural knowledge; and (5) future generations. Discussion: Our findings support that IGI can be leveraged to increase the participation of African American, Caribbean, and Hispanic/Latino older adults in health research.
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Affiliation(s)
- Trudy Gaillard
- Nicole Wertheim College of Nursing and Health Science, Florida International University, Miami, FL, USA
| | | | - Joan A Vaccaro
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Donna F Neff
- College of Nursing, Academic Health Science Center, University of Central Florida, Orlando, FL, USA
| | - Cynthia Morton Padovano
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Phildra Swagger
- College of Nursing, Academic Health Science Center, University of Central Florida, Orlando, FL, USA
| | - Edgar Vieira
- Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Science, Florida International University, Miami, FL, USA
| | - Fern Webb
- Department of Surgery, Center for Health Equity & Engagement Research (CHEER), University of Florida, Jacksonville, FL, USA
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Neblett DA, Kennedy-Malone L. Establishing and Affirming Social Connections: Recruiting Non-Hispanic Black Adults with Type 2 Diabetes. Clin Nurs Res 2024; 33:309-315. [PMID: 38178382 DOI: 10.1177/10547738231216530] [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] [Indexed: 01/06/2024]
Abstract
The underrepresentation of non-Hispanic Black adults in clinical research impacts the generalizability and usefulness of research findings. The purpose of this article is to discuss recruitment strategies used in a research study examining the self-care of diabetes and diabetes distress in non-Hispanic Black adults with type 2 diabetes. In this cross-sectional correlation study, the participants were non-Hispanic Black adults with type 2 diabetes living in North Carolina. A questionnaire collected sociodemographic and clinical characteristics. This study was analyzed using descriptive statistics. In total, 512 individuals accessed the online survey. After data screening, 275 participants were used for data analysis. Sixteen recruitment sites provided letters of support, and 13 were active in the recruitment process. Most participants learned about the research study via social media. Social connections resulting in recruitment partners and using social media supported the successful recruitment. The recruitment strategies implemented can inform researchers of effective evidence-based recruitment strategies to increase the participation of non-Hispanic Black adults in clinical research.
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Goin-Kochel RP, Lozano I, Duhon G, Marzano G, Daniels A, Law JK, Diehl K, Green Snyder L, Feliciano P, Chung WK. Evidence-based recruitment strategies for clinical research: Study personnel's and research participants' perceptions about successful methods of outreach for a U.S. Autism-Research Cohort. J Clin Transl Sci 2024; 8:e65. [PMID: 38690223 PMCID: PMC11058577 DOI: 10.1017/cts.2024.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 02/15/2024] [Accepted: 03/25/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Under enrollment of participants in clinical research is costly and delays study completion to impact public health. Given that research personnel make decisions about which strategies to pursue and participants are the recipients of these efforts, we surveyed research staff (n = 52) and participants (n = 4,144) affiliated with SPARK (Simons Foundation Powering Autism for Knowledge) - the largest study of autism in the U.S. - to understand their perceptions of effective recruitment strategies. Methods In Study 1, research personnel were asked to report recruitment strategies that they tried for SPARK and to indicate which ones they would and would not repeat/recommend. In Study 2, SPARK participants were asked to indicate all the ways they heard about the study prior to enrollment and which one was most influential in their decisions to enroll. Results Staff rated speaking with a SPARK-study-team member (36.5%), speaking with a medical provider (19.2%), word of mouth (11.5%), and a live TV news story (11.5%) as the most successful strategies. Participants most often heard about SPARK via social media (47.0%), speaking with a medical provider (23.1%), and an online search (20.1%). Research personnel's and participants' views on effective recruitment strategies often differed, with the exception of speaking with a medical provider. Conclusion Results suggest that a combination of strategies is likely to be most effective in reaching diverse audiences. Findings have implications for the selection of strategies that meet a study's specific needs, as well as recruitment-strategy "combinations" that may enhance the influence of outreach efforts.
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Affiliation(s)
- Robin P. Goin-Kochel
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Ivana Lozano
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Gabrielle Duhon
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Gabriela Marzano
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Amy Daniels
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - J. Kiely Law
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Katharine Diehl
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Pamela Feliciano
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Wendy K. Chung
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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Randolph SD, Jeter E, Johnson R. Using an Equity in Research Framework to Develop a Community-Engaged Intervention to Improve Preexposure Uptake Among Black Women Living in the United States South. J Assoc Nurses AIDS Care 2024; 35:144-152. [PMID: 38949908 DOI: 10.1097/jnc.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
ABSTRACT In the U.S. South, over half of new HIV diagnoses occur among Black Americans with research lagging for women who face increased HIV rates and low PrEP uptake, among other health inequities. Community engaged research is a promising method for reversing these trends with established best practices for building infrastructure, implementing research, and translating evidence-based interventions into clinical and community settings. Using the 5Ws of Racial Equity in Research Framework (5Ws) as a racial equity lens, the following paper models a review of a salon-based intervention to improve PrEP awareness and uptake among Black women that was co-developed with beauty salons, stylists, and Black women through an established community advisory council. In this paper we demonstrate how the 5Ws framework was applied to review processes, practices, and outcomes from a community-engaged research approach. The benefits of and challenges to successful collaboration are discussed with insights for future research and community impact.
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Affiliation(s)
- Schenita D Randolph
- Schenita D. Randolph, PhD, MPH, RN, FAAN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA
- Elizabeth Jeter, PhD, is a Research Associate, Duke University School of Nursing, Durham, North Carolina, USA
- Ragan Johnson, DNP, FNP-BC, CNE, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA
| | - Elizabeth Jeter
- Schenita D. Randolph, PhD, MPH, RN, FAAN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA
- Elizabeth Jeter, PhD, is a Research Associate, Duke University School of Nursing, Durham, North Carolina, USA
- Ragan Johnson, DNP, FNP-BC, CNE, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA
| | - Ragan Johnson
- Schenita D. Randolph, PhD, MPH, RN, FAAN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA
- Elizabeth Jeter, PhD, is a Research Associate, Duke University School of Nursing, Durham, North Carolina, USA
- Ragan Johnson, DNP, FNP-BC, CNE, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA
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Shaw AR, Vidoni ED, Key MN, Yates BA, Thorpe R. Using Focus Groups to Explore Older Black Men's Perception of Dietary Interventions. Am J Mens Health 2024; 18:15579883241241973. [PMID: 38613210 PMCID: PMC11015773 DOI: 10.1177/15579883241241973] [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: 06/05/2023] [Revised: 02/07/2024] [Accepted: 03/10/2024] [Indexed: 04/14/2024] Open
Abstract
Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer's disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted with a total of 10 cognitively normal Black men aged 55 years and older. Survey data were analyzed using a frequency analysis and qualitative data were analyzed using a six-step thematic analysis process. Most men indicated having hypertension (N = 7, 77.8%) and currently not following a dietary eating pattern (N = 8, 88.9%). Emerging themes identified included (1) knowledge of dementia, (2) perceptions of dietary interventions, (3) barriers impacting participation in dietary interventions, and (4) overcoming barriers to engage Black men in dietary interventions. Findings from this study should inform the design of future dietary interventions for AD prevention to enhance participation among older Black men.
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Affiliation(s)
- Ashley R. Shaw
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric D. Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mickeal N. Key
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Brandon A. Yates
- Indiana Center for Musculoskeletal Health, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Roland Thorpe
- Department of Health Behavior and Society, Johns Hopkins University, Baltimore, MD, USA
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Price KA, Warsame R, O'Shea M, Kim Y, Ellingson SA, Asiedu GB. A Mixed-Method Approach to Explore Successful Recruitment and Treatment of Minority Patients on Therapeutic Cancer Clinical Trials at a Tertiary Referral Center Using Photo-Elicitation Interviews. Health Equity 2024; 8:117-127. [PMID: 38435027 PMCID: PMC10908324 DOI: 10.1089/heq.2023.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Under-represented minority patients (URM) enroll in cancer clinical trials (CCT) at low rates. To gain insight into barriers and facilitators to CCT enrollment, we conducted a mixed method study of URM patients who were successfully treated on a therapeutic CCT from 2018-2021 at all institutional sites. Methods A retrospective chart review of 270 minority patients was conducted to identify patient demographics and characteristics. All living URM patients were requested to participate in a survey and qualitative interview using a photo elicitation technique. Results Most patients who participated in a CCT were patients with solid tumors, metastatic disease, and did not live in a rural area. Survey data showed that the two most significant drivers of CCT enrollment were potential of benefit to self and to others (altruism). Direct recommendation from a healthcare provider to participate in CCT was critical. URM patients enrolled on a CCT experience a significant burden of symptoms and financial distress. Key themes identified from the interviews that motivated patients to participate included chance for cure, staying positive, altruism and advancement of science, and having diverse representation in research. Patient-level facilitators to participation included social support, cost coverage, and limited treatment options. Sytematic facilitators identified included minimizing logistical barriers, decentralizing cancer clinical trials, increasing awareness via patient narratives, diversifying research staff, minimizing cost, and being clear on puropose and benefit of the trial. Conclusion Success stories of minority recruitment can provide useful information to enhance minority accrual. Photo elicitation interviews provide rich narratives of patient experience.
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Affiliation(s)
| | - Rahma Warsame
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary O'Shea
- Alix Mayo Medical School, Rochester, Minnesota, USA
| | - Yonghun Kim
- Alix Mayo Medical School, Rochester, Minnesota, USA
| | - Sara A. Ellingson
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Gladys B. Asiedu
- Mayo Clinic Center for the Science of Healthcare Delivery, Rochester, Minnesota, USA
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Martorella M, Kasela S, Garcia-Flores R, Gokden A, Castel SE, Lappalainen T. Evaluation of noninvasive biospecimens for transcriptome studies. BMC Genomics 2023; 24:790. [PMID: 38114913 PMCID: PMC10729488 DOI: 10.1186/s12864-023-09875-4] [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: 07/17/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
Transcriptome studies disentangle functional mechanisms of gene expression regulation and may elucidate the underlying biology of disease processes. However, the types of tissues currently collected typically assay a single post-mortem timepoint or are limited to investigating cell types found in blood. Noninvasive tissues may improve disease-relevant discovery by enabling more complex longitudinal study designs, by capturing different and potentially more applicable cell types, and by increasing sample sizes due to reduced collection costs and possible higher enrollment from vulnerable populations. Here, we develop methods for sampling noninvasive biospecimens, investigate their performance across commercial and in-house library preparations, characterize their biology, and assess the feasibility of using noninvasive tissues in a multitude of transcriptomic applications. We collected buccal swabs, hair follicles, saliva, and urine cell pellets from 19 individuals over three to four timepoints, for a total of 300 unique biological samples, which we then prepared with replicates across three library preparations, for a final tally of 472 transcriptomes. Of the four tissues we studied, we found hair follicles and urine cell pellets to be most promising due to the consistency of sample quality, the cell types and expression profiles we observed, and their performance in disease-relevant applications. This is the first study to thoroughly delineate biological and technical features of noninvasive samples and demonstrate their use in a wide array of transcriptomic and clinical analyses. We anticipate future use of these biospecimens will facilitate discovery and development of clinical applications.
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Affiliation(s)
- Molly Martorella
- New York Genome Center, New York, NY, USA.
- Department of Systems Biology, Columbia University, New York, NY, USA.
| | - Silva Kasela
- New York Genome Center, New York, NY, USA
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Renee Garcia-Flores
- New York Genome Center, New York, NY, USA
- Department of Computer Science, Columbia University, New York, NY, USA
- Undergraduate Program On Genomic Sciences, National Autonomous University of Mexico, Cuernavaca, Morelos, Mexico
| | | | - Stephane E Castel
- New York Genome Center, New York, NY, USA.
- Department of Systems Biology, Columbia University, New York, NY, USA.
| | - Tuuli Lappalainen
- New York Genome Center, New York, NY, USA.
- Department of Systems Biology, Columbia University, New York, NY, USA.
- Science for Life Laboratory, Department of Gene Technology, KTH Royal Institute of Technology, Stockholm, Sweden.
