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Tsang JLY, Fowler R, Cook DJ, Burns KEA, Hunter K, Forcina V, Hwang A, Duan E, Patterson L, Binnie A. Motivating factors, barriers and facilitators of participation in COVID-19 clinical research: A cross-sectional survey of Canadian community intensive care units. PLoS One 2022; 17:e0266770. [PMID: 35476678 PMCID: PMC9045667 DOI: 10.1371/journal.pone.0266770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/27/2022] [Indexed: 12/15/2022] Open
Abstract
Only a small proportion of COVID-19 patients in Canada have been recruited into clinical research studies. One reason is that few community intensive care units (ICUs) in Canada participate in research. The objective of this study was to examine the motivating factors, barriers and facilitators to research participation amongst Canadian community ICU stakeholders. A cross-sectional online survey was distributed between May and November 2020. The survey focused on 6 domains: participant demographics, ICU characteristics, ICU research infrastructure, motivating factors, perceived barriers, and perceived facilitators. Responses were received from 73 community ICU stakeholders, representing 18 ICUs. 7/18 ICUs had a clinical research program. Participants rated their interest in pandemic research at a mean of 5.2 (Standard Deviation [SD] = 1.9) on a 7-point Likert scale from ‘not interested’ to ‘very interested’. The strongest motivating factor for research participation was the belief that research improves clinical care and outcomes. The most significant facilitators of research involvement were the availability of an experienced research coordinator and dedicated external funding to cover start-up costs, while the most significant barriers to research involvement were a lack of start-up funding for a research coordinator and a lack of ICU research experience. Canadian Community ICU stakeholders are interested in participating in pandemic research but lack basic infrastructure, research personnel, research experience and start-up funding. Evolution of a research support model at community hospitals, where most patients receive acute care, may increase research participation and improve the generalizability of funded research in Canada.
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Affiliation(s)
- Jennifer L. Y. Tsang
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, McMaster University, St. Catharines, Ontario, Canada
- Niagara Health, St. Catharines, Ontario, Canada
- * E-mail:
| | - Robert Fowler
- Interdepartmental Division of Critical Care, Temerty School of Medicine, Toronto, University of Toronto, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Deborah J. Cook
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s HealthCare, Hamilton, Ontario, Canada
| | - Karen E. A. Burns
- Interdepartmental Division of Critical Care, Temerty School of Medicine, Toronto, University of Toronto, Toronto, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Kylee Hunter
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Victoria Forcina
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, McMaster University, St. Catharines, Ontario, Canada
| | - Anna Hwang
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, McMaster University, St. Catharines, Ontario, Canada
| | - Erick Duan
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Niagara Health, St. Catharines, Ontario, Canada
- St. Joseph’s HealthCare, Hamilton, Ontario, Canada
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Lewin J, Bell JAH, Wang K, Forcina V, Tam S, Srikanthan A, Lin YC, Taback N, Mitchell L, Gupta AA. Evaluation of Adolescents’ and Young Adults’ Attitudes Toward Participation in Cancer Clinical Trials. JCO Oncol Pract 2020; 16:e280-e289. [DOI: 10.1200/jop.19.00450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE: Participation in cancer clinical trials (CCTs) for adolescents and young adults (AYAs) remains the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CCT participation. METHODS: A mixed-methods approach was used. AYAs and non-AYAs (≥ 40 years) completed the Cancer Treatment subscale of the Attitudes Toward Cancer Trials Scales and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test, and logistic regression models were constructed to evaluate the effect of demographics on perceptions of CCTs. RESULTS: Surveys were distributed to 61 AYAs (median age, 29 years; range, 17-39 years) and 74 non-AYAs (median age, 55 years; range, 40-88 years). Compared with non-AYAs, AYAs perceived CCTs to be unsafe/more difficult (Personal Barrier/Safety domain; P = .01). There were no differences based on age in other domains. AYAs were also more concerned with CCT interference in their long-term goals ( P = .04). Multivariable ordered logistic regression identified increased personal barriers in the Personal Barrier/Safety domain for AYAs ( P = .01), in patients with English as a second language (ESL; P < .01), and in patients previously not offered a clinical trial ( P = .03). Long-term goals were identified as a barrier in particular tumor types ( P = .01) and in patients with ESL ( P < .01), with a trend identified in AYAs ( P = .12). CONCLUSION: Age-related differences in attitudes toward CCTs suggest that tailored approaches to CCT accrual are warranted. Patient-centered delivery of information regarding CCTs, particularly in patients with ESL and who are trial naïve, may improve accrual.
