title: Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: enhancing minority participation in clinical trials (EMPaCT).
abstract: BACKGROUND
  The study of disparities in minority recruitment to cancer clinical trials has focused primarily on inquiries among minority populations. Yet very little is known about the perceptions of individuals actively involved in minority recruitment to clinical trials within cancer centers. Therefore, the authors assessed the perspectives of cancer center clinical and research personnel on barriers and facilitators to minority recruitment.
  
  
  METHODS
  In total, 91 qualitative interviews were conducted at 5 US cancer centers among 4 stakeholder groups: cancer center leaders, principal investigators, research staff, and referring clinicians. All interviews were recorded and transcribed. Qualitative analyses of response data was focused on identifying prominent themes related to barriers and facilitators to minority recruitment.
  
  
  RESULTS
  The perspectives of the 4 stakeholder groups were largely overlapping with some variations based on their unique roles in minority recruitment. Four prominent themes were identified: 1) racial and ethnic minorities are influenced by varying degrees of skepticism related to trial participation, 2) potential minority participants often face multilevel barriers that preclude them from being offered an opportunity to participate in a clinical trial, 3) facilitators at both the institutional and participant level potentially encourage minority recruitment, and 4) variation between internal and external trial referral procedures may limit clinical trial opportunities for racial and ethnic minorities.
  
  
  CONCLUSIONS
  Multilevel approaches are needed to address barriers and optimize facilitators within cancer centers to enhance minority recruitment for cancer clinical trials.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Raegan W
authors.initials: RW
authors.lastname: Durant
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Wenzel
authors.forename: Isabel C
authors.initials: IC
authors.lastname: Scarinci
authors.forename: Debora A
authors.initials: DA
authors.lastname: Paterniti
authors.forename: Mona N
authors.initials: MN
authors.lastname: Fouad
authors.forename: Thelma C
authors.initials: TC
authors.lastname: Hurd
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Martin
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods*; D003625:Data Collection; D005006:Ethnicity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008297:Male; D008913:Minority Groups; D009369:Neoplasms / Q000628:therapy*; D018579:Patient Selection; D010820:Physicians; D044469:Racial Groups; D012107:Research Design; D012108:Research Personnel; D011795:Surveys and Questionnaires
keywords: cancer; clinical trials; minority; recruitment