OBJECTIVE:Minority and low-income cancer patients are underrepresented in clinical trials, contributing to diminished access to state-of-the-art care and disparities in cancer outcomes including survivorship issues. In cervical cancer, there is a disproportionate disease burden among minority and underserved women and persistent quality of life disruption. We encountered significant challenges in both recruitment and retention in a randomized biobehavioral clinical trial for cervical cancer survivors, identified through California Cancer Registries, leading to this investigation. METHODS: To determine differential rates of accrual and retention, data from our trial are analyzed using descriptive statistics, logistic regression and multivariate analysis of variance. Ethnic differences in associations between covariables and attrition rates were tested by interaction factors. Process evaluation and focus group data were obtained to inform improvement strategies. RESULTS: Of eligible subjects with viable phone numbers, 29% enrolled and 71% actively or passively refused. Enrolled Hispanic women were more likely to have less education (p<0.001), lower income (p=0.003), and more children (p=0.028). The dropout rate was associated with less education (p=0.012), foreign-birth (p=0.061), speaking Spanish in the home (p=0.012). Reported reasons for active refusal were 'too busy' for all women, 'too emotional' for non-Hispanic women, 'too ill' and phlebotomy for Hispanic women. Subsequent focus groups identified specific strategies to improve study materials. CONCLUSION: Although population-based recruitment of minority and underserved cancer patients continues to be a challenge, specific sociodemographic and disease variables can predict accrual difficulties. The information herein, taken together with disease and culturally relevant strategies, can be useful when recruiting underserved cancer survivors.
RCT Entities:
OBJECTIVE: Minority and low-income cancerpatients are underrepresented in clinical trials, contributing to diminished access to state-of-the-art care and disparities in cancer outcomes including survivorship issues. In cervical cancer, there is a disproportionate disease burden among minority and underserved women and persistent quality of life disruption. We encountered significant challenges in both recruitment and retention in a randomized biobehavioral clinical trial for cervical cancer survivors, identified through California Cancer Registries, leading to this investigation. METHODS: To determine differential rates of accrual and retention, data from our trial are analyzed using descriptive statistics, logistic regression and multivariate analysis of variance. Ethnic differences in associations between covariables and attrition rates were tested by interaction factors. Process evaluation and focus group data were obtained to inform improvement strategies. RESULTS: Of eligible subjects with viable phone numbers, 29% enrolled and 71% actively or passively refused. Enrolled Hispanic women were more likely to have less education (p<0.001), lower income (p=0.003), and more children (p=0.028). The dropout rate was associated with less education (p=0.012), foreign-birth (p=0.061), speaking Spanish in the home (p=0.012). Reported reasons for active refusal were 'too busy' for all women, 'too emotional' for non-Hispanic women, 'too ill' and phlebotomy for Hispanic women. Subsequent focus groups identified specific strategies to improve study materials. CONCLUSION: Although population-based recruitment of minority and underserved cancerpatients continues to be a challenge, specific sociodemographic and disease variables can predict accrual difficulties. The information herein, taken together with disease and culturally relevant strategies, can be useful when recruiting underserved cancer survivors.
Authors: Lari Wenzel; Israel DeAlba; Rana Habbal; Brenda Coffey Kluhsman; Diane Fairclough; Linda U Krebs; Hoda Anton-Culver; Ross Berkowitz; Noreen Aziz Journal: Gynecol Oncol Date: 2005-05 Impact factor: 5.482
Authors: Warren B Sateren; Edward L Trimble; Jeffrey Abrams; Otis Brawley; Nancy Breen; Leslie Ford; Mary McCabe; Richard Kaplan; Malcolm Smith; Richard Ungerleider; Michaele C Christian Journal: J Clin Oncol Date: 2002-04-15 Impact factor: 44.544
Authors: Edward L Nelson; Lari B Wenzel; Kathryn Osann; Aysun Dogan-Ates; Nissa Chantana; Astrid Reina-Patton; Amanda K Laust; Kevin P Nishimoto; Alexandra Chicz-DeMet; Nefertiti du Pont; Bradley J Monk Journal: Clin Cancer Res Date: 2008-04-01 Impact factor: 12.531
Authors: Electra D Paskett; Katherine W Reeves; John M McLaughlin; Mira L Katz; Ann Scheck McAlearney; Mack T Ruffin; Chanita Hughes Halbert; Cristina Merete; Faith Davis; Sarah Gehlert Journal: Contemp Clin Trials Date: 2008-07-31 Impact factor: 2.226
Authors: Paul F Pinsky; Marvella Ford; Eduard Gamito; Darlene Higgins; Victoria Jenkins; Lois Lamerato; Sally Tenorio; Pamela M Marcus; John K Gohagan Journal: J Natl Med Assoc Date: 2008-03 Impact factor: 1.798
Authors: Lari Wenzel; Kathryn Osann; Susie Hsieh; Jo A Tucker; Bradley J Monk; Edward L Nelson Journal: J Clin Oncol Date: 2015-02-23 Impact factor: 44.544
Authors: Marilyn M Schapira; Elizabeth R Mackenzie; Regina Lam; David Casarett; Christina M Seluzicki; Frances K Barg; Jun J Mao Journal: Support Care Cancer Date: 2013-12-21 Impact factor: 3.603
Authors: Cheryl L Albright; Alana D Steffen; Lynne R Wilkens; Kami K White; Rachel Novotny; Claudio R Nigg; Kara Saiki; Wendy J Brown Journal: Prev Med Date: 2014-10-05 Impact factor: 4.018
Authors: Yizhao Ni; Andrew F Beck; Regina Taylor; Jenna Dyas; Imre Solti; Jacqueline Grupp-Phelan; Judith W Dexheimer Journal: J Am Med Inform Assoc Date: 2016-04-27 Impact factor: 4.497