"First, Trust Needs to Develop": Hematologists' Perspectives on Factors Influencing Black Persons' Participation in Clinical Trials.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-18 DOI:10.1007/s40615-024-02205-8

Shakira J Grant, Milenka Jean-Baptiste, Jiona A Mills, Paul Mihas

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Abstract

Background: Cancer clinical trials are crucial for treatment standards and innovation but lack racial-ethnic diversity. Understanding physician perspectives on recruiting participants is critical due to their role in decision-making about trial candidacy and enrollment.

Methods: From August 2021 to January 2022 we recruited 13 Academic hematologists experienced with treating blood cancers and enrolling clinical trial participants. Each hematologist participated in a 60-75-minute semistructured interview and completed a sociodemographic survey. Using the National Institute on Minority Health and Health Disparities multilevel model as a framework, we characterized hematologists' perceived barriers to clinical trial participation among Black persons. ATLAS.ti v9 and later v 23.2.1 was used for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk Inc).

Results: All hematologists were White, with 70% being male. Three factors influenced their perspectives on enrolling Black individuals in clinical trials: individual attitudes and beliefs, such as perceptions that Black or socioeconomically disadvantaged persons will be less willing or less compliant with the requirements for trial participation and follow-up. The need to build trusting relationships between themselves and patients prior to discussing clinical trials and the prevailing legacy of medical mistrust among the Black community. Trust was found to be the underlying factor in determining communication between hematologists and Black persons about clinical trials across all three levels.

Conclusion: This study highlights how hematologists' attitudes, beliefs, biases, and views on trust in patient relationships influence their communication with Black individuals about clinical trials. It emphasizes the need for further research to develop interventions that address the lack of racial and ethnic diversity in trials.

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"首先，需要建立信任"：血液学专家对影响黑人参与临床试验的因素的看法。

背景：癌症临床试验对治疗标准和创新至关重要，但缺乏种族-族裔多样性。由于医生在试验候选资格和入组决策中的作用，因此了解医生对招募参与者的观点至关重要：从 2021 年 8 月到 2022 年 1 月，我们招募了 13 名在治疗血癌和招募临床试验参与者方面经验丰富的学术血液科医生。每位血液病专家都参加了 60-75 分钟的半结构化访谈，并完成了一份社会人口调查。我们以美国国家少数族裔健康和健康差异研究所的多层次模型为框架，描述了血液病专家对黑人参与临床试验的障碍的看法。我们使用 ATLAS.ti v9 及以后的 23.2.1 版进行项目管理，并使用排序与筛选、思考与转换方法（ResearchTalk Inc）促进数据分析：所有血液学专家均为白人，其中 70% 为男性。有三个因素影响了他们对黑人参与临床试验的看法：个人态度和信念，如认为黑人或社会经济条件较差的人会不太愿意或不太遵守参与试验和随访的要求。在讨论临床试验之前，需要在自己和患者之间建立信任关系，以及黑人群体中普遍存在的对医学的不信任。研究发现，信任是决定血液科医生与黑人就临床试验在所有三个层面上进行沟通的根本因素：本研究强调了血液科医生的态度、信念、偏见以及对患者关系中信任的看法如何影响他们与黑人就临床试验进行沟通。它强调了进一步研究开发干预措施的必要性，以解决试验中缺乏种族和民族多样性的问题。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.