A Model of Cancer Clinical Trial Decision-making Informed by African-American Cancer Patients.
A Model of Cancer Clinical Trial Decision-making Informed by African-American Cancer Patients.
复制标题
由非裔美国癌症患者提供信息的癌症临床试验决策模型。
DOI：
10.1007/s40615-014-0063-x
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发表时间：
2015
影响因子：
3.9
通讯作者：
Ford,JeanG
中科院分区：
文献类型：
--
作者：
Wenzel,JenniferA;Mbah,Olive;Xu,Jiayun;Moscou-Jackson,Gyasi;Saleem,Haneefa;Sakyi,Kwame;Ford,JeanG
背景临床试验对于推进癌症治疗至关重要。少数群体在试验参与者中代表性不足，而且对其决策过程和参与试验决策结果的关键决定因素了解有限。方法为了了解约翰·霍普金斯大学符合临床试验条件的非裔美国癌症患者的研究决策，我们对接受试验的 18 岁以上诊断患有肺癌、乳腺癌、前列腺癌或结直肠癌的患者进行了七个焦点小组 (n= 32) ≤5 年。进行了三个“接受者”和四个“拒绝者”焦点小组。解决的问题：对临床试验的态度、接受或拒绝参与的原因以及改善少数族裔招募和入组的建议。在 NVivo 9.0 中使用传统的内容和主题分析方法对数据进行转录和分析。数据编码产生了支持模型构建的主题。结果参与者的经验在描述决策过程时揭示了以下主题：信息收集、个人观点和人际影响。决策结果包括是否存在决策后悔和满意度。根据这些主题，我们生成了癌症临床试验决策模型。结论我们的模型应该在假设驱动的研究中进行测试，以阐明影响决策平衡和试验相关决策结果的因素和过程。该模型还应该在其他差异人群和癌症以外的诊断中进行测试。
BackgroundClinical trials are critical to advancing cancer treatment. Minority populations are underrepresented among trial participants, and there is limited understanding of their decision-making process and key determinants of decision outcomes regarding trial participation.MethodsTo understand research decision-making among clinical trial-eligible African-American cancer patients at Johns Hopkins, we conducted seven focus groups (n= 32) with trial-offered patients ≥18 years diagnosed with lung, breast, prostate, or colorectal cancer ≤5 years. Three “acceptor” and four “decliner” focus groups were conducted. Questions addressed: attitudes towards clinical trials, reasons for accepting or declining participation, and recommendations to improve minority recruitment and enrollment. Data were transcribed and analyzed using traditional approaches to content and thematic analysis in NVivo 9.0. Data coding resulted in themes that supported model construction.ResultsParticipant experiences revealed the following themes when describing the decision-making process:Information gathering,Intrapersonal perspectives, andInterpersonal influences. Decision outcomesincluded the presence or absence of decision regret and satisfaction. From these themes, we generated a Model of Cancer Clinical Trial Decision-making.ConclusionOur model should be tested in hypothesis-driven research to elucidate factors and processes influencing decision balance and outcomes of trial-related decision-making. The model should also be tested in other disparities populations and for diagnoses other than cancer.