Motivators and barriers to Latinas' participation in clinical trials: The role of contextual factors
Motivators and barriers to Latinas' participation in clinical trials: The role of contextual factors
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DOI：
10.1016/j.cct.2014.11.013
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发表时间：
2015-01-01
影响因子：
2.2
通讯作者：
Sheppard, Vanessa B.
中科院分区：
文献类型：
--
作者：
London, Laricca;Hurtado-de-Mendoza, Alejandra;Sheppard, Vanessa B.
目的：尽管拉美裔人口增加，但拉美裔在临床试验中的代表性不足。本研究探讨了与拉丁美洲人参与预防性乳腺癌随机临床试验（rct）意愿相关的因素。方法：自认为是拉丁裔的女性，年龄超过40岁，无乳腺癌病史。使用弱势群体行为模型，我们进行了一项调查（n = 168），以评估易感因素（例如，知识），使能因素（例如，信任）和需求因素（例如，风险感知）。参与意向的定义使用宽松（可能、可能或肯定）和严格（可能和肯定）标准。卡方检验和逻辑回归模型检验了易感因素、使能因素和需要因素与妇女参与随机对照试验的意愿之间的关系。结果：大多数参与者（74.9%）是单语西班牙语移民。大多数（83.9%）报告愿意参加宽松定义下的临床试验（严格定义下为43.1%）。使用宽松的定义，愿意参加rct的几率在未婚女性（OR = 0.25,95% CI = 0.08 - 0.79）和癌症风险认知较低的女性（OR = 0.20,95% Cl = 0.06 - 0.63）中显著较低，而在语言适应程度较低的女性中显著较高（OR = 62,95% CI = 1.8-20.9）。使用严格的定义，那些不支持注册的动机来帮助家庭成员（如果他们患有癌症）的妇女报告意图的几率显着降低（OR = 0.33, 95% Cl = 0.13 - 0.86）。结论：由于少数民族的代表性较低，许多随机对照试验可能具有有限的普遍性。针对拉丁美洲人家庭重要性的文化针对性干预可能最终会增加他们在随机对照试验中的参与度。(C) 2014爱思唯尔公司版权所有。
Objective: Latinas are underrepresented in clinical trials despite the rise in Hispanic population. This study examines the factors associated with Latinas' willingness to participate in preventive breast cancer randomized clinical trials (RCTs).Methods: Women self-identifying as Latina, over age 40, with no prior history of breast cancer were eligible. Using the Behavior Model for Vulnerable Populations, we administered a survey (n = 168) to assess predisposing ( e.g., knowledge), enabling (e.g., trust) and need factors (e.g., risk perception). Intention to participate was defined using a lenient (maybe, probably or definitely) and a stringent criterion (probably and definitely). Chi-square tests and logistic regression models examined the associations of predisposing, enabling, and need factors with women's intentions to participate in RCTs.Results: Most participants (74.9%) were monolingual Spanish-speaking immigrants. Most (83.9%) reported willing to participate in clinical trials using the lenient definition (vs. 43.1% under the stringent definition). Using the lenient definition, the odds of willing to participate in RCTs were significantly lower for unmarried women (OR = .25, 95% CI = .08-.79) and those with lower cancer risk perceptions (OR = .20,95% Cl = .06-.63), while being significantly higher for women with lower language acculturation (OR = 62,95% CI = 1.8-20.9). Using the stringent definition, women who did not endorse a motivation to enroll to help family members (if they had cancer) had significantly lower odds to report intent (OR = .33, 95% Cl = .13-.86).Conclusion: Many RCTs may have limited generalizability due to the low representation of minorities. Culturally targeted interventions that address the importance of family for Latinos may ultimately increase their participation in RCTs. (C) 2014 Elsevier Inc. All rights reserved.