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Behavioral aspects of clinical trials. An integrated framework from behavior theory
G R Morrow1, J T Hickok, T G Burish
1Cancer Center, University of Rochester School of Medicine and Dentistry, New York 14642.
Cancer
|November 1, 1994
Summary
Low patient enrollment in National Cancer Institute clinical trials is a significant issue. Understanding patient and physician factors, guided by health behavior theories, can improve oncology clinical trial accrual.
Area of Science:
- Oncology
- Clinical Trials
- Health Behavior Science
Background:
- A suboptimal proportion of cancer patients participate in National Cancer Institute-sponsored clinical trials.
- Low accrual rates in oncology clinical trials limit research progress and patient access to novel therapies.
Purpose of the Study:
- To review the literature on oncology clinical trial accrual.
- To characterize the extent of the low accrual problem.
- To identify reasons for low accrual and suggest strategies for improvement.
Main Methods:
- Literature review of studies on oncology clinical trial accrual.
- Application of health behavior theories (Health Belief Model, Subjective Expected Utility Theory, Protection Motivation Theory, Theory of Reasoned Action) as a framework.
- Analysis of patient and physician factors influencing trial participation.
Main Results:
- Identified key concepts influencing health behavior: perceived threat (probability and severity of health event), perceived benefits (effectiveness of behavior), and perceived costs.
- Synthesized patient and physician factors associated with clinical trial participation.
- Established a framework for understanding and addressing low accrual.
Conclusions:
- Patient and physician factors are critical determinants of oncology clinical trial accrual.
- Recommendations derived from health behavior theories can guide strategies to increase patient enrollment in clinical trials.
- Improving accrual is essential for advancing cancer research and patient care.