Breast cancer prevention in community clinics: will low-income Latina patients participate in clinical trials?
Breast cancer prevention in community clinics: will low-income Latina patients participate in clinical trials?
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DOI：
10.1016/j.ypmed.2004.09.004
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发表时间：
2005-06-01
影响因子：
5.1
通讯作者：
Huerta, E
中科院分区：
文献类型：
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作者：
Mandelblatt, J;Kaufman, E;Huerta, E
背景拉丁裔参与乳腺癌预防试验的比例较低。我们评估了一项随机试验的可行性和有效性，与单独使用印刷材料相比，简短的咨询和印刷材料可以增加参与乳腺癌预防试验的意愿。我们从三个城市社区初级保健诊所招募了450名讲西班牙语的妇女。结局是意向性的，定义为可能、很可能或肯定会入组试验。我们还研究了结果使用更严格的定义限制可能和肯定打算参与。这项试验在这些忙碌的诊所是可行的，96%的妇女同意参加。乳腺癌知识水平较高（66%正确回答），但对临床试验的理解较低（40.5%正确回答）。使用不太严格的意向标准，72%的女性表示，如果符合条件，她们打算入组星星试验，但如果纳入药物副作用，意向率降至52%，如果提及子宫癌，则降至45%（趋势P 0.01）。使用更严格的定义，略少于一半的女性表示有兴趣参与，随着副作用的增加，意图减少的趋势相同。只有在使用不太严格的定义并且没有提到副作用的情况下，干预才是有效的（干预组和对照组分别为77%和67%，P = 0.03）。意愿与对乳腺癌的更大担忧和更年轻独立相关，但与文化适应或知识无关。拉丁妇女有兴趣参加预防乳腺癌的临床试验，尽管随着对副作用的讨论越来越多，兴趣下降。不幸的是，简短的教育只增加了使用最不严格的定义，当没有副作用时，提出的问题。未来的工作应侧重于定性研究，以了解预防性健康行为在这一人群中的理论基础。© 2004 Elsevier Inc. All rights reserved.
Background. Latinas have low rates of participation in breast cancer prevention trials. We evaluated the feasibility and effectiveness of a randomized trial of brief counseling and print materials compared to print materials alone to increase intent to participate in a breast cancer prevention trial.Methods. We enrolled 450 women Spanish-speaking women from three urban community primary care clinics. The outcome was intent, defined as might, probably, or definitely would enroll in the trial. We also examined results using a more stringent definition restricted to probably and definitely intend to participate.Results. The trial was feasible within these busy clinics, and 96% of women agreed to participate. The level of breast cancer knowledge was fairly high (66% correct answers), but understanding about clinical trials was lower (40.5% correct answers). Using the less stringent criteria for intent, 72% of women stated that they intended to enroll in the STAR trial if eligible, but rates of intent decreased to 52% with framing that included medication side effects and 45% if uterine cancer was mentioned (P < 0.01 for trend). Using the more stringent definition, slightly fewer than half of the women indicated an interest in participating, with the same trend towards decreasing intent with increasing presentation of side effects. The intervention was only effective using the less stringent definition and if no side effects were mentioned (77% intent vs. 67% in the intervention and control groups, respectively, P = 0.03). Intention was independently associated with greater worry about breast cancer and younger age, but not acculturation or knowledge.Conclusions. Latina women are interested in participating in clinical trials to prevent breast cancer, although interest declines with increasing discussion of side effects. Unfortunately, brief education only increased rates of intention using the least stringent definition and when no side effects were presented in framing the question. Future work should focus on qualitative research to understand the theoretical foundations of preventive health behaviors in this population. © 2004 Elsevier Inc. All rights reserved.