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Agbonmwandolor JO, Brand S. Evaluating ethnically diverse patients' perspectives of considering participation in renal clinical research. Nurse Res 2023; 31:38-44. [PMID: 37881871 DOI: 10.7748/nr.2023.e1904] [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] [Accepted: 06/13/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Clinical trial cohorts do not often reflect target patient populations because minority ethnic groups are underrepresented in clinical trials. AIM To increase minority ethnic groups' opportunities to participate in clinical trials, by evaluating ethnically diverse patients' perspectives of considering participation in renal clinical research. DISCUSSION The authors gave patients participating in at least one research study the opportunity to take part in a structured survey. The survey explored preferences, barriers and opportunities that patients considered when deciding whether to take part in a clinical trial. The authors included participants from multiple ethnic groups so they could compare data for different ethnicities. CONCLUSION Participation was a positive experience for most patients, mostly because of the research team's flexibility and professionalism. Researchers' gender and ethnicity did not affect the participants' decision to participate. Cultural preferences were not obvious from the data as 80% of the participants were white. IMPLICATIONS FOR PRACTICE Patients preferred a face-to-face approach and the expertise of the research team affected participation more than any other characteristics did. However, respondents were already research-engaged and conducting a similar study with those who have declined to participate in research may show different results.
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Affiliation(s)
| | - Sarah Brand
- Renal and Transplant Unit, David Evans Medical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, England
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Kim K, Jergel A, Bai S, Bradley K, Karim B, Shah A, Suglia S, Ugboh N, Gooding HC. Feasibility of recruiting adolescents into a prospective cohort study of the effects of social isolation during COVID-19. Pilot Feasibility Stud 2023; 9:191. [PMID: 38001548 PMCID: PMC10668405 DOI: 10.1186/s40814-023-01418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Social connection and loneliness in adolescence are increasingly understood as critical influences on adult mental and physical health. The unique impact of the social isolation imposed by the COVID-19 lockdown on emerging adults is therefore expected to be especially profound. We sought to investigate the feasibility of using ecological momentary assessment (EMA) and wearable accelerometers to characterize the effects of social isolation and/or loneliness experienced by adolescents during the COVID-19 pandemic. METHODS We recruited 19 participants aged 13-18 from an Adolescent Medicine practice in Atlanta, GA. Participants completed surveys at baseline and throughout a 2-week study period using EMA regarding their degree of social isolation, loneliness, family functioning, school climate, social media use, and COVID-19 experiences surrounding their physical, mental, and social domains. Six participants agreed to wear an activity tracker and heart rate measurement device for 14 days to monitor their emotional state and physical health. Participant feedback was collected via open-ended exit interviews. Feasibility of recruitment/retention, adherence, and outcome measures were investigated. Implementation was also assessed by evaluating the barriers and facilitators to study delivery. Associations between the social isolation and loneliness variables and all other variables were performed with univariate linear regression analysis with significance set at p < 0.05. The progression criteria were a recruitment rate of > 30% and a retention rate of > 80%. RESULTS Progression criteria were met for recruitment (76%) of participants, but not retention (38%). Adherence to EMA survey completion was highly variable with only 54% completing ≥ 1 survey a day, and accelerometry use was not feasible. Social isolation was significantly correlated with lower school climate, higher COVID-19 experiences, higher depression scores, and lower sleep quality. Loneliness also showed a significant correlation with all these factors except COVID-19 experiences. CONCLUSIONS EMA and wearable accelerometer use was not feasible in this longitudinal study of adolescents during the COVID-19 pandemic. Future research should further investigate barriers to conducting long-term research with adolescents and the potential effects of the pandemic on subject recruitment and retention.
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Affiliation(s)
- Kain Kim
- Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA, 30307, USA
| | - Andrew Jergel
- Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA
| | - Shasha Bai
- Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA
| | - Kolbi Bradley
- Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA
| | - Brianna Karim
- Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA
| | - Amit Shah
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA, 30322, USA
| | - Shakira Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA, 30322, USA
| | - Ngozi Ugboh
- Ross University School of Medicine, 2300 SW 145th Ave #200, Miramar, FL, 33027, USA
| | - Holly C Gooding
- Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA.
- Children's Healthcare of Atlanta, Atlanta, GA, USA.
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Gwizdala KL, Bazzano LA, Newton RL, Carmichael OT. Race and sex differences in the association between lifespan glycemic status and midlife cognitive function: the Bogalusa heart study. Front Public Health 2023; 11:1200415. [PMID: 38035298 PMCID: PMC10684774 DOI: 10.3389/fpubh.2023.1200415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Glycemic markers throughout life are associated with increased risk of midlife cognitive decline, yet it is unclear whether these associations differ by race and sex. Methods This study used cross-sectional analysis of prospectively maintained cohort. 1,295 participants in the Bogalusa Heart Study, a biracial epidemiological cohort located in a micropolitan area core setting, provided fasting plasma insulin (FPI) and glucose (FPG) biannually from 1973 to 2016. Memory, executive function (EF), attention, working memory (WM), and global cognition (GC), collected 2013-2016. Glycemic markers (i.e., FPG, FPI, and HOMA-IR) averaged within lifespan epochs (≤ 20 years, childhood/adolescence (C/A); 21-40 years, early adulthood (EA); and 40-58 years, midlife). Linear regression models were analyzed for each epoch and separate models were analyzed with sex and race, education as a covariate. Results Sample was 59% women, 34% African American (AA). Among women, higher C/A FPG was associated with poorer memory and poorer GC. Higher EA FPG was associated with poorer WM. Among men, higher EA HOMA-IR was associated with worse attention. Higher C/A HOMA-IR and FPI were associated with better memory, as was higher EA FPI. Among AA, higher C/A FPG was associated with worse attention, EF, and GC. Higher EA HOMA-IR was associated with worse attention. Higher midlife FPI and C/A HOMA-IR were associated with worse WM and EF among White Americans (WAs). Discussion Markers indicative of hyperglycemia at different epochs were associated with worse midlife cognition in women, AAs, and WAs; but not in men. Differences in the relationship between lifespan glycemic exposures and midlife cognition could reflect broader health disparities.
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Affiliation(s)
- Kathryn L. Gwizdala
- Physical Activity and Ethnic Minority Health Laboratory, Department of Population and Public Health Sciences, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Lydia A. Bazzano
- Tulane Center for Lifespan Epidemiology Research, Tulane University School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Robert L. Newton
- Physical Activity and Ethnic Minority Health Laboratory, Department of Population and Public Health Sciences, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Owen T. Carmichael
- Biomedical Imaging Center, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
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Hensel B, Askins N, Ibarra E, Aristizabal C, Guzman I, Barahona R, Hazelton-Glenn B, Lee J, Zhang Z, Odedina F, Wilkie DJ, Stern MC, Baezconde-Garbanati L, Suther S, Webb F. Florida-California Cancer Health Equity Center (CaRE 2) Community Scientist Research Advocacy Program. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1429-1439. [PMID: 37642919 PMCID: PMC10509126 DOI: 10.1007/s13187-023-02351-3] [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] [Accepted: 07/30/2023] [Indexed: 08/31/2023]
Abstract
The Community Scientist Program (CSP), a model connecting researchers with community members, is effective to inform and involve the general population in health-related clinical research. Given the existing cancer disparities among Black/African American and Hispanic/Latino/a populations, more models describing how cancer-related CSPs are designed, implemented, and evaluated are needed. The Florida-California Cancer Research, Education and Engagement (CaRE2) Health Equity Center is a tri-institutional, bicoastal center created to eliminate cancer health disparities among Black/African American and Hispanic/Latino/a populations living in California and in Florida. The CaRE2 Center created a Community Scientist Research Advocacy (CSRA) training program for community members to become cancer research advocates. The CSRA program is currently a 13-week program conducted 100% virtually with all materials provided in English and Spanish for participants to learn more about prostate, lung, and pancreas cancers, ongoing research at CaRE2, and ways to share cancer research throughout their communities. Participants attend didactic lectures on cancer research during weeks 1-5. In week 4, participants join CSRA self-selected groups based on cancer-related topics of interest. Each group presents their cancer-related advocacy project developed during weeks 5-12 at the final session. In this paper, we describe the CaRE2 Health Equity Center's CSRA program, share results, and discuss opportunities for improvement in future program evaluation as well as replication of this model in other communities.
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Affiliation(s)
- B Hensel
- Department of Biobehavioral Nursing Science, University of Florida, Orlando, FL, USA.
| | - N Askins
- Department of Research and Graduate Programs, Florida State University, Orlando, FL, USA
| | - E Ibarra
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - C Aristizabal
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - I Guzman
- Department of Biobehavioral Nursing Science, University of Florida, Orlando, FL, USA
| | - R Barahona
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - B Hazelton-Glenn
- Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - J Lee
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Z Zhang
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - F Odedina
- Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA
| | - D J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - M C Stern
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - L Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - S Suther
- Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - F Webb
- Department of Surgery, University of Florida, Jacksonville, FL, USA
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Dimitropoulos G, Singh M, Mushquash C, Kimber M, Hutt-MacLeod D, Moore EK, Perri A, Webb C, Norman L, Sauerwein J, Nicula M, Couturier J. TransitionED: A protocol for Co-designing and implementing Canadian practice guidelines for transitions for youth with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2023. [PMID: 37690096 DOI: 10.1002/erv.3026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/16/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Limited guidelines inform the transition from paediatric to adult healthcare for youth and young adults (YYA) with eating disorders (EDs). This study will develop, implement, and evaluate Canadian Clinical Practice Guidelines for ED transition, including identifying the relevant measurement and evaluation tools for transition readiness and continuity of care. METHODS This study consists of three phases. Phase 1 involves conducting a scoping review of the evidence on transition interventions, outcomes, and measurement tools for YYA with EDs, along with guideline development using the modified Delphi method. Phase 2 identifies the contextual/cultural factors relevant to guideline implementation and co-designing an implementation protocol with governance committees and research partners. Phase 3 involves the application and evaluation of the proposed guide lines using the implementation protocol, and assessing the acceptability and feasibility of a prototype transition intervention in two Canadian paediatric ED programs. CONCLUSIONS Results will provide the knowledge needed to enhance the lives of YYA, improve the effectiveness of the ED care system, and support the scale of the transition guidelines across Canada. These guidelines will have international relevance by potentially informing the field on how to support young people with EDs transitioning in similar funding structures and systems of care.
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Affiliation(s)
- Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Manya Singh
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Christopher Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Ontario, Canada
- Thunder Bay Regional Health Sciences Centre/Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Andrea Perri
- Child and Adolescent Addictions, Mental Health and Psychiatry Program, Alberta Health Services, Edmonton, Alberta, Canada
| | - Cheryl Webb
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lia Norman
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Jessica Sauerwein
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Maria Nicula
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Couturier
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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13
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Nissim NR, Fudge MR, Lachner C, Babulal GM, Allyse MA, Graff-Radford NR, Lucas JA, Day GS. Age-Specific Barriers and Facilitators to Research Participation Amongst African Americans in Observational Studies of Memory and Aging. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01741-z. [PMID: 37555913 PMCID: PMC10853486 DOI: 10.1007/s40615-023-01741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/15/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Black/African Americans experience a high burden of Alzheimer disease and related dementias yet are critically underrepresented in corresponding research. Understanding barriers and facilitators to research participation among younger and older African Americans is necessary to inform age-specific strategies to promote equity in studies of early- and late-onset neurodegenerative diseases. STUDY DESIGN Survey respondents (n = 240) rated barriers and facilitators of research participation. Age-specific differences were evaluated using nonparametric Kruskal-Wallis tests across respondents aged 18-44 years (n = 76), 45-64 years (n = 83), and ≥ 65 years (n = 81). Strategies to mitigate barriers and promote facilitators were further explored via community-based focus groups. Pooled frequency of common themes discussed in focus groups were evaluated and compared across different ages including ≥ 45 years, ≥ 65 years, and mixed ages ≥ 45 years. RESULTS Younger respondents (aged 18-44 and 45-64 years) expressed a greater need for flexibility in when, where, and how research testing takes place versus adults ≥ 65 years. Focus groups emphasized long-lasting consequences of systemic racism and the need to build and foster trust to resolve barriers and promote research engagement amongst African Americans. DISCUSSION Age-specific strategies are needed to increase engagement, address recruitment disparities, and promote retention of African American participants in memory and aging studies across the lifespan.
