title: Breast cancer survivors willingness to participate in an acupuncture clinical trial: a qualitative study.
abstract: OBJECTIVE
  Acupuncture is a complementary and alternative medicine (CAM) modality that shows promise as a component of supportive breast cancer care. Lack of robust recruitment for clinical trial entry has limited the evidence base for acupuncture as a treatment modality among breast cancer survivors. The objective of this study is to identify key decision-making factors among breast cancer survivors considering entry into an acupuncture clinical trial for treatment of symptoms.
  
  
  METHODS
  Semistructured interviews were conducted among African-American (n=12) and Caucasian (n=13) breast cancer survivors. Verbatim transcripts were made and analyzed by two or more independent coders using NVivo software. Major recurring themes were identified and a theoretical framework developed.
  
  
  RESULTS
  Six themes emerged reflecting key attributes of the decision to enter a clinical trial: (1) symptom appraisal, (2) practical barriers (e.g., distance and travel), (3) beliefs about the interventions (e.g., fear of needles and dislike of medications), (4) comfort with elements of clinical trial design (e.g., randomization, the nature of the control intervention, and blinding), (5) trust, and (6) altruism. African-American and Caucasian women weighed similar attributes but differed in the information sources sought regarding clinical trial entry and in concerns regarding the use of a placebo in a clinical trial.
  
  
  CONCLUSIONS
  Our findings contribute to the development of a theoretical model of decision making for breast cancer survivors considering participation in a CAM clinical trial. Insights regarding the decision making process can inform interventions to support informed decision making and robust recruitment to CAM trials among cancer survivors.
authors.affiliation: The Philadelphia VA Center for Health Equity Research and Promotion, University of Pennsylvania, Philadelphia, PA, USA, mschap@upenn.edu.
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Schapira
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Mackenzie
authors.forename: Regina
authors.initials: R
authors.lastname: Lam
authors.forename: David
authors.initials: D
authors.lastname: Casarett
authors.forename: Christina M
authors.initials: CM
authors.lastname: Seluzicki
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
authors.forename: Jun J
authors.initials: JJ
authors.lastname: Mao
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods / Q000523:psychology*; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D017741:Survivors / Q000523:psychology; D044465:White People / Q000523:psychology