Faith, Culture, and Cancer: A Qualitative Study Exploring Muslim Women's Perspectives on Clinical Trials in the...

Despite breast cancer disproportionately affecting ethnically diverse populations, these groups remain underrepresented in UK cancer clinical trials, limiting the validity and generalisability of research findings, including treatment efficacy and safety. Around one-third of the UK's ethnic minority population is Muslim, yet little is known about Muslim women's experiences of breast cancer and clinical trial participation. This study aims to explore how faith, culture and religious beliefs influence Muslim women's experiences, understanding, perceptions and participation in cancer clinical trials.

Purposive and snowball sampling were used to recruit a diverse group of Muslim women with breast cancer. Women whose first language was non-English were included. Semi-structured interviews were conducted either face to face, online Teams or telephone. All participants completed a demographic questionnaire. Research ambassadors, well versed in the research protocol, supported translation and participants' linguistic needs. An inductive reflexive thematic analysis (RTA) was conducted to generate codes and themes, which were then mapped onto the capability, opportunity and motivation behaviour system COM-B model.

Fifteen Muslim women and three immediate family members were consented and interviewed. Participants were from a wide geographical area across Greater Manchester and Lancashire in the United Kingdom, representing diverse ethnicities, age and social position. Women with primary and secondary breast cancer participated; the majority were undergoing systemic anticancer therapy, and three had taken part in randomised clinical trials. RTA generated five main themes: 'What defines who I am,' 'perception of cancer,' 'perception and experience of clinical trials,' 'information & education to support decision making,' and 'the role of the healthcare professional (HCP) in supporting trial participation.' Women's capability to participate was shaped by their knowledge of clinical trials and access to information. Opportunities were influenced by sociocultural factors, including gender roles, family expectations and HCPs' cultural competence, while motivation was shaped by women's identity, religion and trust in HCPs.

This study provides insight into Muslim women's health-related beliefs and behaviours that influence participation in cancer clinical trials. Findings will help identify areas where action can be taken at intrapersonal, interpersonal and community level to help empower women to participate in cancer clinical trials.

Ethnically diverse patients and members from community grassroots organisations informed a culturally sensitive protocol. Research ambassadors contributed across the research cycle, including adapting interview materials, supporting recruitment and participation (particularly for non-English speakers), and providing cultural and religious insight during analysis and interpretation.