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Affiliation(s)
- Nicole R Nissim
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Michelle R Fudge
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Christian Lachner
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Megan A Allyse
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - John A Lucas
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA.
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14
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Knopf A, Draucker CB, Fortenberry JD, Ott MA, Arrington-Sanders R, Reirden D, Schneider J, Straub D, Ofner S, Bakoyannis G, Zimet G. Parental Engagement in Consent Processes for Enrollment in Biomedical HIV Prevention Trials: Implications for Minor Adolescents' Willingness to Participate. J Adolesc Health 2023; 72:703-711. [PMID: 36646563 PMCID: PMC11114099 DOI: 10.1016/j.jadohealth.2022.11.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/10/2022] [Accepted: 11/22/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE Minor adolescents are often excluded from HIV prevention clinical trials due to unresolved ethical issues. Their under-representation in research leads to delayed access to new HIV prevention approaches. We examine the relationship between consent procedures, trial features, demographic and social characteristics, and minor adolescents' willingness to participate (WTP) in biomedical HIV prevention research. METHODS We recruited 14-17-year-olds at risk of HIV for this quasi-experimental study. Adolescents were randomly assigned to (1) self-consent, (2) adult permission required, or (3) parental permission required and underwent simulated consent procedures for two types of HIV prevention trials. They rated likelihood of participating in each study if offered the opportunity and completed a survey with demographic, social, and behavioral measures. RESULTS One hundred and twenty nine adolescents with diverse identities and socioeconomic status enrolled. Among the 58% of participants who identified as lesbian, gay, bisexual, transgender, or queer (LGBTQ), 76% were out to at least one parent/guardian (outness). Mean WTP was 3.6 (of 5; 5 = definitely would participate) across all participants and both trial types. We found no evidence of an association between WTP and consent condition, LGBTQ identity, or outness. However, medical mistrust, communication with parents, and concern about HIV were associated with WTP. DISCUSSION Our results suggest adolescents are willing to participate in HIV prevention trials and parental involvement in the consent process may not be the most important deciding factor. However, variation in WTP within consent groups, and variation in other significant variables, underscores the need for individualized approaches to recruitment and consent for these trials.
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Affiliation(s)
- Amelia Knopf
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, Indiana.
| | - Claire Burke Draucker
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Mary A Ott
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Renata Arrington-Sanders
- Division of Adolescent and Young Adult Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Daniel Reirden
- Section of Adolescent Medicine & Children's Hospital Colorado, School of Medicine, University of Colorado, Aurora, Colorado
| | - John Schneider
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Diane Straub
- Section of Adolescent Medicine & Children's Hospital Colorado, School of Medicine, University of Colorado, Aurora, Colorado
| | - Susan Ofner
- Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Giorgos Bakoyannis
- Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, Indiana; Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Gregory Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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15
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Syder NC, Elbuluk N. Racial and Ethnic Disparities in Research and Clinical Trials. Dermatol Clin 2023; 41:351-358. [PMID: 36933925 DOI: 10.1016/j.det.2022.10.007] [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] [Indexed: 02/04/2023]
Abstract
Clinical trials are an essential component of research for determining the safety and efficacy of treatments for medical diseases. In order for the results of clinical trials to be generalizable to diverse populations, they must include participants at ratios that are reflective of national and global populations. A significant number of dermatology studies not only lack racial/ethnic diversity but also fail to report data on minority recruitment and enrollment. Reasons for this are multifold and are discussed in this review. Although steps have been implemented to improve this issue, greater efforts are needed for sustained and meaningful change.
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Affiliation(s)
- Nicole C Syder
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 South Flower Street, Ste 100, Los Angeles, CA 90017, USA
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 South Flower Street, Ste 100, Los Angeles, CA 90017, USA.
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16
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Fakolade A, Akbar N, Mehelay S, Phadke S, Tang M, Alqahtani A, Pullattayil AK, Busse M. Mapping two decades of multiple sclerosis rehabilitation trials: A systematic scoping review and call to action to advance the study of race and ethnicity in rehabilitation research. Mult Scler Relat Disord 2023; 72:104606. [PMID: 36917889 DOI: 10.1016/j.msard.2023.104606] [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: 11/21/2022] [Revised: 01/16/2023] [Accepted: 03/04/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Multiple sclerosis (MS), is prevalent across many racial and ethnic groups, and disproportionately impacts racially minoritized populations. Rehabilitation interventions are an important component of comprehensive MS care. Yet, we do not know the extent to which MS rehabilitation trials consider race and ethnicity in defining eligibility criteria, planning recruitment strategies, selecting outcome measures, supporting intervention delivery, and designing approaches to promote adherence and retention. METHODS We conducted a scoping review of five databases (MEDLINE, CINAHL, Cochrane Central, EMBASE, and Web of Science) to locate randomized controlled rehabilitation trials published from January 2002 to March 2022. We extracted data from relevant studies, assessed their methodological quality, and narratively summarized results. Reporting of this review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS Fifty-six studies of neurorehabilitation (n = 3), cognitive rehabilitation (n = 6), exercise training (n = 9) and self-management (n = 38) interventions were included in this review. The studies were predominantly from North America (n = 44; 73%) or Europe (n = 12; 20%) and included 4280 participants. Most participants (n = 3669; 86%) were Caucasians. Less than 10% of participants were Black (n = 282), Latinx/Hispanic (n = 60), Asian (n = 46), Indigenous (n = 7), or Arab (n = 2). Few studies discussed how race and/or ethnicity were considered in trial planning or execution. CONCLUSIONS Without consistent and systematic attention to race and ethnicity, both in terms of trial design and reporting, it is impossible to know how MS rehabilitation interventions will translate into real-world applications. This call to action - to the MS rehabilitation research community to ensure trial and intervention processes that accommodate the needs of diverse racial and ethnic groups - is an important first step in addressing inequities in rehabilitation care for persons with MS.
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Affiliation(s)
- Afolasade Fakolade
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston K7L 3N6, Canada.
| | - Nadine Akbar
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston K7L 3N6, Canada; Research Department, Humber River Hospital, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sumaya Mehelay
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Siona Phadke
- Department of Psychology, Queen's University, Kingston, Canada; Department of Biology, Queen's University, Kingston, Canada
| | - Matthew Tang
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Ashwaq Alqahtani
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston K7L 3N6, Canada; Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraydah 52645, Saudi Arabia
| | | | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
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17
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Fears NE, Sherrod GM, Templin TN, Bugnariu NL, Patterson RM, Miller HL. Community-based postural control assessment in autistic individuals indicates a similar but delayed trajectory compared to neurotypical individuals. Autism Res 2023; 16:543-557. [PMID: 36627838 PMCID: PMC10023334 DOI: 10.1002/aur.2889] [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] [Received: 02/15/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023]
Abstract
Autistic individuals exhibit significant sensorimotor differences. Postural stability and control are foundational motor skills for successfully performing many activities of daily living. In neurotypical development, postural stability and control develop throughout childhood and adolescence. In autistic development, previous studies have focused primarily on individual age groups (e.g., childhood, adolescence, adulthood) or only controlled for age using age-matching. Here, we examined the age trajectories of postural stability and control in autism from childhood through adolescents using standardized clinical assessments. In study 1, we tested the postural stability of autistic (n = 27) and neurotypical (n = 41) children, adolescents, and young adults aged 7-20 years during quiet standing on a force plate in three visual conditions: eyes open (EO), eyes closed (EC), and eyes open with the head in a translucent dome (Dome). Postural sway variability decreased as age increased for both groups, but autistic participants showed greater variability than neurotypical participants across age. In study 2, we tested autistic (n = 21) and neurotypical (n = 32) children and adolescents aged 7-16 years during a dynamic postural control task with nine targets. Postural control efficiency increased as age increased for both groups, but autistic participants were less efficient compared to neurotypical participants across age. Together, these results indicate that autistic individuals have a similar age trajectory for postural stability and control compared to neurotypical individuals, but have lower postural stability and control overall.
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Affiliation(s)
- Nicholas E. Fears
- University of Michigan, 830 N. University Ave., Ann Arbor, Michigan, 48170, USA
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- Louisiana State University, 50 Fieldhouse Dr. Baton Rouge, Louisiana, 70802, USA
| | - Gabriela M. Sherrod
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- University of Alabama at Birmingham, 1720 University Blvd., Birmingham, AL, 35294, USA
| | - Tylan N. Templin
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- Southwest Research Institute, 6220 Culebra Rd., San Antonio, TX, 78238, USA
| | - Nicoleta L. Bugnariu
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
- University of the Pacific, School of Health Sciences, 155 Fifth St., San Francisco, CA, 94103, USA
| | - Rita M. Patterson
- University of North Texas Health Science Center, Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
| | - Haylie L. Miller
- University of Michigan, 830 N. University Ave., Ann Arbor, Michigan, 48170, USA
- University of North Texas Health Science Center, School of Health Professions, 3500 Camp Bowie Blvd., Fort Worth, TX, 76109, USA
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18
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Understanding the Association Between Mental Health Knowledge and Mental Health Service Utilization Among Black Adults. Community Ment Health J 2023; 59:57-67. [PMID: 35794413 PMCID: PMC10371774 DOI: 10.1007/s10597-022-00988-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/16/2022] [Indexed: 01/07/2023]
Abstract
Mental health knowledge limitations may contribute to the treatment gap among Black adults. We conducted an online cross-sectional study of Black adults in the United States (n = 262, aged 18-65 years) from diverse ethnic backgrounds (African-Americans, African immigrants, Afro-Caribbean immigrants). Gamma regression using generalized linear models was used to estimate the associations between mental health knowledge and willingness to seek help from mental health professionals. After adjusting for age, education and ethnicity, participants with higher specific knowledge about mental health (such as recognition of schizophrenia as a mental illness) were 26% more likely to report willingness to seek help from a mental health professional for personal and emotional problems (RR = 1.26, CI 1.12-1.41, p < 0.001). Knowledge building interventions (such as psychoeducation) that seek to increase specific knowledge (rather than general knowledge) may correlate more strongly with utilization of mental health services among Black adults.
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Eliacin J, Hathaway E, Wang S, O'Connor C, Saykin AJ, Cameron KA. Factors influencing the participation of Black and White Americans in Alzheimer's disease biomarker research. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12384. [PMID: 36505397 PMCID: PMC9728547 DOI: 10.1002/dad2.12384] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022]
Abstract
Introduction Alzheimer's disease (AD) is a public health priority. AD biomarkers may vary based on race, but the recruitment of diverse participants has been challenging. Methods Three groups of Black and White participants with and without prior research advocacy or participation were interviewed individually or in focus groups to better understand perspectives related to AD biomarker research participation. A rapid qualitative data analytic approach was used to analyze the data. Results Identified barriers to AD biomarker research participation included hesitancy due to fear, distrust of research and researchers, lack of relevant knowledge, and lack of research test results disclosure. Drivers for engagement in biomarker research procedures included knowledge about research, AD, and related clinical procedures, perceived benefits of participation, and outreach from trusted sources. Discussion Participants' comments related to the need for diversity in research and desire for results disclosure suggest opportunities to engage Black individuals. Highlights Black Americans experience more salient barriers to Alzheimer's disease (AD) biomarker research participation.Concerns about research diversity influence research participation decisions.Research test disclosure may affect research participation and retention.
