This application addresses the broad Challenge Area-- 02 Bioethics and the specific Challenge Topic: 02-0DCOSP)-102 WEthicallssues in Health DisDarities and Access to ParticiDation in Research"""""""" . The research focuses on the critical need to develop patient-level interventions to increase the representation of African Americans in cancer clinical trials. This need extends to the general underrepresentation of African Americans in clinical trials throughout the nation. We will design and assess the impact of a culturally appropriate educational video, developed with active community participation, which targets six documented cultural and attitudinal barriers to African American participation in clinical trials. The video will show, through compelling patient stories and physician interviews, how barriers can """"""""fall away."""""""" The 15-minute video will be divided into 6 mini-segments, one for each barrier. A representative Community Advisory Group (GAG) will be established to offer insight and guidance toward initial planning of the script for the video. The GAG will be comprised of leaders from faith-based organizations, businesses, community organizations, political leaders, someone with a high family incidence of cancer, and African American cancer patients who enrolled to a therapeutic clinical trial. One of the nation's most successful health videographers will work with us to use proven media techniques effective with African American patients. The study sample will be African American cancer patients at Washington Cancer Institute with any type of cancer whose oncologist has determined to be potentially eligible for a therapeutic clinical trial. Prior to making a decision about enrolling to the therapeutic clinical trial, the oncologist will ask his/her patient to consider this educational video study. Consented patients will undergo a one-page interviewer-administered survey questionnaire designed to assess attitudes toward therapeutic clinical trials and likelihood of trial participation. Participants will be asked to view the educational video immediately after completing the baseline questionnaire and will complete the same questionnaire immediately after viewing the video. The proposed design utilizes a pre-testlpost-test method to determine the impact of the patient education video on three variables: 1) attitudes toward therapeutic clinical trials (Trust in doctors, Altruism, Perceived personal benefits, perceived negative aspects, Inconvenience factors);2) likely participation in therapeutic clinical trials;and 3) actual trial enrollment. We expect to demonstrate significant improvements in attitudes toward clinical trials after viewing the educational video and achieve a rate of therapeutic trial participation equal to the national average for all cancer patients. This research has a potential national impact and will be designed for immediate national dissemination. The video, if proven effective, will be offered to NCI Cooperative Groups, such as the National Surgical Adjuvant Breast and Bowel Project (NSABP), Cancer and Leukemia Group B (GALGB), and Eastern Cooperative Oncology Group (ECOG). In addition, the video may be shown in churches and other community settings to initiate and facilitate dialogue within the African American community.
The high rate of mortality from cancer among African Americans is a major public health problem in the United States. There is an urgent need to develop effective ways to increase the participation of African Americans in cancer prevention, early detection and treatment research trials to address our nation's cancer disparities.
| Robinson, Brandi N; Newman, Antoinette F; Tefera, Eshetu et al. (2017) Video intervention increases participation of black breast cancer patients in therapeutic trials. NPJ Breast Cancer 3:36 |
| Banda, Deliya R; Libin, Alexander V; Wang, Hong et al. (2012) A pilot study of a culturally targeted video intervention to increase participation of African American patients in cancer clinical trials. Oncologist 17:708-14 |
