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Exploring Racial Disparities in Awareness and Perceptions of Oncology Clinical Trials: Cross-Sectional Analysis of
Ariel Hoadley1, Linda Fleisher2, Cassidy Kenny2
1Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States.
Background:
Black/African American adults are underrepresented in oncology clinical trials in the United States, despite efforts at narrowing this disparity.
Objective:
This study aims to explore differences in how Black/African American oncology patients perceive clinical trials to improve support for the clinical trial participation decision-making process.
Methods:
As part of a larger randomized controlled trial, a total of 244 adult oncology patients receiving active treatment or follow-up care completed a cross-sectional baseline survey on sociodemographic characteristics, clinical trial knowledge, health literacy, perceptions of cancer clinical trials, patient activation, patient advocacy, health care self-efficacy, decisional conflict, and clinical trial intentions. Self-reported race was dichotomized into Black/African American and non-Black/African American. As appropriate, 2-tailed t tests and chi-square tests of independence were used to examine differences between groups.
Results:
Black/African American participants had lower clinical trial knowledge (P=.006), lower health literacy (P<.001), and more medical mistrust (all P values <.05) than non-Black/African American participants. While intentions to participate in a clinical trial, if offered, did not vary between Black/African American and non-Black/African American participants, Black/African American participants indicated lower awareness of clinical trials, fewer benefits of clinical trials, and more uncertainty around clinical trial decision-making (all P values <.05). There were no differences for other variables.
Conclusions:
Despite no significant differences in intent to participate in a clinical trial if offered and high overall trust in individual health care providers among both groups, beliefs persist about barriers to and benefits of clinical trial participation among Black/African American patients. Findings highlight specific ways that education and resources about clinical trials could be tailored to better suit the informational and decision-making needs and preferences of Black/African American oncology patients.
Insights
Black/African American oncology patients show lower awareness and understanding of clinical trials, despite similar intentions to participate. Tailored education is crucial to address their specific decision-making needs and improve trial access.
Area of Science:
- Oncology
- Health Disparities
- Clinical Trials
Background:
- Black/African American adults remain underrepresented in U.S. oncology clinical trials.
- Efforts to reduce this disparity have had limited success.
Purpose of the Study:
- To explore how Black/African American oncology patients perceive clinical trials.
- To identify differences in perceptions to enhance support for clinical trial participation decisions.
Main Methods:
- A cross-sectional survey of 244 adult oncology patients (Black/African American vs. non-Black/African American).
- Assessed sociodemographics, clinical trial knowledge, health literacy, perceptions, patient activation, advocacy, self-efficacy, decisional conflict, and intentions.
- Used t tests and chi-square tests to compare groups.
Main Results:
- Black/African American participants had lower clinical trial knowledge (P=.006) and health literacy (P<.001).
- They reported greater medical mistrust (P<.05), lower awareness of trial benefits, and more decision-making uncertainty (P<.05).
- Intentions to participate did not differ between groups.
Conclusions:
- Beliefs about clinical trial barriers and benefits differ among Black/African American patients, despite similar participation intent and trust in providers.
- Findings emphasize the need for tailored education and resources to meet the informational and decision-making needs of this population.
- Improving understanding and addressing specific concerns can enhance clinical trial participation for Black/African American oncology patients.
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