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Affiliation(s)
- Johanne Eliacin
- VA HSR&D Center for Health Information and CommunicationRichard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
- Regenstrief InstituteIndianapolisIndianaUSA
- National Center for PTSDBoston VA Healthcare SystemBostonMassachusettsUSA
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisIndianaUSA
| | - Elizabeth Hathaway
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Sophia Wang
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Caitlin O'Connor
- VA HSR&D Center for Health Information and CommunicationRichard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Andrew J. Saykin
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisIndianaUSA
- Center for NeuroimagingDepartment of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Kenzie A. Cameron
- Department of MedicineDivision of General Internal MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
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20
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Jones LM, de Marco K, Keener K, Monroe KE. Blood Pressure and Self-Management in Black Women with Hypertension: Protocol Revisions to the BRAINS Study due to the COVID-19 Pandemic (Preprint). JMIR Res Protoc 2022; 12:e43849. [PMID: 37104029 PMCID: PMC10176141 DOI: 10.2196/43849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and the halt to in-person research activities beginning in March 2020 brought new challenges to protocol development and implementation. Due to the pandemic, we had to revise our protocol for the Brain Relationships Among Information, Neuroprocessing, and Self-Management (BRAINS) study, which was designed to examine health information behavior, brain activity, diabetes status, and self-management behavior among Black women with hypertension. OBJECTIVE This report outlines 7 steps describing how our research team (1) revised the BRAINS study protocol, (2) implemented a remote method of data collection, and (3) mitigated the challenges we faced. METHODS Prior to March 2020, Black women with hypertension were invited to participate in the BRAINS study to undergo a functional magnetic resonance imaging scan, complete surveys, have their blood pressure measured, and have their blood drawn. After these measures were collected, participants would receive phone calls from a dietician to complete two 24-hour dietary recalls using the Nutrition Data System for Research. Our revised protocol relied on a web-based, interactive approach. Participants received a study kit that included an Omron automatic home blood pressure monitor and a hemoglobin A1c kit from the DTIL laboratory. In a Zoom meeting with each participant, our team played an introductory video, administered surveys (via Qualtrics), and guided participants through measuring their blood pressure and performing a finger stick to collect a blood sample for hemoglobin A1c testing. We examined cognitive function using the TestMyBrain Digital Neuropsychology Toolkit, as we were unable to access the functional magnetic resonance imaging laboratory to assess brain activity. The 7 steps in revising our protocol were as follows: conceptualizing the move from in-person to remote study activities (step 1); contacting the funders (step 2); submitting changes for Institutional Review Board approval (step 3); preparing to implement the revised protocol (step 4); implementing the study changes (step 5); mitigating challenges (step 6); and evaluating protocol implementation (step 7). RESULTS Approximately 1700 individuals responded to web-based advertisements about the BRAINS study. A total of 131 individuals completed our eligibility screener. We conducted our first Zoom appointment in July 2020 and our last Zoom appointment in September 2020. Using our revised strategies, a total of 99 participants completed all study measures within a 3-month period. CONCLUSIONS In this report, we discuss successes and challenges in revising our protocol and reaching our population of interest remotely, safely, and effectively. The information we have outlined can help researchers create similar protocols to reach and conduct research remotely with diverse populations, such as individuals who are unable to participate in studies in person. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43849.
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Affiliation(s)
- Lenette M Jones
- Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Kayla de Marco
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Katharine Keener
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Korrey E Monroe
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
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21
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Promoting Inclusive Recruitment: a Qualitative Study of Black Adults' Decision to Participate in Genetic Research. J Urban Health 2022; 99:803-812. [PMID: 35879487 PMCID: PMC9312310 DOI: 10.1007/s11524-022-00664-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 11/05/2022]
Abstract
Underrepresentation of Black individuals in genetic research is a longstanding issue. There are well-documented strategies to improve the enrollment of Black participants; however, few studies explore these strategies-as well as the barriers and facilitators for participation-by sampling Black people who have previously participated in genetic research. This study explores the decision-making process of Black adults who have participated in genetic research to identify best practices in the recruitment of Black subjects in genetic research. We conducted 18 semi-structured interviews with Black adults with prior research participation in genetic studies housed at an urban academic medical center in the United States of America (USA). An online survey was conducted with the participants to gather demographic data and information on prior research participation. Trust in research was ascertained with the Corbie-Smith Distrust in Clinical Research Index. Two participants scored high levels of distrust using the validated index. Using thematic content analysis, 4 themes emerged from the interviews: (1) Participants are active players in health system, (2) information is power, and transparency is key, (3) therapeutic alliances and study characteristics facilitate participation, and (4) race pervades the research process. The decision to participate in genetic research for the participants in our study was prompted by participants' internal motivations and facilitated by trust in their doctor, trust in the institution, and ease of participation. Most participants viewed their enrollment in genetic research in the context of their own racial identity and the history of medical racism in the USA.
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22
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Clark LR, Erickson CM, Jonaitis EM, Ma Y, Chin NA, Basche K, Ketchum FB, Gleason CE. Anticipated reactions to learning Alzheimer's disease biomarker results. Alzheimers Res Ther 2022; 14:85. [PMID: 35733219 PMCID: PMC9214979 DOI: 10.1186/s13195-022-01027-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION We developed the Alzheimer's Biomarker Survey to assess willingness to enroll in biomarker studies that disclose results and anticipated reactions to an elevated biomarker result. METHODS Participants included cognitively unimpaired adults enrolled in longitudinal AD studies (n = 334, mean age = 64.8 ± 7.7, 44% non-Hispanic Black or African American). Exploratory and confirmatory factor analyses determined the latent structure comprising anticipated reactions to learning AD biomarker results. Measurement invariance was tested across racial groups. RESULTS Two models comprising behavior change and psychological impact fit well for the total sample and the two racial groups. The 2-factor behavior change model assessed constructs of planning and dementia risk-reduction. The 3-factor psychological impact model assessed constructs of distress, cognitive symptoms, and stigma. Both models exhibited measurement invariance across racial groups. DISCUSSION The 28-item Anticipated Reactions to AD Biomarker Disclosure scale is a reliable and valid measure of anticipated reactions when communicating AD biomarker results to research participants.
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Affiliation(s)
- Lindsay R. Clark
- grid.14003.360000 0001 2167 3675Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA ,grid.417123.20000 0004 0420 6882Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI USA
| | - Claire M. Erickson
- grid.14003.360000 0001 2167 3675Neuroscience & Public Policy Program, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA
| | - Erin M. Jonaitis
- grid.14003.360000 0001 2167 3675Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA
| | - Yue Ma
- grid.14003.360000 0001 2167 3675Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA
| | - Nathaniel A. Chin
- grid.14003.360000 0001 2167 3675Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA
| | - Kristin Basche
- grid.14003.360000 0001 2167 3675Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA
| | - Frederick B. Ketchum
- grid.14003.360000 0001 2167 3675Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA
| | - Carey E. Gleason
- grid.14003.360000 0001 2167 3675Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI USA ,grid.417123.20000 0004 0420 6882Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI USA
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Erickson CM, Chin NA, Ketchum FB, Jonaitis EM, Zuelsdorff ML, Gleason CE, Clark LR. Predictors of Willingness to Enroll in Hypothetical Alzheimer Disease Biomarker Studies that Disclose Personal Results. Alzheimer Dis Assoc Disord 2022; 36:125-132. [PMID: 35125399 PMCID: PMC9132241 DOI: 10.1097/wad.0000000000000490] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We examined factors related to willingness to enroll in hypothetical Alzheimer disease (AD) biomarker studies. METHODS Using linear regression, we assessed the relationship among enrollment willingness and demographics, family dementia history, research attitudes, concern about AD, experiences of discrimination, and belief in AD risk modifiability. Inductive coding was used to assess qualitative data. RESULTS In middle-aged and older adult AD research participants (n=334), willingness to enroll in biomarker studies was driven by biomarker collection method, research attitudes, and disclosure of personal results. Predictors of willingness were similar for Black and White participants. Themes associated with increased willingness included a desire to learn biomarker results and support research. DISCUSSION Research attitudes were an important predictor of biomarker study willingness regardless of race. As seen elsewhere, Black participants were more hesitant to participate in biomarker research. Disclosure of biomarker results/risk can bolster willingness to enroll in biomarker studies, particularly for Black participants.
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Affiliation(s)
| | | | | | | | - Megan L. Zuelsdorff
- Alzheimer’s Disease Research Center
- University of Wisconsin School of Nursing, Madison, WI
| | - Carey E. Gleason
- Alzheimer’s Disease Research Center
- Department of Medicine
- Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Lindsay R. Clark
- Alzheimer’s Disease Research Center
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI
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Pearson S, Temple L, Bishop T, Ukaegbu A, Alden J, Kwagyan J, Sanses TVD. Community-based Versus Traditional Research Among Older Minority Women With Urinary Incontinence. Female Pelvic Med Reconstr Surg 2022; 28:201-206. [PMID: 34387261 PMCID: PMC8831655 DOI: 10.1097/spv.0000000000001089] [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: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate research retention of older minority women with urinary incontinence (UI) using a community-based participatory research (CBPR) versus a traditional research approach. METHODS An ancillary prospective study was conducted within an ongoing pilot randomized clinical trial to treat UI. Participants were recruited using CBPR in collaboration with a local community versus a traditional research approach at an academic center. Inclusion criteria were women 65 years and older and symptomatic UI. The primary outcome was the randomization rate defined as the proportion of women randomized into the randomized clinical trial out of screened participants. Screening and consent rates were also evaluated. Pearson χ2, Fisher exact, and t tests were used. The effect of CBPR on research retention rates was expressed as odds ratio (OR) with 95% confidence intervals (CI). RESULTS There were 10 and 88 women screened in the CBPR and traditional research groups, respectively. The CBPR participants were Hispanic (n = 10, 100%) and older (78.4 ± 8.3 years; P < 0.01). Most of the traditional research participants were non-Hispanic Black (n = 55, 62.5%) and younger (71.0 ± 4.9 years). The CBPR group had higher rates of screening (76.9% vs 40.6%; P = 0.01), consent (80% vs 44.3%; P = 0.045), and randomization (50.0% vs 14.8%; P < 0.01) compared with the traditional research group. Community-based participatory research increased the odds of research retention during screening (OR, 4.9; 95% CI, 1.3-18.2), consent (OR, 5.0; 95% CI, 1.0-25.0), and randomization (OR, 5.8; 95% CI, 1.5-22.7). CONCLUSION Compared with traditional research, CBPR yielded higher research retention among older minority women with UI in a clinical study.
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Affiliation(s)
- Sharee Pearson
- From the Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC
| | - Luisa Temple
- From the Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC
| | | | | | | | | | - Tatiana V D Sanses
- From the Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC
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Mansfield LN, Nagy GA, Solorzano R, Carreño M, Mercado Emerson M, Solis Guzman ML, Gonzalez-Guarda RM. Targeted Strategies for Recruitment and Engagement of Latinx Immigrants in Longitudinal Biobehavioral Research. HISPANIC HEALTH CARE INTERNATIONAL 2022; 21:68-77. [PMID: 35238247 DOI: 10.1177/15404153221083659] [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: 11/16/2022]
Abstract
Introduction: Racial/ethnic minority communities are underrepresented in research. Medical mistrust and mistreatment, discrimination, and a lack of diverse research workforce may influence recruitment and engagement. Engaging Latinx immigrants for research presents unique recruitment challenges, especially for biobehavioral research which is not well explored. The purpose of this paper is to examine the effect of targeted strategies for recruiting young adult, Latinx immigrants. Methods: Recruitment occurred from 2018 to 2019 in an ongoing, longitudinal, community-engaged research study examining risk and resilience factors for health outcomes in Latinx immigrants. Strategies included active recruitment (e.g., community-based events and public events) and passive recruitment (e.g., word-of-mouth and radio and flyer advertisements). Logistic regression analysis was conducted to examine the influence of type of recruitment on participant enrollment. Results: The study enrolled 391 participants of 701 interested individuals (55%). Greater odds of enrollment were among participants recruited through radio and flyer advertisements (adjusted odds ratio [AOR]=2.90, 95%CI [1.59, 5.27], p=.001), word-of-mouth (AOR=2.50, 95% CI [1.55, 4.03], p<.000), or community-based organization events (AOR=1.68, 95% CI [1.19, 2.38], p=.003). Conclusions: Passive recruitment strategies through trusted sources increased the odds of enrollment of Latinx immigrants in biobehavioral research. Future recruitment efforts should leverage trusted sources to disseminate recruitment materials addressing barriers to recruiting Latinx participants for research.
