JMIR Publications

ABSTRACT

Background:

Black and African American (AA) adults are underrepresented in oncology clinical trials (CTs) in the US, despite efforts at narrowing this disparity.

Objective:

This study explores differences in how Black/AA oncology patients perceive CTs to improve support for the CT-participation decision-making process.

Methods:

As part of a larger randomized controlled trial, N=244 adult oncology patients receiving active treatment or follow-up care completed a cross-sectional baseline survey on sociodemographic characteristics, CT knowledge, health literacy, perceptions of cancer CTs, patient activation, patient advocacy, healthcare self-efficacy, decisional conflict, and CT intentions. Self-reported race was dichotomized into Black/AA and non-Black/AA. As appropriate, t-tests and chi-squared tests of independence were used to examine differences between groups.

Results:

Black/AA participants had lower CTs knowledge (p = .006), lower health literacy (p < .001), and more medical mistrust (p’s < .05) than non-Black/AA participants. While intentions to participate in a clinical trial, if offered, did not vary between Black/AA and non-Black/AA participants, Black/AA participants indicated lower awareness of CTs, fewer benefits of CTs, and more uncertainty around CT decision-making (p’s < .05). There were no differences for other variables.

Conclusions:

Despite no significant differences in intent to participate in a CT if offered and high overall trust in individual healthcare providers among both groups, beliefs persist about barriers to and benefits of CT participation among Black/AA patients. Findings highlight specific ways that education and resources about CTs could be tailored to better suit the informational and decision-making needs and preferences of Black/AA oncology patients.