title: A systematic review of the factors influencing African Americans' participation in cancer clinical trials.
abstract: OBJECTIVE
  This systematic review was conducted to synthesize the existing evidence regarding key considerations influencing African Americans' participation in cancer clinical trials (CCTs).
  
  
  METHODS
  The PubMed and PsycINFO databases were searched to identify peer-reviewed publications during the last decade (2002-2011) that met our inclusionary criteria. Our search utilized Boolean combinations of the following terms: "clinical trial"; "cancer"; "neoplasm"; "African American"; "Black"; "caregiver"; "decision making"; "recruitment"; "companion"; "family"; "significant other"; and "social support".
  
  
  RESULTS
  A total of 267 articles were identified in the database searches. Of these articles, a total of 31 were determined to meet the inclusion criteria and were retained for review. Key issues that emerged as impediments to a successful recruitment of African Americans to CCTs included negative attitudes towards clinical trials, low levels of knowledge and awareness regarding CCTs, religious beliefs, and structural barriers, such as transportation, childcare, and access to health care. Recommendations from physicians, family members, and friends may promote CCT participation. Multimedia, and culturally-appropriate recruitment approaches may also be effective in soliciting participation among African Americans.
  
  
  CONCLUSIONS
  Existing research underscores the importance of social support from family and friends, cultural appropriateness and sensitivity from physicians and in the design of the CCT, and enhanced education among African Americans in decision-making processes. As African Americans are underrepresented in CCTs, targeted strategies to enhance recruitment efforts and improve cancer treatment outcomes are essential.
authors.affiliation: Center for Equal Health, Tampa, FL 33612, USA. drivers@health.usf.edu
authors.forename: Desiree
authors.initials: D
authors.lastname: Rivers
authors.forename: Euna M
authors.initials: EM
authors.lastname: August
authors.forename: Ivana
authors.initials: I
authors.lastname: Sehovic
authors.forename: B
authors.initials: B
authors.lastname: Lee Green
authors.forename: Gwendolyn P
authors.initials: GP
authors.lastname: Quinn
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D001290:Attitude; D002986:Clinical Trials as Topic / Q000523:psychology* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D018579:Patient Selection; D012067:Religion
keywords: AA; African American; African Americans; Blacks; CCT; Cancer clinical trials; Education; Recruitment; Social support; cancer clinical trial