title: Asian Americans and cancer clinical trials: a mixed-methods approach to understanding awareness and experience.
abstract: Cancer clinical trials have been based on low accrual rates. Barriers to recruitment of minority populations affect the generalizability and impact of trial findings for those populations. The authors undertook a mixed-methods approach to understanding levels of awareness and experiences with cancer clinical trials. A survey was administered to new cancer patients and their caretakers (family, close friends, or other social support) at outpatient oncology clinics. Field observations of the trial accrual process also were conducted by employing the grounded theory approach in qualitative methods. Comparison of survey results for Asian-American respondents and non-Asian respondents indicated that Asians were less likely to have heard the term "clinical trial" and were more likely to define a clinical trial as "an experiment" or "a test procedure in a clinic" than non-Asians. Asians were more likely to have employer-based insurance and to report understanding issues related to cost reimbursement. Asians were less likely to have been involved in or to know someone in a trial and reported less willingness than white respondents to consider trial participation. Qualitative observations suggested that Asians who presented for a potential trial were interested in the availability of a novel cancer therapy but were not eligible for available trials. Multiple strategies will be necessary to enhance awareness of and experience with accrual to cancer clinical trials for Asians, including richer understanding and increased involvement of Asians in cancer clinical trials and greater attention to the location and diversity of the Asian population in structuring study centers and evaluating trial results.
authors.affiliation: Center for Health Services Research in Primary Care, University of California-Davis Cancer Center, Sacramento, CA 95817, USA. dspaterniti@ucdavis.edu
authors.forename: Debora A
authors.initials: DA
authors.lastname: Paterniti
authors.forename: Moon S
authors.initials: MS
authors.lastname: Chen
authors.forename: Christine
authors.initials: C
authors.lastname: Chiechi
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Beckett
authors.forename: Nora
authors.initials: N
authors.lastname: Horan
authors.forename: Corinne
authors.initials: C
authors.lastname: Turrell
authors.forename: Ligaya
authors.initials: L
authors.lastname: Smith
authors.forename: Claudia
authors.initials: C
authors.lastname: Morain
authors.forename: Lisa
authors.initials: L
authors.lastname: Montell
authors.forename: Jose
authors.initials: J
authors.lastname: Luis Gonzalez
authors.forename: Sharon
authors.initials: S
authors.lastname: Davis
authors.forename: Primo N
authors.initials: PN
authors.lastname: Lara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000208:ethnology*; D002986:Clinical Trials as Topic; D003710:Demography; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009027:Mortuary Practice; D009369:Neoplasms / Q000628:therapy*