Abstract
Background: A study of patients enrolled in NCI-sponsored cooperative group nonsurgical treatment trials for breast, lung, colorectal, or prostate cancers reported an enrollment rate of only 1.8% among Caucasian patients. The comparable rate for African Americans was even lower at 1.3%. Recent statistics confirm markedly higher cancer-specific mortality rates for African Americans than members of other racial/ethnic groups. The recognition of cultural beliefs and attitudes towards clinical trials has been acknowledged as critical to ameliorating disparities in cancer outcomes. Our study thus focuses on the need to develop patient-level interventions to increase the representation of African Americans in cancer clinical trials. To date there have been qualitative studies to determine the nature of attitudes preventing participation but to our knowledge no actual intervention in the African American population.
Aims and Focus: With active community involvement, we have developed a 15-minute narrative-based video for African American men and women with cancer. Using positive messaging the video addresses six cultural and attitudinal barriers to African American participation that have been documented in literature. We aim to assess whether African American patients are more likely to participate in trials after viewing the video and evaluate whether attitudes on the six trial barriers are impacted. We will also determine if the trial enrollment rate is higher than the national average after viewing the video.
Methods: We are in the process of enrolling 114 African American patients at Washington Cancer Institute (WCI), a large urban cancer institute serving a predominantly African American patient population. We will use a mixed-methods approach including a pre-post test analysis with a survey instrument developed specifically to assess attitudes on the six study barriers. Semistructured interviews for participants consenting to follow-up will also be conducted and analyzed to provide additional context to inform our findings.
Research Implications: This study has a potential national impact as it addresses the sociodemographic context and culturally rooted beliefs and preferences that may further hinder African American enrollment on therapeutic trials. The study and its products should have particular benefit for National Cancer Institute (NCI) cooperative groups as well as utility in community-based settings. The video we have developed will be an important tool to stimulate dialogue in African American community settings.
Acknowledgement of Funding: National Center on Minority Health and Health Disparities: 1RC1MD004185-01.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A15.