title: Psychosocial barriers and facilitators to clinical trial enrollment and adherence for adolescents with cancer.
abstract: Adolescents (aged 15-19 years) have not experienced the same survival gains as children and older adults diagnosed with cancer. Poor clinical trial enrollment and adherence rates among adolescents may account for some of this disparity. Although biological, regulatory, systemic, and practice-related challenges to clinical trial enrollment and adherence have been examined, studies of psychosocial factors, which can serve as barriers or facilitators to enrollment and adherence, are limited. To bring attention to these psychological factors, we reviewed existing literature on psychosocial barriers and facilitators that can affect an adolescent's decision to enroll and adhere to a clinical trial. We also provide potential strategies to address psychosocial factors affecting clinical trial accrual and adherence.
authors.affiliation: Epidemiology and Applied Research Branch, and nbuchanan@cdc.gov.
authors.forename: Natasha D
authors.initials: ND
authors.lastname: Buchanan
authors.affiliation: Oregon Health & Science University, Portland, Oregon; and.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Block
authors.affiliation: National Cancer Institute, Outcomes Research Branch, Bethesda, Maryland.
authors.forename: Ashley Wilder
authors.initials: AW
authors.lastname: Smith
authors.affiliation: Comprehensive Cancer Control Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia;
authors.forename: Eric
authors.initials: E
authors.lastname: Tai
mesh_terms: D000293:Adolescent; D002986:Clinical Trials as Topic / Q000379:methods / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology*; D018579:Patient Selection; D011584:Psychology
keywords: adherence; adolescent; cancer survivors; clinical trial; enrollment; psychosocial