title: Adolescent knowledge and attitudes related to clinical trials.
abstract: OBJECTIVE
  Poor enrollment plagues most clinical trials. Furthermore, despite mandates to improve minority representation in clinical trial participation, little progress has been made. We investigated the knowledge and attitudes of adolescents related to clinical trials and made race/ethnicity comparisons in an attempt to identify a possible educational intervention target.
  
  
  METHODS
  Students aged 13-18 years in southeast Michigan were offered participation through a class at one high school or two academic summer enrichment programs that drew from multiple high schools (73% response). Questionnaires previously validated in adults were administered. Non-Hispanic whites were compared with minorities using Wilcoxon rank-sum tests.
  
  
  RESULTS
  Of the 82 respondents, the median age was 16 years (interquartile range: 15-17 years); 22 (28%) were white, 41 (51%) were African American, 11 (14%) were multiracial, 2 (2%) were American Indian or Alaska Native, 1 (1%) was Asian, 3 (4%) were Native Hawaiian or other Pacific Islander, and 2 respondents did not report a race (but did report Hispanic ethnicity). Nine (12%) were Hispanic. Only 27 (33%) had ever heard of a clinical trial. On a scale from 1 (most receptive) to 5 (least receptive) for learning more about a clinical trial for a relevant medical condition, the median score was 2 (interquartile range: 1-3) and for participating in a clinical trial for a relevant medical condition was 2 (interquartile range: 2-3). Overall knowledge was poor, with a median of 46% (interquartile range: 23%-62%) of knowledge answers correct. Knowledge was reduced (p = 0.0006) and attitudes were more negative (p = 0.05) in minorities than non-Hispanic whites, while minorities also endorsed more substantial barriers to trial participation (p = 0.0002). Distrust was similar between minority students and non-Hispanic whites (p = 0.15), and self-efficacy was greater in non-Hispanic whites (p = 0.05).
  
  
  CONCLUSIONS
  Educational interventions directed toward adolescents that address knowledge, attitudes, and distrust in order to improve clinical trial awareness and receptivity overall are needed and may represent a tool to address disparities in minority enrollment in clinical trials.
authors: Stroke Program, The Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA devinb@umich.edu.
authors: Devin L
authors: DL
authors: Brown
authors: School of Health Promotion & Human Performance, Eastern Michigan University, Ypsilanti, MI, USA.
authors: Joan E
authors: JE
authors: Cowdery
authors: Department of Teacher Education, Eastern Michigan University, Ypsilanti, MI, USA.
authors: Toni Stokes
authors: TS
authors: Jones
authors: Center for Clinical Management Research, U.S. Department of Veterans Affairs, Washington, DC, USA Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA.
authors: Aisha
authors: A
authors: Langford
authors: Science Department, Melvindale High School, Melvindale, MI, USA.
authors: Catherine
authors: C
authors: Gammage
authors: Stroke Program, The Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
authors: Teresa L
authors: TL
authors: Jacobs
mesh_terms: D000293:Adolescent; D002986:Clinical Trials as Topic / Q000523:psychology*; D005006:Ethnicity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D044469:Racial Groups; D035842:Research Subjects / Q000523:psychology*; D012959:Socioeconomic Factors
keywords: Adolescent; attitude; biomedical research; clinical trials; knowledge