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Affiliation(s)
- Jeremy Lewin
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Medical Oncology and Hematology, Princes Margaret Cancer Center, Toronto, Ontario, Canada
| | - Jennifer A. H. Bell
- Department of Bioethics, University Health Network; Department of Supportive Care, Princess Margaret Cancer Centre; and Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kate Wang
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Victoria Forcina
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Seline Tam
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Amirrtha Srikanthan
- Department of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada
| | - Yu-Chung Lin
- Departments of Statistical Science and Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Taback
- Departments of Statistical Science and Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Laura Mitchell
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Abha A. Gupta
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Medical Oncology and Hematology, Princes Margaret Cancer Center, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Lenton-Brym T, Samadi M, Papadakos J, Charow R, Forcina V, Thavaratnam A, Mitchell L, Lorenzo A, Gupta A. 34 Using a video to introduce fertility preservation to female adolescents with cancer. Paediatr Child Health 2019. [DOI: 10.1093/pch/pxz066.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - Janet Papadakos
- University Health Network
- Princess Margaret Cancer Centre
- Cancer Care Ontario
| | - Rebecca Charow
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre
| | | | | | | | | | - Abha Gupta
- The Hospital for Sick Children
- University of Toronto
- Princess Margaret Cancer Centre
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Gupta AA, Lenton-Brym T, Charow R, Paulo C, Samadi M, Forcina V, Chen SL, Thavaratnam A, Mitchell L, Lorenzo AJ, Papadakos J. Using a video to introduce fertility preservation to women with cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e18021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18021 Background: Women with cancer risk premature ovarian insufficiency with implications for future fertility due to chemotherapy and radiotherapy. Still, infertility discussions are inconsistently provided. Options for egg cryopreservation exist for females, but discussing these topics can be overwhelming for patients and families. This paper aims to assess the understandability, actionability, and readability of a fertility preservation (FP) educational video, as well as patient (pt) and caregiver pre- and post-video perceptions and knowledge. Methods: A video was created by the institution's Adolescent and Young Adult Program to explain relevant anatomy, pathophysiology of ovulation and process of cryopreservation. Understandability and actionability were evaluated using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) and readability using the SMOG and Flesch-Kincaid indices. Pt perceptions and knowledge growth were captured using pre-post questionnaires. Female pts (n = 108) were recruited in oncology clinics over 2 months, using a convenience sample. Questionnaire responses were analyzed using SPSS to calculate descriptive statistics to conduct correlation analyses. Results: The median age of the participants was 28 (range 14-39 yrs). The average PEMAT-A/V score was 79% (±11.3%) for understandability and 72% (±13.1%) for actionability. A score of 70% is regarded as acceptable. The readability assessment determined that the video script was, on average, at a grade 8 reading level. Pts’ interest in learning about FP increased, with 14% of those initially uninterested or unsure wanting to learn more after viewing the video. Pts’ general knowledge on FP increased from the pre- to post-video questionnaire, from a mean score of 75% initially (±17.9%), to a mean score of 84% (±14.5%) after watching the video (t = -5.972, p = 0.000). On average, overall satisfaction with the video was 85% (±8.5%). Conclusions: Women commonly use online tools for researching health questions. This study demonstrates that the video is understandable and provides guidance for future discussion. It shows that videos can spark interest in sensitive discussions and can improve fertility knowledge. This video may encourage providers to more consistently initiate discussions about infertility. Furthermore, the video can be translated for related topics to help provide accurate information in a patient-friendly medium.