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Affiliation(s)
- Lisa N Mansfield
- Department of Medicine, Division of General Internal Medicine & Health Services Research, 8783University of California, Los Angeles, CA, USA.,15776Duke University School of Nursing, Durham, NC, USA
| | - Gabriela A Nagy
- 15776Duke University School of Nursing, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, 12277Duke University School of Medicine, Durham, NC, USA
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Webber-Ritchey KJ, Taylor-Piliae RE, Loescher LJ. Recruiting African American parents of school-aged children in a physical activity study: Lessons learned. Chronic Illn 2022; 18:181-192. [PMID: 32483997 DOI: 10.1177/1742395320928389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge. METHODS Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment. RESULTS We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers (n = 87, 69%) and males/fathers (n = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust. DISCUSSION Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.
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Affiliation(s)
| | - Ruth E Taylor-Piliae
- Biobehavioral Health Sciences, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Lois J Loescher
- College of Nursing, University of Arizona, Tucson, AZ, USA.,Biobehavioral Health Sciences, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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Langford AT, Orellana KT, Buderer N. Correlates of knowledge of clinical trials among U.S. adults: Findings from the 2020 Health Information National Trends Survey. Contemp Clin Trials 2022; 114:106676. [PMID: 35026434 DOI: 10.1016/j.cct.2022.106676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/20/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Knowledge about clinical trials affects efficient and equitable clinical trial recruitment and retention. This study explored correlates of clinical trial knowledge in a nationally representative sample of US adults. METHODS Cross-sectional data from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4) were evaluated. There were 3,865 responses in the full dataset; 2,648 remained after eliminating respondents without complete data for all covariates of interest. Participants were asked, "How would you describe your level of knowledge about clinical trials?" The response options "know a little bit" and "know a lot" were combined and compared to the response option "don't know anything." Covariates of interest included patient-provider communication, history of medical conditions, eHealth use, knowledge of clinicaltrials.gov, prior invitation to join a clinical trial, and socio-demographic factors. RESULTS Participants with a history of cancer were 1.6 times more likely [CI 1.2, 2.2] to have knowledge of clinical trials. Participants who used electronic means to look for health information were 1.7 times more likely [CI 1.2, 2.4] to have knowledge of clinical trials. Participants who had heard of the website clinicaltrials.gov had 5.1 times greater odds of knowing about clinical trials [CI 2.6, 10.3] and 4.5 greater odds if they had been invited to participate in a clinical trial [CI 2.0, 9.8]. College graduates had higher odds than others. CONCLUSION Several factors affect clinical trial knowledge in US adults. Findings from this study may inform interventions to raise awareness about clinical trials and thereby, potentially improve enrollment.
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Affiliation(s)
- Aisha T Langford
- Department of Population Health, NYU Langone Health, 227 East 30th Street, New York, NY 10016, USA.
| | - Kerli T Orellana
- Department of Population Health, NYU Langone Health, 227 East 30th Street, New York, NY 10016, USA.
| | - Nancy Buderer
- Nancy Buderer Consulting, LLC, Biostatistician, 230 S. Gordon Dr., Oak Harbor, OH 43449, USA.
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Patient and Caregiver Health-related Quality of Life and Caregiver Burden While Awaiting Heart Transplantation: Findings From the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support (SUSTAIN-IT) Study. Transplant Direct 2021; 7:e796. [PMID: 34841048 PMCID: PMC8613352 DOI: 10.1097/txd.0000000000001249] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background We sought to compare change over time (baseline to 2 y) in health-related quality of life (HRQOL) between older (60-80 y) patients awaiting heart transplantation (HT) with mechanical circulatory support (MCS) versus without MCS and their caregivers and caregiver burden. Methods This study was conducted at 13 United States sites. Patient HRQOL was examined using the EuroQol 5-dimensional questionnaire (EQ-5D-3L) and Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12). Caregiver measures included the EQ-5D-3L and Oberst Caregiving Burden Scale, measuring time on task and difficulty. Analyses included analysis of variance, χ2, and linear regression. Results We enrolled 239 HT candidates (n = 118 with MCS and n = 121 without MCS) and 193 caregivers (n = 92 for candidates with MCS and n = 101 for candidates without MCS). Baseline differences in HRQOL were observed between HT candidates with and without MCS: EQ-5D-3L visual analog scale (VAS) score (67.7 ± 17.6 versus 54.1 ± 23.3, P < 0.001) and KCCQ-12 overall summary score (59.9 ± 21.0 versus 48.9 ± 21.6, P < 0.001), respectively. HT candidates with MCS had significantly higher EQ-5D-3L VAS scores and KCCQ-12 overall summary score across time versus without MCS. Baseline EQ-5D-3L VAS scores did not differ significantly between caregivers of HT candidates with and without MCS (84.6 ± 12.9 versus 84.3 ± 14.4, P = 0.9), respectively, nor were there significant between-group differences over time. Caregivers for HT candidates with MCS reported more task difficulty (range: 1 = not difficult to 5 = extremely difficult) versus caregivers for those without MCS at baseline (1.4 ± 0.5 versus 1.2 ± 0.3, P = 0.004) and over time. Conclusions Understanding differences in HRQOL and caregiver burden among older HT candidates with and without MCS and their caregivers may inform strategies to enhance HRQOL and reduce burden.
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Sheppard VB, Sutton A, Holmes E, Edmonds M, Preston MA, Namoos AM, Wells M, Thomson MD. Recruitment of African Americans into Cancer Clinical Research: Strategies and Outcomes. J Urban Health 2021; 98:149-154. [PMID: 34374033 PMCID: PMC8352149 DOI: 10.1007/s11524-021-00565-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
This study utilized data from four cancer-focused research studies that recruited and retained African Americans. Strategies and outcomes across four cancer prevention and control studies were analyzed. Descriptive statistics were used to display participant characteristics. There were 712 African American (Black) participants of which 14.6% were males. Common strategies involved connecting with community stakeholders and identifying study champions. Study recruitment methods might not be generalizable to all populations of African Americans due to geographic locations, study protocols (e.g., risk reduction), target populations (i.e., eligibility criteria), and available resources. Many African Americans have a strong interest in cancer-related research as demonstrated by participation levels. Teams that connect with relevant stakeholders and include diverse teams may be useful to engage larger numbers of minorities in cancer control research to impact morbidity and mortality.
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Affiliation(s)
- Vanessa B Sheppard
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
| | - Arnethea Sutton
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
| | - Esther Holmes
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
| | - Megan Edmonds
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
| | - Michael A Preston
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
| | - Asmaa M Namoos
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA.
| | - Matthew Wells
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
| | - Maria D Thomson
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, Virginia Commonwealth University, 830 East Main Street, PO Box 980149, Richmond, VA, 23298-0149, USA
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Racial and ethnic representation in primary research contributing to pelvic organ prolapse treatment guidelines. Int Urogynecol J 2021; 32:2959-2967. [PMID: 34570246 DOI: 10.1007/s00192-021-04983-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To evaluate whether the studies contributing to the national treatment guidelines on pelvic organ prolapse adequately represent the racial and/or ethnic makeup of the American population. METHODS This analysis examines the racial and ethnic makeup of all primary study cohorts contributing to the American College of Obstetricians and Gynecologists/American Urogynecologic Society Practice Bulletin No. 214 on pelvic organ prolapse. References were excluded if they lacked a primary patient population or were from outside the US. Mean proportional representation of racial/ethnic groups was compared to the 2018 United States Census data on race/ethnicity. The representation quotient was also calculated to evaluate for relative representation of each group. Descriptive statistics were used. RESULTS Of the 110 references, 53 primary studies were included in the final analysis with 30 studies reporting on race/ethnicity. On average, 82% (SD = 15%) of study populations were White, while Blacks, Hispanics, and Asians represented 67% (SD = 7%), 4% (SD = 8%), and < 1% (SD = 1%), respectively, differing significantly from the 2018 US Census (p < 0.01.) The representation quotients for White women was 1.36, demonstrating a 36% overrepresentation, while Black, Hispanic, and Asian women were underrepresented among studies of all evidence levels, with representative quotients of 0.50, 0.23, and 0.09, respectively. CONCLUSIONS Our study demonstrates a significant underrepresentation of non-White populations in primary cohorts of studies contributing to the ACOG/AUGS Practice Bulletin No. 214 on POP. This analysis reinforces that more efforts are required to include and report on racial and ethnically diverse cohorts to better serve all patients.
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Magwood GS, Ellis C, Buie JNJ, Slan S, Bonilha L, Adams RJ. High tech and high touch: Recruitment strategies for enrolling African American stroke survivors in Community Based Intervention under Nurse Guidance after stroke (CINGS) trial. Contemp Clin Trials Commun 2021; 24:100844. [PMID: 34541374 PMCID: PMC8441066 DOI: 10.1016/j.conctc.2021.100844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/24/2021] [Accepted: 09/06/2021] [Indexed: 10/26/2022] Open
Abstract
Background Substantial effort has been undertaken to improve the recruitment and retention of participants in stroke trials. African Americans are disproportionately under-represented in stroke clinical trials as well as clinical trials for other chronic disease conditions. To circumvent barriers to recruitment, clinical trial recruitment strategies used to recruit African Americans have focused on different aspects of community engagement. Purpose This study examined a community-engaged, multi-phased tailored approach to recruiting African Americans with stroke. The recruitment approach described was designed to support the Community Based Intervention under Nurse Guidance after Stroke (CINGS) trial, part of the Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM) Center established to explore stroke disparities. Methods A multiple-phased recruitment approach was undertaken and involved a recruitment planning phase and a recruitment phase. The recruitment planning phase involved the use of focus groups designed to explore barriers and facilitators of stroke recovery. The active recruitment phase included multiple strategies with ongoing evaluation. Results Information gained from focus groups offered insights into strategies critical to recruiting African Americans with stroke for behavioral research during the early recovery period. Strategies to enhance the identification of and recruitment of potential participants included use of: a) a hospital system stroke database, b) system-wide friendly visits/warm handoff approaches, c) electronic health record, d) associated external sites and e) protocol adjustments. Conclusions Developing tailored approaches to curtail barriers to research participation is critical for increasing the probability of reaching African American study participant recruitment and retention goals. Research teams may require training in community-engagement research strategies essential for obtaining achieving target recruitment goals.
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Affiliation(s)
- Gayenell S Magwood
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Charles Ellis
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Joy N J Buie
- WISSDOM Center Disparities Fellow, Medical University of South Carolina, Charleston, SC, USA
| | - Stephanie Slan
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Leo Bonilha
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Robert J Adams
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
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Hvisdas C, Louisias M, Laidlaw TM, Akenroye A. Addressing disparities in biologic drug development in the United States. J Allergy Clin Immunol 2021; 148:1154-1156. [PMID: 34530019 DOI: 10.1016/j.jaci.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/11/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Christopher Hvisdas
- Department of Pharmacy, Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pa
| | - Margee Louisias
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass
| | - Tanya M Laidlaw
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass
| | - Ayobami Akenroye
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass; Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
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Beliefs, Understanding, and Barriers Related to Dementia Research Participation Among Older African Americans. Alzheimer Dis Assoc Disord 2021; 36:52-57. [PMID: 34483256 DOI: 10.1097/wad.0000000000000476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 08/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND United States Census Bureau projects African Americans (AAs) will be one of the fastest growing populations over the next 30 years. Research suggests they are at higher risk for developing dementia. It is important to know about AA adults' beliefs about, and knowledge of, dementia; and how these beliefs and knowledge impact participation in dementia research. METHODS Four focus groups were completed with 51 older AA adults (76.5% female; mean age=68) in Baton Rouge, Louisiana to examine understanding of dementia and barriers influencing willingness to participate in a clinical trial on dementia risk reduction. FINDINGS Participants exhibited awareness of several risk and protective factors related to dementia, including family history of dementia, lack of cognitive engagement, and sedentary lifestyles. They were willing to participate in interventions to lower the risk of developing dementia. Barriers to participation included invasive procedures, pharmaceutical interventions, mistrust of investigators, inadequate compensation, and long study duration. DISCUSSION Given the high relevance of dementia research to older AAs, their knowledge of dementia, and their willingness to participate in dementia research once barriers are addressed, it is imperative to continue to identify and remediate factors contributing to the poor representation of AAs in dementia research.
