Massey researcher awarded ACS grant to study communication barriers between African Americans and physicians about clinical trials
April 29, 2015
Virginia Commonwealth University Massey Cancer Center researcher Richard Brown, Ph.D., has been awarded a nearly $1 million Research Scholar Grant from the American Cancer Society to test tailored messaging that would aid African Americans in making decisions about enrolling in therapeutic cancer clinical trials.
“Cancer treatments progress through clinical trials. Currently, the percentage of people enrolling in clinical studies in general is low, with African-American participation rates being even lower,” said Brown, member of the Cancer Prevention and Control research program and chair of the Protocol Review and Monitoring Cancer Prevention and Control Subcommittee at Massey.
In a 2012 pilot program at VCU, Brown joined a team of researchers who sought to identify and understand why more African Americans do not enroll in clinical trials. That study ended with two significant findings. First, they found that African-American patients are less likely than Caucasians to be eligible for a trial. And second, they found that the African-American patients who are eligible are likely to refuse participation due to a variety of reasons, which included a general mistrust of the clinical trial system or family pressures. The results of that study were published in the journal Clinical Trials.
Brown, who is also an assistant professor in the Department of Social and Behavioral Health at the VCU School of Medicine, said it is important to recruit a diverse demographic group to cancer clinical trials in order to compile more comprehensive results of the treatments being tested so that the treatment results have wider applicability and medical advancements can help more people.
“Having African Americans enroll in clinical trials could potentially allow the medical community to overcome health disparities and could lead to new discoveries in cancer treatment,” he said.
For this new study, Brown’s team will build on the results of the 2012 study by using tailored, or personalized, messages to specifically address and overcome the concerns of African-American patients about enrolling in potentially life-changing clinical trials.
“Poor communication between a physician and patient could have a negative effect on patient outcomes,” said Brown. “If people hear messages directed toward them and their needs, then the message is going to have more impact.”
To create more active communication between African-American cancer patients and their physicians during the oncology consultation, Brown’s team will start by identifying the patient’s particular concerns through a survey. These results will be analyzed using the Michigan Tailoring System, a software package designed to help tailor content specifically for an individual, to determine what messages should be included in an informational brochure given to the patients. While all patients will receive a brochure before meeting with an oncologist, only half will receive ones with what Brown called “deep tailoring” messages that could help the patient more fully understand their specific areas of concern. Additionally, prior to the consultation, half of the physicians will be given their patient’s survey responses.
Audio of the consultations will be recorded and transcripts will be analyzed to determine if the patients who received personalized messages speak with their physician differently than those who received “shallow tailoring” brochures that only provided information about clinical trials based on their demographics.
“Our hypothesis is that the patients with the least amount of intervention will be the least engaged in the consultation, and those with the most intervention, we hope, will be the most involved and engaged in the discussion,” said Brown.
The researchers will also evaluate the degree to which physicians involve their patients in the decision-making process.
Massey is designated by the National Cancer Institute as a Minority/Underserved NCI Community Oncology Research Program (NCORP-MU) to lead a statewide clinical trial network that fosters access to cancer research for minority and medically underserved patients.
This study is supported by an American Cancer Society Research Scholar Grant No. 14–227–01-CPPB, and, in part, by VCU Massey Cancer Center’s NIH-NCI Cancer Center Support Grant P30 CA016059.