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Affiliation(s)
- Abha A. Gupta
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | | | - Rebecca Charow
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Chelsea Paulo
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Mahsa Samadi
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Victoria Forcina
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Shian Li Chen
- Princess Margaret Cancer Centre, Toronto, ON, Canada
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Greenspoon T, Charow R, Papadakos J, Samadi M, Maloney AM, Paulo C, Forcina V, Chen L, Thavaratnam A, Mitchell L, Lorenzo A, Gupta AA. Evaluation of an Educational Whiteboard Video to Introduce Fertility Preservation to Female Adolescents and Young Adults With Cancer. JCO Oncol Pract 2019; 16:e488-e497. [PMID: 32048948 DOI: 10.1200/op.19.00365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Fertility is an important issue for adolescents and young adults with cancer facing potential infertility. Egg cryopreservation options exist, but information is sometimes overwhelming. We evaluated a fertility preservation educational video and assessed patient and family knowledge and impressions at pre- and post-video timepoints. METHODS We developed a whiteboard video to explain egg cryopreservation to patients and families. The video was evaluated on the basis of patient education best practices (readability, understandability, actionability). Participants were recruited using convenience sampling in oncology clinics. They completed questionnaires before and after watching to assess knowledge and interest. Inclusion criteria were patients age 13-39 years and minimum 1 month from diagnosis. Descriptive statistics, correlation analyses, and mean comparisons were conducted. RESULTS The video script read at a grade 8 reading level. Average understandability and actionability scores were below the acceptable standard. We recruited 108 patients (mean age, 27 years) and 39 caregivers/partners. Patients' knowledge about fertility preservation increased after viewing the video. Interest was high before and after, and satisfaction was high for both patients and caregivers. Participants appreciated information on process, procedure, and delivery but desired more information on logistics, including cost. CONCLUSION A targeted patient education video about fertility preservation options can build knowledge and encourage discussions about infertility. The video can be used as a model for videos on related topics to provide accurate information in a youth-friendly medium; however, following patient education best practices for readability, understandability, and actionability may increase video effectiveness. Future research should assess how audiovisual patient education material affects patient behavior.
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Affiliation(s)
- Talia Greenspoon
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Charow
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Janet Papadakos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Patient Education, Cancer Care Ontario; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada
| | - Mahsa Samadi
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Anne Marie Maloney
- Division of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Chelsea Paulo
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Victoria Forcina
- Adolescent & Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Li Chen
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Adrian Thavaratnam
- Adolescent & Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Laura Mitchell
- Adolescent & Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Armando Lorenzo
- Division of Pediatric Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Abha A Gupta
- Division of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Adolescent & Young Adult Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Forcina V, Vakeesan B, Paulo C, Mitchell L, Bell JA, Tam S, Wang K, Gupta AA, Lewin J. Perceptions and attitudes toward clinical trials in adolescent and young adults with cancer: a systematic review. Adolesc Health Med Ther 2018; 9:87-94. [PMID: 29942170 PMCID: PMC6005317 DOI: 10.2147/ahmt.s163121] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose Although cancer clinical trials (CT) offer opportunities for novel treatments that may lead to improved outcomes, adolescents and young adults (AYA) are less likely to participate in these trials as compared to younger children and older adults. We aimed to identify the perceptions and attitudes toward CT in AYA that influence trial participation. Materials and methods A systematic review of cancer literature was conducted that assessed perceptions and attitudes toward CT enrollment limited to AYA patients (defined as age 15–39). We estimated the frequency of identified themes by pooling identified studies. Results In total, six original research articles were identified that specifically addressed perceptions or attitudes that influenced CT participation in AYA patients. Three studies were conducted at pediatric centers – one at an AYA unit, one at an adult cancer hospital, and one was registry based. Major themes identified for CT acceptability included: hope for positive clinical affect, altruism, and having autonomy. Potential deterrents included: prolonged hospitalization, worry of side effects, and discomfort with experimentation. Conclusion Limited information is available with regard to the perceptions and attitudes toward CT acceptability among AYA patients, especially those treated at adult cancer centers, which prevents generalization of data and themes. Future research assessing strategies for understanding and supporting CT decision-making processes among AYA represents a key focus for future funding to improve CT enrollment.