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Abstract
Supplemental digital content is available in the text. Background Despite numerous efforts to create more equitable healthcare systems, minority populations face long-standing health disparities compared to White populations. Healthcare research is the necessary foundation for creating equitable health systems and providing patient-centered care. Significant challenges exist, however, with recruiting and engaging underrepresented populations in clinical research. Objectives The purpose of this analysis was to determine how research participants' race, trust, and level of education influence participation barriers in clinical research. Methods The study used secondary, cross-sectional survey data that were collected between 2014 and 2016 through the former Mid-South Clinical Data Research Network, currently known as the Stakeholders, Technology, and Research Clinical Research Network. Descriptive statistics and Spearman rank correlations were performed between level of education, level of trust, and each attitude statement for each racial category. Results A total of 2,190 survey responses were used in the data analysis. The mean age of respondents was 52 years, with majority being women, White, insured, and working full time. Overall, the respondents had favorable attitudes toward research participation. Trust was correlated with agreement in many attitude statements for both White and African American respondents, whereas correlations with education level were more variable depending on racial grouping. Trust level was negatively associated with agreement toward the statement “researchers do not care about me” in White and Native American respondents. Discussion The results support the importance of trust to research participation. Generally, education level was not strongly predictive of research participation, although prediction was influenced by race and attitude.
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Cunningham-Erves J, Stewart E, Duke J, Akohoue SA, Rowen N, Lee O, Miller ST. Training researchers in dissemination of study results to research participants and communities. Transl Behav Med 2021; 11:1411-1419. [PMID: 33823019 DOI: 10.1093/tbm/ibab023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Dissemination of research beyond the academic community is an ethical responsibility of researchers and necessary in translational research to help ensure the uptake of research findings to improve health outcomes. Often, partnerships between community and academicians do not include research dissemination plans, possibly reflecting researchers not knowing how to create these plans. This manuscript details the development process of a research dissemination training module for academicians and researchers. This training was conceptualized and developed by Core faculty and staff. Development steps were: (a) identifying researchers' dissemination needs using the Core Investigator Survey; (b) identifying communities dissemination needs/preferences using feedback from our community advisory board; (c) conducting a literature search to identify dissemination concepts from researchers and community perspectives; (d) developing the training module; (e) conducting a cognitive review with one basic science researcher and one community-based participatory researcher; (f) evaluating the training; and (g) finalizing the training module. Training attendees included 1 clinical and 3 basic science clinical researchers, a biomedical postdoctoral fellow, and 10 research staff. Of those completing the feedback survey, 60% had some experience with research dissemination. As a result of training, more than 50% of respondents strongly agreed that as researchers they have a clear understanding of dissemination, a greater understanding of the dissemination process, how to identify stakeholders and successfully develop a dissemination plan. While disseminating research findings beyond academic publications may be new to some researchers, this training provided the tools to implement dissemination practices in their current and future research.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Elizabeth Stewart
- Department of Surgery, Meharry Medical College, Nashville, TN 37208, USA
| | - Jillian Duke
- Department of Surgery, Meharry Medical College, Nashville, TN 37208, USA
| | - Sylvie A Akohoue
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA
| | - Nicole Rowen
- Global Outreach Community Development Corporation, 3634b Clarksville Pk, Nashville, TN 37218, USA
| | - Omaran Lee
- St. John AME Church, Springfield, TN 37172, USA
| | - Stephania T Miller
- Department of Surgery, Meharry Medical College, Nashville, TN 37208, USA
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Hwang DA, Lee A, Song JM, Han HR. Recruitment and Retention Strategies Among Racial and Ethnic Minorities in Web-Based Intervention Trials: Retrospective Qualitative Analysis. J Med Internet Res 2021; 23:e23959. [PMID: 34255658 PMCID: PMC8314154 DOI: 10.2196/23959] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/26/2020] [Accepted: 04/30/2021] [Indexed: 12/17/2022] Open
Abstract
Background Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States. Identifying effective recruitment and retention strategies among minority groups and their subpopulations is an important research agenda. Web-based intervention approaches are becoming increasingly popular with the ubiquitous use of the internet. However, it is not completely clear which recruitment and retention strategies have been successful in web-based intervention trials targeting racial and ethnic minorities. Objective This study aims to describe lessons learned in recruiting and retaining one of the understudied ethnic minority women—Korean Americans—enrolled in a web-based intervention trial and to compare our findings with the strategies reported in relevant published web-based intervention trials. Methods Multiple sources of data were used to address the objectives of this study, including the study team’s meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews. In addition, an electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions. Qualitative analysis was then performed to identify common themes addressing recruitment and retention strategies across the trials using web-based intervention modalities. Results A total of 9 categories of recruitment and retention strategies emerged: authentic care; accommodation of time, place, and transportation; financial incentives; diversity among the study team; multiple, yet standardized modes of communication; mobilizing existing community relationships with efforts to build trust; prioritizing features of web-based intervention; combined use of web-based and direct recruitment; and self-directed web-based intervention with human support. Although all the studies included in the analysis combined multiple strategies, prioritizing features of web-based intervention or use of human support were particularly relevant for promoting recruitment and retention of racial and ethnic minorities in web-based intervention trials. Conclusions The growing prevalence of internet use among racial and ethnic minority populations represents an excellent opportunity to design and deliver intervention programs via the internet. Future research should explore and compare successful recruitment and retention methods among race and ethnic groups for web-based interventions. Trial Registration ClinicalTrials.gov NCT03726619; https://clinicaltrials.gov/ct2/show/NCT03726619.
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Affiliation(s)
- DaSol Amy Hwang
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Alex Lee
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Jae Min Song
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Hae-Ra Han
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
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Danila MI, Allison JJ, Goins KV, Chiriboga G, Fischer M, Puliafico M, Mudano AS, Rahn EJ, Merchant J, Lawrence CE, Dunkel L, Israel T, Barton B, Jenoure F, Alexander T, Cruz D, Douglas M, Sims J, Richmond A, Roberson ED, Chambless C, Harris PA, Saag KG, Lemon SC. Development of a multi-component intervention to promote participation of Black and Latinx individuals in biomedical research. J Clin Transl Sci 2021; 5:e134. [PMID: 34367678 PMCID: PMC8327553 DOI: 10.1017/cts.2021.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Barriers to research participation by racial and ethnic minority group members are multi-factorial, stem from historical social injustices and occur at participant, research team, and research process levels. The informed consent procedure is a key component of the research process and represents an opportunity to address these barriers. This manuscript describes the development of the Strengthening Translational Research in Diverse Enrollment (STRIDE) intervention, which aims to improve research participation by individuals from underrepresented groups. METHODS We used a community-engaged approach to develop an integrated, culturally, and literacy-sensitive, multi-component intervention that addresses barriers to research participation during the informed consent process. This approach involved having Community Investigators participate in intervention development activities and using community engagement studios and other methods to get feedback from community members on intervention components. RESULTS The STRIDE intervention has three components: a simulation-based training program directed toward clinical study research assistants that emphasizes cultural competency and communication skills for assisting in the informed consent process, an electronic consent (eConsent) framework designed to improve health-related research material comprehension and relevance, and a "storytelling" intervention in which prior research participants from diverse backgrounds share their experiences delivered via video vignettes during the consent process. CONCLUSIONS The community engaged development approach resulted in a multi-component intervention that addresses known barriers to research participation and can be integrated into the consent process of research studies. Results of an ongoing study will determine its effectiveness at increasing diversity among research participants.
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Affiliation(s)
- Maria I. Danila
- Department of Medicine, Division of Clinical Immunology/Rheumatology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
- University of Alabama at Birmingham Center for Clinical and Translational Science, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Jeroan J. Allison
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Karin Valentine Goins
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Germán Chiriboga
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Melissa Fischer
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Melissa Puliafico
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Amy S. Mudano
- Department of Medicine, Division of Clinical Immunology/Rheumatology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
- University of Alabama at Birmingham Center for Clinical and Translational Science, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Elizabeth J. Rahn
- Department of Medicine, Division of Clinical Immunology/Rheumatology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Jeanne Merchant
- Department of Medicine, Division of Clinical Immunology/Rheumatology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
- University of Alabama at Birmingham Center for Clinical and Translational Science, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Colleen E. Lawrence
- Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leah Dunkel
- Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tiffany Israel
- Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bruce Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Fred Jenoure
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
| | - Tiffany Alexander
- University of Alabama at Birmingham Center for Clinical and Translational Science, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Danny Cruz
- Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marva Douglas
- University of Alabama at Birmingham Center for Clinical and Translational Science, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Jacqueline Sims
- Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Al Richmond
- Community Campus Partnerships for Health, Raleigh, NC, USA
| | - Erik D. Roberson
- Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Carol Chambless
- Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Paul A. Harris
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kenneth G. Saag
- Department of Medicine, Division of Clinical Immunology/Rheumatology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
- University of Alabama at Birmingham Center for Clinical and Translational Science, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Stephenie C. Lemon
- UMass Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Sneed RS, Mason M, Williams JN, Sinnette C, Taber K, Mancera-Cuevas K, Curry G, Canessa P, Ramsey-Goldman R, Feldman CH. Using Critical Race Theory to Understand Trial Participation Among Black Individuals with Systemic Lupus Erythematosus: A Qualitative Study of Patients and Caregivers. Arthritis Care Res (Hoboken) 2021; 73:1387-1395. [PMID: 33973413 DOI: 10.1002/acr.24635] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Black patients with systemic lupus erythematous (SLE) experience greater disease incidence and severity than White patients yet are underrepresented in SLE clinical trials. We applied Critical Race Theory to qualitatively explore the influence of racism on the underrepresentation of Black patients in SLE clinical trials and to develop a framework for future intervention. METHODS We conducted groups in Chicago and Boston with Black adults (age ≥18 years) with SLE and their caregivers. We queried participants' knowledge about clinical trials, factors that might motivate or hinder trial participation, and how race and experiences of racism might impact clinical trial participation. Focus group responses were transcribed verbatim and analyzed thematically. RESULTS We held four focus groups (N=31); 20 participants had SLE, 11 were caregivers. All participants were Black, 90% were female and the mean age was 54 years. Qualitative analyses revealed several themes that negatively impact trial participation including mistrust related to racism, concerns about assignment to placebo groups, strict study exclusion criteria, and SLE-related concerns. Factors that motivated trial participation included recommendations from physicians and reputable institutions, a desire to help the greater good, and culturally-sensitive marketing of trials. CONCLUSION Actions to improve clinical trial participation among Black individuals should focus on reframing how trial information is presented and disseminated and on reevaluating barriers that may restrict trial participation. Additionally, researchers must acknowledge and respond to the presence of racial bias in healthcare. Community-Academic Partnerships may help build trust and reduce fears of mistreatment among Black individuals with SLE.
