Increasing Recruitment of underrepresented cancer survivors with awareness enhancing interventions (RUN AWEI)

消除癌症健康差异的关键是让少数种族和族裔参与研究的能力。

Critical to eliminating cancer health disparities is the ability to engage racial and ethnic minorities in research. Inadequate representation of African Americans (AAs) in research severely limits the opportunity to understand underlying causes of disparate health outcomes between AAs and other race groups and the opportunity to advance knowledge on how to reduce the cancer burden in this vulnerable population. Finding ways to increase recruitment of AA cancer survivors in research is urgent. The question is how. We propose that one mechanism is to increase awareness about research in AA potential participants, a solution supported both by our previous observational study (IMPaCT) in AA cancer survivors, and research by others, in which survivors indicated that having information about clinical trials was important in their decision-making regarding trial participation. However, evidence-based methods to increase awareness in AAs remain largely absent. Unknown is what type of strategy, information, and perspective, is needed. We will test awareness- enhancing interventions (AWEI) that vary in these dimensions among AA cancer survivors for whom disparities in cancer incidence and mortality are widely documented and concerning. We propose a highly innovative and efficient factorial trial design embedded into the recruitment effort for AMPLIFI (P01 CA22997). AMPLIFI will recruit 652 cancer survivors to be randomized to lifestyle interventions. Participants will be from four southeastern states with a high burden of cancer in AAs. During the AMPLIFI recruitment process, 2,000 AA cancer survivors will be randomized to one of 8 AWEI conditions that vary by type of strategy, type of information, and perspective, or to the AMPLIFI basic recruitment strategy (No AWEI). Aims are: 1: Determine the impact of AWEIs on recruitment of AA cancer survivors. We hypothesize that AWEIs will have a significantly higher recruitment yield than the basic AMPLIFI recruitment strategy (H1). In line with IMPaCT, we expect AWEI to have a significant impact doubling the recruitment yield; 2: Identify the AWEI key features that increase recruitment of AA cancer survivors. We will test whether AWEI-navigation vs. AWEI- brochure (type of strategy, H2), study-specific vs general research messages (type of information, H3), and, survivor “voice” vs. not (type of perspective, H4) will result in higher recruitment yield; and 3: Determine the optimal AWEI combination in terms of recruitment yield and cost. We hypothesize that AWEI combination of navigation with study-specific messages and the survivor “voice” will be the most efficacious and may be most cost-effective compared to the other combinations. In summary, building on an important trial that will oversample minorities in underserved US states, our expert team will adopt this innovative and rigorous study design to advance the science of recruitment and have a high impact on representation of AAs in research.