title: Motivators and barriers to Latinas' participation in clinical trials: the role of contextual factors.
abstract: OBJECTIVE
  Latinas are underrepresented in clinical trials despite the rise in Hispanic population. This study examines the factors associated with Latinas' willingness to participate in preventive breast cancer randomized clinical trials (RCTs).
  
  
  METHODS
  Women self-identifying as Latina, over age 40, with no prior history of breast cancer were eligible. Using the Behavior Model for Vulnerable Populations, we administered a survey (n=168) to assess predisposing (e.g., knowledge), enabling (e.g., trust) and need factors (e.g., risk perception). Intention to participate was defined using a lenient (maybe, probably or definitely) and a stringent criterion (probably and definitely). Chi-square tests and logistic regression models examined the associations of predisposing, enabling, and need factors with women's intentions to participate in RCTs.
  
  
  RESULTS
  Most participants (74.9%) were monolingual Spanish-speaking immigrants. Most (83.9%) reported willing to participate in clinical trials using the lenient definition (vs. 43.1% under the stringent definition). Using the lenient definition, the odds of willing to participate in RCTs were significantly lower for unmarried women (OR=.25, 95% CI=.08-.79) and those with lower cancer risk perceptions (OR=.20, 95% CI=.06-.63), while being significantly higher for women with lower language acculturation (OR=6.2, 95% CI=1.8-20.9). Using the stringent definition, women who did not endorse a motivation to enroll to help family members (if they had cancer) had significantly lower odds to report intent (OR=.33, 95% CI=.13-.86).
  
  
  CONCLUSIONS
  Many RCTs may have limited generalizability due to the low representation of minorities. Culturally targeted interventions that address the importance of family for Latinos may ultimately increase their participation in RCTs.
authors.affiliation: Department of Microbiology, Howard University College of Medicine, Washington, DC, USA.
authors.forename: Laricca
authors.initials: L
authors.lastname: London
authors.affiliation: Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Hurtado-de-Mendoza
authors.affiliation: Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA.
authors.forename: Minna
authors.initials: M
authors.lastname: Song
authors.affiliation: Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA.
authors.forename: Ankita
authors.initials: A
authors.lastname: Nagirimadugu
authors.affiliation: Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA.
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Luta
authors.affiliation: Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA. Electronic address: vls3@georgetown.edu.
authors.forename: Vanessa B
authors.initials: VB
authors.lastname: Sheppard
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D035842:Research Subjects / Q000523:psychology*; D018570:Risk Assessment; D012959:Socioeconomic Factors; D035502:Trust
keywords: Clinical trials participation; Health disparities; Latina; Psychosocial factors