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Affiliation(s)
- Rodlescia S Sneed
- Division of Public Health, College of Human Medicine, Michigan State University
| | - Maryann Mason
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago
| | - Jessica N Williams
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Corine Sinnette
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Kreager Taber
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Karen Mancera-Cuevas
- Illinois Department of Public Health, Springfield.,Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago
| | - Gina Curry
- Biological Sciences Division, Comprehensive Cancer Center, University of Chicago (UCCCC), Office of Community Engagement & Cancer Health Equity
| | | | | | - Candace H Feldman
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
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Occa A, Morgan SE, Peng W, Mao B, McFarlane SJ, Grinfeder K, Byrne M. Untangling interactivity's effects: The role of cognitive absorption, perceived visual informativeness, and cancer information overload. PATIENT EDUCATION AND COUNSELING 2021; 104:1059-1065. [PMID: 33969824 PMCID: PMC8110950 DOI: 10.1016/j.pec.2020.10.007] [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: 02/27/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Learning about clinical trials is as stressful and challenging for cancer patients as it is for the clinical staff who provide education to patients. Information aids (IAs) can support both discussions and patients' decision-making, especially when IAs offer interactive features that provide information based on individuals' needs and experiences. However, it is not clear which factors contribute to interactive IAs' effectiveness. METHODS An experiment with cancer patients and survivors (n = 313) compared the effects of two IAs about clinical trial participation: one with modality (i.e. website/technological) interactivity only and one with both modality and message interactivity (i.e. provides information contingent on individual users' information needs). RESULTS The IA with both modality and message interactivity features elicited the higher perceived visual informativeness (PVI) and cognitive absorption (CA) scores. The model supports the moderating role of PVI and cancer information overload (CIO), and the mediating role of CA. CONCLUSION The IA with both modality and message interactivity better supported individuals' decision-making and improved attitudes and knowledge scores. CIO was experienced more by participants using the modality interactivity-only IA. PRACTICE IMPLICATIONS Message interactivity may simplify individuals' cognitive processes. IAs about clinical trial participation should include both message and modality interactivity.
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Affiliation(s)
- Aurora Occa
- Department of Communication, University of Kentucky, United States.
| | - Susan E Morgan
- Department of Communication Studies, University of Miami, Coral Gables, FL, 33146, United States
| | - Wei Peng
- The Edward R. Murrow College of Communication, Washington State University, United States
| | - Bingjing Mao
- Department of Communication Studies, University of Miami, Coral Gables, FL, 33146, United States
| | - Soroya Julian McFarlane
- Department of Communication Studies, University of Georgia, Athens, GA, 30602, United States
| | - Kim Grinfeder
- Department of Interactive Media, University of Miami, Coral Gables, FL, 33146, United States
| | - Margaret Byrne
- Department of Health Outcomes and Behavior, Moffit Cancer Center, Tampa, FL, 33612, United States
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McFarlane SJ, Morgan SE, Occa A, Peng W. An Evaluation of Clinical Trial Multimedia to Support Hispanic Cancer Patients' Informational and Decision-Making Needs. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:110-117. [PMID: 31444640 DOI: 10.1007/s13187-019-01606-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The inclusion of diverse populations in clinical trial research is a social justice imperative. Creating the communicative tools that can support cancer patients across varied cultural backgrounds in processing complex clinical trial information, to achieve informed consent, has been a challenge. This study sought to evaluate specific clinical trial multimedia-a website, four animations, and a decision aid-to meet the decision-making and informational needs of Hispanic patients. The multimedia content was positively evaluated by Hispanic cancer patients. However, the discussions also yielded important steps for culturally adapting these tools to account for particular informational needs and cultural values that would be important to incorporate into these, and future, clinical trial multimedia interventions that target Hispanic populations.
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Affiliation(s)
| | - Susan E Morgan
- School of Communication, University of Miami, Coral Gables, FL, USA
| | - Aurora Occa
- Department of Communication, University of Kentucky, Lexington, KY, USA
| | - Wei Peng
- School of Communication, University of Miami, Coral Gables, FL, USA
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Knopf AS, Krombach P, Katz AJ, Baker R, Zimet G. Measuring research mistrust in adolescents and adults: Validity and reliability of an adapted version of the Group-Based Medical Mistrust Scale. PLoS One 2021; 16:e0245783. [PMID: 33481944 PMCID: PMC7822238 DOI: 10.1371/journal.pone.0245783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022] Open
Abstract
Mistrust of health care providers among persons of color is a significant barrier to engaging them in research studies. Underrepresentation of persons of color is particularly problematic when the health problem under study disproportionately affects minoritized communities. The purpose of this study was to test the validity and reliability of an abbreviated and adapted version of the Group Based Medical Mistrust Scale. The GBMMS is a 12-item scale with three subscales that assess suspicion, experiences of discrimination, and lack of support in the health care setting. To adapt for use in the research setting, we shortened the scale to six items, and replaced “health care workers” and “health care” with “medical researchers” and “medical research,” respectively. Using panelists from a market research firm, we recruited and enrolled a racially and ethnically diverse sample of American adults (N = 365) and adolescents aged 14–17 (N = 250). We administered the adapted scale in a web-based survey. We used Cronbach’s alpha to evaluate measure internal reliability of the scale and external factor analysis to evaluate the relationships between the revised scale items. Five of the six items loaded onto a single factor, with (α = 0.917) for adolescents and (α = 0.912) for adults. Mean scores for each item ranged from 2.5–2.9, and the mean summary score (range 6–25) was 13.3 for adults and 13.1 for adolescents. Among adults, Black respondents had significantly higher mean summary scores compared to whites and those in other racia/ethnic groups (p<0.001). There was a trend toward significance for Black adolescents as compared to white respondents and those in other racial/ethnic groups (p = 0.09). This five-item modified version of the GBMMS is reliable and valid for measuring research mistrust with American adults and adolescents of diverse racial and ethnic identities.
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Affiliation(s)
- Amelia S. Knopf
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, United States of America
- * E-mail:
| | - Peter Krombach
- Office of Evaluation, Indiana University School of Nursing, Indianapolis, Indiana, United States of America
| | - Amy J. Katz
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Rebecca Baker
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, United States of America
| | - Gregory Zimet
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
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Sinha CB, Bakshi N, Ross D, Loewenstein G, Krishnamurti L. Primary caregiver decision-making in hematopoietic cell transplantation and gene therapy for sickle cell disease. Pediatr Blood Cancer 2021; 68:e28749. [PMID: 33034129 PMCID: PMC8246626 DOI: 10.1002/pbc.28749] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/23/2020] [Accepted: 09/04/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Improved outcomes and the availability of clinical trials of hematopoietic cell transplantation (HCT) from alternate donors and genetically modified autologous hematopoietic progenitor cells have expanded the applicability of HCT for sickle cell disease (SCD). To understand the perspective of primary caregivers exploring HCT in the current milieu, we asked the research question "What motivates primary caregivers to decide to consider HCT and to seek, and to attend, an HCT consultation?" PROCEDURES We conducted qualitative interviews with primary caregivers within one week after a consultation for HCT for SCD. Data were analyzed using open and axial coding stages of grounded theory methodology. RESULTS We interviewed 29 primary caregivers (26 females, age 29 to 64 [median 42] years). Primary caregivers report of SCD complications in their child included at least one in the last year by 23 (82%), few or none by 8 (28%), and pain on ≥3 days a week by 13 (46%) primary caregivers. Qualitative analysis revealed that primary caregivers, (i) learn about curative options through social networks, social media, and the news media; (ii) seek consultation because of their child's diminished quality of life, recent complications, an imminent major medical decision, or anxiety about future severe complications; and (iii) see gene therapy as a new, less invasive, and more acceptable treatment. CONCLUSION Primary caregivers of children with SCD learn about HCT through social networks, social and news media, and explore HCT as a means to prevent SCD complications and help their child live a normal life.
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Affiliation(s)
- Cynthia B. Sinha
- Department of Pediatric Hematology-Oncology-BMT, Emory University, Atlanta, Georgia
| | - Nitya Bakshi
- Department of Pediatric Hematology-Oncology-BMT, Emory University, Atlanta, Georgia,Aflac Cancer and Blood Disorders, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Diana Ross
- Department of Pediatric Hematology-Oncology-BMT, Emory University, Atlanta, Georgia
| | - George Loewenstein
- Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Lakshmanan Krishnamurti
- Department of Pediatric Hematology-Oncology-BMT, Emory University, Atlanta, Georgia,Aflac Cancer and Blood Disorders, Children’s Healthcare of Atlanta, Atlanta, Georgia
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Reynolds TS, Lynch CD, Hade EM, Allain DC, Westman JA, Toland AE. Maternal age at delivery and fertility of the next generation. Paediatr Perinat Epidemiol 2020; 34:629-636. [PMID: 32150298 DOI: 10.1111/ppe.12666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/29/2019] [Accepted: 01/21/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND While most known causes of infertility relate to the health of the woman and/or her partner, questions have been raised regarding the possible contributions of transgenerational or epigenetic factors. OBJECTIVE The goal of this hypothesis-generating work was to examine whether Generation 1's (G1's) age at the delivery of G2 (Generation 2) was associated with G2's fertility in later life. METHODS We conducted a retrospective cohort study of women (G2s) recruited online in 2016. A questionnaire queried G2s regarding demographics and fertility. The primary exposure was G1's age at G2's birth. Outcome measures included the following: 12-month infertility, time to pregnancy, and childlessness. The adjusted relative risk (RR) of G2 infertility and childlessness by G1 age at G2's birth was estimated through a modified Poisson regression approach. The fecundity odds ratio (FOR) for the association between G1's age at G2 birth and time to pregnancy for G2 was estimated by discrete-time survival models, with complementary log-log link. RESULTS A total of 2,854 women enrolled. We found no association between G1 age at G2's birth and G2 infertility. Being born to a G1 aged 15-19 years was associated with a longer time to pregnancy for G2 (FOR 0.84, 95% confidence interval 0.72, 0.99), relative to being born to a G1 aged 20-24 years. We observed the suggestion of a possible increased risk of childlessness among G2s born to older G1s, but the estimate was imprecise. CONCLUSIONS While being born to a G1 who was 15-19 years old was associated with an increase in G2 time to pregnancy, we found no association between G1 age at G2's birth and infertility and only the suggestion of a modest association with childlessness. These data suggest a possible subtle effect of G1 age at G2's birth on G2 fertility, which warrants further study.
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Affiliation(s)
- Tamara S Reynolds
- Genetic Counseling Graduate Program, Department of Internal Medicine, Division of Human Genetics, The Ohio State University College of Medicine, Columbus, Ohio, United States
| | - Courtney D Lynch
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, United States
| | - Erinn M Hade
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, United States
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio, United States
| | - Dawn C Allain
- Genetic Counseling Graduate Program, Department of Internal Medicine, Division of Human Genetics, The Ohio State University College of Medicine, Columbus, Ohio, United States
| | - Judith A Westman
- Genetic Counseling Graduate Program, Department of Internal Medicine, Division of Human Genetics, The Ohio State University College of Medicine, Columbus, Ohio, United States
| | - Amanda E Toland
- Genetic Counseling Graduate Program, Department of Internal Medicine, Division of Human Genetics, The Ohio State University College of Medicine, Columbus, Ohio, United States
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Masese RV, DeMartino T, Bonnabeau E, Burns EN, Preiss L, Varughese T, Nocek JM, Lasley P, Chen Y, Davila C, Nwosu C, Scott S, Bowman L, Gordon L, Clesca C, Peters-Lawrence M, Melvin C, Shah N, Tanabe P. Effective Recruitment Strategies for a Sickle Cell Patient Registry Across Sites from the Sickle Cell Disease Implementation Consortium (SCDIC). J Immigr Minor Health 2020; 23:725-732. [PMID: 33034793 PMCID: PMC8032811 DOI: 10.1007/s10903-020-01102-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 10/27/2022]
Abstract
Sickle cell disease (SCD) is a genetic disorder predominantly affecting people of African descent and is associated with significant morbidity and mortality. To improve SCD outcomes, the National Heart Lung and Blood Institute funded eight centers to participate in the SCD Implementation Consortium. Sites were required to each recruit 300 individuals with SCD, over 20 months. We aim to describe recruitment strategies and challenges encountered. Participants aged 15-45 years with confirmed diagnosis of SCD were eligible. Descriptive statistics were used to analyze the effectiveness of each recruitment strategy. A total of 2432 participants were recruited. Majority (95.3%) were African American. Successful strategies were recruitment from clinics (68.1%) and affiliated sites (15.6%). Recruitment at community events, emergency departments and pain centers had the lowest yield. Challenges included saturation of strategies and time constraints. Effective recruitment of participants in multi-site studies requires multiple strategies to achieve adequate sample sizes.