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Affiliation(s)
- Victoria Forcina
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Branavan Vakeesan
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Chelsea Paulo
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Laura Mitchell
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Jennifer Ah Bell
- Joint Center for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Seline Tam
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Kate Wang
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Abha A Gupta
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jeremy Lewin
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,ONTrac, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Bell JA, Forcina V, Mitchell L, Tam S, Wang K, Gupta AA, Lewin J. Perceptions of and decision making about clinical trials in adolescent and young adults with Cancer: a qualitative analysis. BMC Cancer 2018; 18:629. [PMID: 29866065 PMCID: PMC5987432 DOI: 10.1186/s12885-018-4515-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 05/17/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adolescent and young adults (AYA) enrolment rates into cancer clinical trials (CCT) are the lowest of any age group globally. As AYA have distinct biological, psychosocial and relational needs, we aimed to explore any unique factors influencing their CCT decision-making process, including AYA-specific perceptions or attitudes towards CCT. METHODS Qualitative interpretive descriptive methodology was used to explore AYA perceptions and decision-making related to CCT. An analytic approach conducive to inductive imagining and exploratory questioning was used in order to generate insights and interpret data. RESULTS A total of 21 AYA were interviewed (median age: 31 (18-39)). Twelve (57%) participants had previously been approached to participate in CCT. Major themes influencing trial enrolment decisions were: 1) severity of illness/urgency for new treatment 2) side effect profile of investigational drug in the short and long term (e.g., impact on future quality of life) 3) who approached patient for trial participation (oncologist vs. other) 4) additional information found on-line about the trial and investigators, and 5) family, friends and peer group opinion regarding the CCT. CONCLUSIONS Several psychosocial and relational factors were identified as influencing AYA CCT decisions, some of which are unique to this demographic. Specific strategies to address barriers to CCT and enable supportive decision-making include: 1) involving family in decision-making and 2) helping AYA appreciate short- and long-term implications of trial participation. Finally, exploring social networking and general education about CCT that AYA can independently access may increase participation.
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Affiliation(s)
- Jennifer A.H. Bell
- Joint Center for Bioethics, University of Toronto, Toronto, Canada
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Victoria Forcina
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Laura Mitchell
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Seline Tam
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Kate Wang
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Abha A. Gupta
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, Canada
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Jeremy Lewin
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Present Address: OnTrac at PeterMac, Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
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Gupta AA, Bell JA, Wang K, Forcina V, Tam S, Lin YC, Taback N, Mitchell L, Lewin JH. Evaluation of adolescents and young adults (AYA) attitudes towards participation in cancer clinical trials. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.10047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10047 Background: Participation in clinical trials (CT) for AYA ( < 39 years) remain the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CT participation. Methods: A mixed methods approach included 1) qualitative: interpretive descriptive methodology guided individual semi-structured interviews with 21 AYA for factors influencing CT enrollment and 2) quantitative: AYA and non-AYA (≥40) matched for histology completed Cancer Treatment subscale of Attitudes toward Cancer Trials Scales (ACTS-CT) (Schuber, 2008) and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test and ordered logistic regression models were constructed for prediction of the effect of baseline demographics. Results: The major themes influencing CT participation were: (1) family/peer group opinion (2) CT impact on daily/future life (e.g. school; starting a family) and (3) illness severity/psychological readiness for CT information. Surveys were distributed to 61 AYA (median age: 29 years (17-39)); 74 non-AYA (55 (40-88)). Compared with non-AYA, AYA perceived CT to be unsafe/more difficult (Personal Barrier/Safety domain; p = 0.01). AYA were also more concerned with CT interference in their long term goals (p = 0.04). Logistic regression identified participants who had previously been offered a CT (p = 0.01) or who spoke English as their first language (80% of cohort)(p = 0.01) reported less barriers to CT. There were no differences based on age in other domains (Personal Benefits; Personal/Social Value; Trust in CT). In all participants, differences were seen in the Personal Benefits domain if respondents had children (p = 0.05) or were currently working (p = 0.04). Conclusions: Age-related differences in attitudes towards CT suggest that tailored approaches to CT accrual of different patient groups may be warranted. Patient-centered delivery of information regarding CT, particularly for those in whom English is a second language and who are trial-naïve, may improve accrual and warrants further prospective, randomized study.
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Affiliation(s)
- Abha A. Gupta
- Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jennifer A.H Bell
- Department of Bioethics, University Health Network, Toronto, ON, Canada
| | - Kate Wang
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Victoria Forcina
- Adolescent and Young Adult Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Seline Tam
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Yu-Chung Lin
- Department of Statistical Science, University of Toronto, Toronto, ON, Canada
| | - Nathan Taback
- Department of Statistical Science, University of Toronto, Toronto, ON, Canada
| | | | - Jeremy Howard Lewin
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
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Toci F, Viola A, Edwards R, Mencarelli T, Forcina V. Sorbent materials for fusion reactor tritium processing. Fusion Engineering and Design 1995. [DOI: 10.1016/0920-3796(95)90063-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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