Testing Effective Methods to Recruit Sexual and Gender Minority Cancer Patients for Cancer Studies

摘要 最近，NCI呼吁研究有效地研究与癌症研究相关的小或罕见人群。 性和性别少数群体（SGM）是癌症风险不成比例的小群体，但他们 在癌症研究中研究不足。女同性恋、男同性恋、双性恋和 跨性别人群是制定有效的方法来识别和招募患者和幸存者谁是 SGM进入NCI癌症研究。两项技术进步具有推动研究的变革潜力， SGM癌症患者的健康差异。首先，在线招聘在其他国家产生了大量的SGM样本， 研究领域（例如，艾滋病毒初级预防），但使用在线方法招募SGM癌症患者， 没有被严格研究过。其次，癌症诊所已经开始将性取向和性别纳入其中 身份（SOGI）数据在电子病历，但我们需要测试协议，如何招募SGM 癌症患者使用此数据源。这项申请是基于我们最近成功地克服了 招募400多名同性恋和双性恋前列腺癌患者参加R 01干预试验的挑战 为这一人群量身定制的康复方案。我们将复制和扩展这些基于诊所和在线的 研究如何招募三个小SGM人群的方法-（1）性少数顺性别男性，（2）性 少数cisgender妇女，和（3）跨性别和性别非二元癌症患者-进入癌症研究 问题研究我们有三个具体目标。在目标1中，我们将深入记录SGM对 参与NIH癌症研究，确定每个小组报告影响的促进因素和障碍 他们的参与意愿。我们还将调查贫困的癌症护理和歧视对 研究参与。我们将调查这些在顺性SM男性，顺性SM女性和性别 少数癌症患者（每组n=15），并比较这些小人群的经验， SGM和一个顺性别、异性恋患者对照组之间的差异。在目标2中，我们将测试 使用两种基于诊所SOGI的策略和三种在线策略的有效性、效率、成本和工作量 与招募顺性别样本相比，招募SGM小群体（每个群体150人）的策略， 异性恋癌症患者我们预测小人口的规模将与工作，成本， 与产量呈正相关。在目标3中，我们将进行一项网上定量调查， 450例SGM癌症患者（每组150例）与顺性别患者相比， 异性恋组（150名男性和150名女性）。关键措施评估促进者和参与障碍 在NIH癌症研究中。为了推进措施，我们将评估每个小组在五个有效的 癌症量表，比较癌症护理经验，治疗歧视和结果。最后我们将 综合和三角调查结果，并评估与种族/族裔的交叉性。这项研究将确定什么 招募策略在SGM人群中有效，并且可能对每个亚组具有特异性。

Abstract Recently, NCI called for research to effectively study small or rare populations relevant to cancer research. Sexual and gender minorities (SGM) are small populations at disproportionate risk for cancer but who have been under-researched in cancer studies. The principal challenge common across lesbian, gay, bisexual, and transgender populations is to develop effective methods to identify and recruit patients and survivors who are SGM into NCI cancer studies. Two technical advances have transformative potential to advance research on health disparities in SGM cancer patients. First, online recruitment has yielded large SGM samples in other areas of research (e.g., HIV primary prevention), but using online methods to recruit SGM cancer patients has not been rigorously studied. Second, cancer clinics have begun to include sexual orientation and gender identity (SOGI) data in the electronic medical record, but we need to test protocols on how to recruit SGM cancer patients using this data source. This application is based upon our recent success in overcoming challenges to recruit over 400 gay and bisexual prostate cancer patients into an R01 intervention trial of tailored rehabilitation for this population. We will replicate and expand upon these clinic-based and online methods to study how to recruit three small SGM populations – (1) sexual minority cisgender men, (2) sexual minority cisgender women, and (3) transgender and gender non-binary cancer patients - into cancer research studies. We have three specific aims. In Aim 1, we will document, in depth, SGM’s attitudes towards participating in NIH cancer research, identifying the facilitators and barriers that each group reports influences their willingness to participate. We will also investigate any impact poor cancer care and discrimination has on research participation. We will investigate these in cisgender SM men, cisgender SM women and gender minority cancer patients (n=15 per group) and compare experiences within these small populations and between SGM and a cisgender, heterosexual patient comparison group. In Aim 2, we will test the effectiveness, efficiency, cost, and workload in using two clinic SOGI-based strategies and three online strategies to recruit SGM small populations (150 each) compared to recruiting a sample of cisgender, heterosexual cancer patients. We predict size of the small population will negatively correlate with work, cost, and time involved, but positively correlate with yield. In Aim 3, we will conduct an online quantitative survey of willingness to participate in cancer research with 450 SGM cancer patients (150 per group) versus a cisgender heterosexual group (150 men and 150 women). Key measures assess facilitators and barriers to participation in NIH cancer research. To advance measures, we will assess performance of each group on five validated cancer scales to compare cancer care experience, discrimination in treatment, and outcomes. Finally, we will integrate and triangulate findings and assess intersectionality with race/ethnicity. This study will establish what recruitment strategies are effective across SGM populations, and which may be specific to each subgroup.