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Affiliation(s)
- Rita V Masese
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC, 27710, USA.
| | - Terri DeMartino
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC, 27710, USA
| | - Emily Bonnabeau
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC, 27710, USA
| | - Ebony N Burns
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC, 27710, USA
| | | | - Taniya Varughese
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Judith M Nocek
- Department of Medicine, Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Yumei Chen
- University of California, San Francisco, Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA, 94609, USA
| | | | | | - Samantha Scott
- Augusta University Center for Blood Disorders, Augusta, GA, USA
| | - Latanya Bowman
- Augusta University Center for Blood Disorders, Augusta, GA, USA
| | - Lauren Gordon
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Cindy Clesca
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Marlene Peters-Lawrence
- Division of Blood Diseases and Resources, National Institute of Health, National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Cathy Melvin
- Medical University of South Carolina, Charleston, SC, USA
| | - Nirmish Shah
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC, 27710, USA
| | - Paula Tanabe
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC, 27710, USA
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Hong SJ, Drake B, Goodman M, Kaphingst KA. Race, Trust in Doctors, Privacy Concerns, and Consent Preferences for Biobanks. HEALTH COMMUNICATION 2020; 35:1219-1228. [PMID: 31167570 PMCID: PMC6893100 DOI: 10.1080/10410236.2019.1623644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study investigates how patients' privacy concerns about research uses of biospecimen and trust in doctors are associated with their preferences for informed consent and need for control over biospecimens in a biobank. Particularly, this study focuses on the perspectives of Communication Privacy Management theory, precision medicine, and racial health disparities. We recruited 358 women aged 40 and older stratified by race (56% African American and 44% European American). Multivariable linear regression models examined hypothesis and research questions. Individuals' privacy concerns and trust in doctors were significantly associated with their need for control. Although participants' privacy concerns were positively associated with their preference for study-specific model, trust in doctors had no effect on the preference. African American participants needed more control over their sample and were more likely to prefer study-specific model compared to European American participants. Significant interactions by race on the associations between trust and need for control and between privacy concerns and preference for study-specific model were found. These findings suggest that when developing large diverse biobanks for future studies it is important to consider privacy concerns, trust, and need for control with an understanding that there are differences in preferences by race.
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Affiliation(s)
- Soo Jung Hong
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Bettina Drake
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Melody Goodman
- Department of Biostatistics, NYU College of Global Public Health, New York City, NY
| | - Kimberly A. Kaphingst
- Department of Communication, University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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Cunningham‐Erves J, Mayo‐Gamble T, Vaughn Y, Hawk J, Helms M, Barajas C, Joosten Y. Engagement of community stakeholders to develop a framework to guide research dissemination to communities. Health Expect 2020; 23:958-968. [PMID: 32452067 PMCID: PMC7495063 DOI: 10.1111/hex.13076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Dissemination of research findings to past study participants and the community-at-large is important. Yet, a standardized process for research dissemination is needed to report results to the community. OBJECTIVE We developed a framework and strategies to guide community-academic partnerships in community-targeted, dissemination efforts. METHODS From 2017 to 2019, a community-academic partnership was formed in Nashville, Tennessee, and iteratively developed a framework and strategies for research dissemination using cognitive interviews. A deductive, constant comparative analysis was conducted on interview responses to examine framework and strategy content. Feedback was used to finalize the framework and strategies for the evaluation. Using existing data, the framework's utility was evaluated in seven town hall meetings (n = 117). Bivariate analyses determined its effect on community members' trust and willingness to participate in research using pre- and post-surveys. Evaluation results were used to finalize the framework. RESULTS The Community-Engaged Research Dissemination (CERD) framework has two phases. Phase one is a preliminary planning phase with two steps, and phase two is the four-step dissemination process. There are five standards to be upheld conducting these phases. We provide competencies for each component. Three feasible, culturally adapted strategies were developed as exemplars to disseminate research findings. Using pre- and post-surveys for intervention evaluation, there was a significant difference in trust in medical research and researchers (P = .006) and willingness to participate in research (P = .013). DISCUSSION AND CONCLUSION The CERD framework can potentially standardize the process and compare the effect of dissemination efforts on the community's trust and willingness to participate in research.
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Affiliation(s)
| | - Tilicia Mayo‐Gamble
- Department of Health Policy and Community HealthGeorgia Southern UniversityStatesboroGAUSA
| | | | - Jim Hawk
- Neighbor 2 NeighborNashvilleTNUSA
| | - Mike Helms
- Bridges for the Deaf and Hard of HearingNashvilleTNUSA
| | - Claudia Barajas
- Vanderbilt Ingram Cancer CenterVanderbilt UniversityNashvilleTNUSA
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Quantifying Patient Subpopulation Disparities in New Drugs and Biologics Approved Between 2007 and 2017. Ther Innov Regul Sci 2020; 54:1541-1550. [PMID: 32557009 DOI: 10.1007/s43441-020-00181-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/06/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Tufts CSDD conducted a study to quantify the magnitude of participant subgroup demographic disparities in industry-funded pivotal trials and establish baseline participant diversity measures. METHODS Eleven years of data on pivotal trials of all novel drugs and biologics approved between 2007 and 2017 (n = 341 drugs and n = 757 pivotal trials) was compiled and analyzed. RESULTS The availability of reported participant demographic subgroup data was poor-most notably participant ethnicity with 63% of pivotal trials supporting all approved treatments missing data. The availability of data on participant race and ethnicity did not improve between 2007 and 2017. Participants of Black or of African Descent were the subgroup most highly under-represented. Three times as many participants in this demographic subgroup should have been enrolled in pivotal trials to achieve representation as dictated by disease prevalence rates and population census figures. Although variation was observed between disease conditions, under-representation of Black/African Descent participants occurred in nearly all conditions. Participants from indigenous communities were also highly under-represented. Asian participants were highly over-represented in pivotal trials. Approximately 14% more Hispanic/Latinx participants should have been enrolled in clinical trials to achieve population-proportional representation. CONCLUSIONS The results suggest that participant demographic disclosure practices are falling short and that insufficient diversity in clinical trials is limiting the value of guidance on medical treatment dosing and response. The study findings supplement the FDA's Drug Trial Snapshot Reports and offer insight into the magnitude of, and trends in, participant demographic subgroup disparities.
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Crane MM, Seburg EM, Levy RL, Jeffery RW, Sherwood NE. Using targeting to recruit men and women of color into a behavioral weight loss trial. Trials 2020; 21:537. [PMID: 32546253 PMCID: PMC7298816 DOI: 10.1186/s13063-020-04500-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/10/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The majority of participants in weight loss trials are non-Hispanic White women, while men and women of color are underrepresented. This study presents data obtained from non-targeted and targeted recruitment approaches in a trial of behavioral weight loss programs to (1) describe the yields from each approach and (2) compare the demographics, weight control histories, and study involvement of samples recruited by each approach. METHODS Data for this observational study include source of recruitment, demographic information, weight loss experiences (e.g., lifetime weight loss, current weight loss behaviors), and completion of the 6-month assessment visit. RESULTS Men comprised 14.2% of participants who responded to non-targeted recruitment efforts, while targeted efforts yielded 50.4% men. Similarly, people of color comprised 12.8% of those who responded to non-targeted approaches, whereas targeted recruitment methods yielded 47.2% people of color. Men recruited through targeted methods were younger (p = 0.01) than men recruited through non-targeted means but were otherwise similar. Women of color recruited through targeted methods reported use of fewer weight loss strategies relative to women of color recruited through non-targeted means (p = 0.006) but were otherwise similar. There were no differences by recruitment method on retention to the study. CONCLUSIONS Using targeted recruitment methods increased the ethnic and gender diversity of the recruited sample without reducing study retention. This targeting also increased the enrollment of women with less weight loss experience who may not have otherwise sought out a weight loss program. Developing and implementing a targeted recruitment plan should be considered early in the clinical trial development process. TRIAL REGISTRATION Clinicaltrials.gov, NCT02368002. Registered on 20 February 2015.
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Affiliation(s)
- Melissa M Crane
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA.
| | - Elisabeth M Seburg
- HealthPartners Institute, 8170 33rd Ave South, Minneapolis, MN, 55440-1524, USA
| | - Rona L Levy
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA, 98105-6250, USA
| | - Robert W Jeffery
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
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Zhang B, Liu W, Lemon SC, Barton BA, Fischer MA, Lawrence C, Rahn EJ, Danila MI, Saag KG, Harris PA, Allison JJ. Design, analysis, power, and sample size calculation for three-phase interrupted time series analysis in evaluation of health policy interventions. J Eval Clin Pract 2020; 26:826-841. [PMID: 31429175 PMCID: PMC7028460 DOI: 10.1111/jep.13266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To discuss the study design and data analysis for three-phase interrupted time series (ITS) studies to evaluate the impact of health policy, systems, or environmental interventions. Simulation methods are used to conduct power and sample size calculation for these studies. METHODS We consider the design and analysis of three-phase ITS studies using a study funded by National Institutes of Health as an exemplar. The design and analysis of both one-arm and two-arm three-phase ITS studies are introduced. RESULTS A simulation-based approach, with ready-to-use computer programs, was developed to determine the power for two types of three-phase ITS studies. Simulations were conducted to estimate the power of segmented autoregressive (AR) error models when autocorrelation ranged from -0.9 to 0.9 with various effect sizes. The power increased as the sample size or the effect size increased. The power to detect the same effect sizes varied largely, depending on testing level change, trend changes, or both. CONCLUSION This article provides a convenient tool for investigators to generate sample sizes to ensure sufficient statistical power when three-phase ITS study design is implemented.
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Affiliation(s)
- Bo Zhang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Wei Liu
- School of Management, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Stephenie C Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Bruce A Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Melissa A Fischer
- Department of Internal Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.,Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation, and Fallon Community Health Plan, Worcester, Massachusetts
| | - Colleen Lawrence
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth J Rahn
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Maria I Danila
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kenneth G Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Paul A Harris
- Department of Biomedical Informatics and Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Jeroan J Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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Porsdam Mann S, Savulescu J, Ravaud P, Benchoufi M. Blockchain, consent and prosent for medical research. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2019-105963. [PMID: 32366703 PMCID: PMC8053330 DOI: 10.1136/medethics-2019-105963] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/20/2020] [Accepted: 03/27/2020] [Indexed: 05/31/2023]
Abstract
Recent advances in medical and information technologies, the availability of new types of medical data, the requirement of increasing numbers of study participants, as well as difficulties in recruitment and retention, all present serious problems for traditional models of specific and informed consent to medical research. However, these advances also enable novel ways to securely share and analyse data. This paper introduces one of these advances-blockchain technologies-and argues that they can be used to share medical data in a secure and auditable fashion. In addition, some aspects of consent and data collection, as well as data access management and analysis, can be automated using blockchain-based smart contracts. This paper demonstrates how blockchain technologies can be used to further all three of the bioethical principles underlying consent requirements: the autonomy of patients, by giving them much greater control over their data; beneficence, by greatly facilitating medical research efficiency and by reducing biases and opportunities for errors; and justice, by enabling patients with rare or under-researched conditions to pseudonymously aggregate their data for analysis. Finally, we coin and describe the novel concept of prosent, by which we mean the blockchain-enabled ability of all stakeholders in the research process to pseudonymously and proactively consent to data release or exchange under specific conditions, such as trial completion.
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Affiliation(s)
- Sebastian Porsdam Mann
- Department of Communication, University of Copenhagen Faculty of Humanities, København, Denmark
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Julian Savulescu
- Faculty of Philosophy, Oxford Uehiro Centre for Practical Ethics, Oxford, UK
| | - Philippe Ravaud
- Mailman School of Public Health, Columbia University, New York, New York, USA
- Clinical Epidemiology, Université Paris Descartes Faculté de Médecine, Paris, Île-de-France, France
| | - Mehdi Benchoufi
- Clinical Epidemiology, Universite Paris Descartes Faculté de Médecine, Paris, Île-de-France, France
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