Ensuring Representation: A Scoping Review of Interventions to Increase Minority Participation in Cancer-Related Research.

Abstract

Purpose: Minority representation in cancer-related clinical trials (CCTs) is often inadequate. This poses a threat to the generalizability of studies and risks promoting health inequities. This scoping review set out to examine strategies to promote minority participation in CCTs and across the entire continuity of cancer-related care.

Methods: We reviewed articles in the following databases: EMBASE, Scopus, and PubMed. For inclusion, studies were required to focus, to a significant extent, on interventions to increase minority enrollment/retention. They were also required to objectively report the strength of these interventions, and either compare them with a control, or with a different intervention attempted.

Results: After initially identifying 817 articles, we reviewed 337 articles in their entirety, and found 37 that satisfied our full list of inclusion and exclusion criteria. Five general categories of interventions emerged in these studies. These included educational interventions (n = 17), patient navigation (n = 12), community engagement (n = 8), autonomous recruitment strategies (n = 4), and financial assistance/incentives (n = 4). We then examined rates of statistical significance (for studies that assessed this). Seven of 10 articles that used education intervention strategies and assessed statistical significance demonstrated improvement in at least one variable. For patient navigation, 5/5 showed significance. For community engagement, 1/1 found a significant difference. For studies using an autonomous recruitment strategy, 2/2 showed an improvement. Finally, for financial assistance/incentives, 1/3 found a significant improvement in minority enrollment.

Conclusion: Our study highlights the critical role of tailored educational interventions and patient navigation in increasing minority participation in cancer-related clinical trials. However, all five categories of interventions showed promise. More research is needed, particularly in assessing the efficacy of multipronged approaches, to ensure adequate minority participation in CCTs.