Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial
ABSTRACT Background Although breast cancer (BC) clinical trials offer novel treatments, participating patients often do not represent populations seen in clinics. This study assessed how patient sociodemographics, attitudes, and knowledge about clinical trials may be associated with participation. M...
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| Format: | Article |
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Wiley
2025-08-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.71010 |
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| author | Nicole E. Caston Luqin Deng Courtney P. Williams Emily B. Levitan Andres Azuero Russell Griffin Karen L. Smith Antonio C. Wolff Michelle E. Melisko Eileen H. Shinn Kathleen Gallagher Rebekah Angove Stephanie B. Wheeler Gabrielle B. Rocque |
| author_facet | Nicole E. Caston Luqin Deng Courtney P. Williams Emily B. Levitan Andres Azuero Russell Griffin Karen L. Smith Antonio C. Wolff Michelle E. Melisko Eileen H. Shinn Kathleen Gallagher Rebekah Angove Stephanie B. Wheeler Gabrielle B. Rocque |
| author_sort | Nicole E. Caston |
| collection | DOAJ |
| description | ABSTRACT Background Although breast cancer (BC) clinical trials offer novel treatments, participating patients often do not represent populations seen in clinics. This study assessed how patient sociodemographics, attitudes, and knowledge about clinical trials may be associated with participation. Methods This cross sectional analysis used survey data collected August–September 2021 by Translational Breast Cancer Research Consortium (TBCRC) and December 2022 by Patient Advocate Foundation (PAF) among women with a BC diagnosis. Respondents reported BC clinical trial participation, Attitudes Toward Cancer Trials Scale, clinical trial knowledge, diagnosis age, race, education level, household income, employment status, and BC stage. Descriptive and bivariate analyses were conducted using Cramer's V or Cohen's d as effect sizes. Standardized total effects (bTot) were estimated using a prespecified Structural Equation Model with 0.1, 0.3, and 0.5 indicating weak, medium, and large magnitude, respectively. Results Of 612 respondents, 26% were Black, Indigenous, or a Person of Color, 44% < Bachelor's degree, and 48% had incomes < $50,000. Respondents who reported trial participation (18%) more often had positive attitudes toward trials (mean 94 of 126, SD 19.3 vs. 86, SD 15.5; d = 0.48) compared to those not reporting participation. Positive attitude was associated with trial participation for both survey cohorts (TBCRC: bTot = 0.22, p = 0.0002; PAF: bTot = 0.13, p = 0.01). Furthermore, clinical trial knowledge was associated with attitudes (TBCRC: bTot = 0.27, p = < 0.0001; PAF: bTot = 0.15, p = 0.003). Discussion Although we found that positive attitudes and high knowledge were associated with clinical trial participation, it is unknown if the trial itself directly affected this. However, trial enrollment may be increased and diversified via future interventions focused on promotion of positive attitudes toward clinical trials, potentially through increased trial education and knowledge. |
| format | Article |
| id | doaj-art-e90a150114364e0691950455fb91390d |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-e90a150114364e0691950455fb91390d2025-08-26T10:58:44ZengWileyCancer Medicine2045-76342025-08-011416n/an/a10.1002/cam4.71010Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical TrialNicole E. Caston0Luqin Deng1Courtney P. Williams2Emily B. Levitan3Andres Azuero4Russell Griffin5Karen L. Smith6Antonio C. Wolff7Michelle E. Melisko8Eileen H. Shinn9Kathleen Gallagher10Rebekah Angove11Stephanie B. Wheeler12Gabrielle B. Rocque13Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham (UAB) Birmingham Alabama USADivision of Preventive Medicine UAB Birmingham Alabama USADivision of Preventive Medicine UAB Birmingham Alabama USADepartment of Epidemiology UAB Birmingham Alabama USASchool of Nursing UAB Birmingham Alabama USADepartment of Epidemiology UAB Birmingham Alabama USAMerck Rahway New Jersey USAJohns Hopkins University Sidney Kimmel Cancer Center Baltimore Maryland USADivision of Hematology and Oncology, Department of Medicine University of California San Francisco San Francisco California USADepartment of Behavioral Science University of Texas MD Anderson Cancer Center Houston Texas USAPatient Advocate Foundation Hampton Virginia USAPatient Advocate Foundation Hampton Virginia USADepartment of Health Policy and Management, Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill North Carolina USADivision of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham (UAB) Birmingham Alabama USAABSTRACT Background Although breast cancer (BC) clinical trials offer novel treatments, participating patients often do not represent populations seen in clinics. This study assessed how patient sociodemographics, attitudes, and knowledge about clinical trials may be associated with participation. Methods This cross sectional analysis used survey data collected August–September 2021 by Translational Breast Cancer Research Consortium (TBCRC) and December 2022 by Patient Advocate Foundation (PAF) among women with a BC diagnosis. Respondents reported BC clinical trial participation, Attitudes Toward Cancer Trials Scale, clinical trial knowledge, diagnosis age, race, education level, household income, employment status, and BC stage. Descriptive and bivariate analyses were conducted using Cramer's V or Cohen's d as effect sizes. Standardized total effects (bTot) were estimated using a prespecified Structural Equation Model with 0.1, 0.3, and 0.5 indicating weak, medium, and large magnitude, respectively. Results Of 612 respondents, 26% were Black, Indigenous, or a Person of Color, 44% < Bachelor's degree, and 48% had incomes < $50,000. Respondents who reported trial participation (18%) more often had positive attitudes toward trials (mean 94 of 126, SD 19.3 vs. 86, SD 15.5; d = 0.48) compared to those not reporting participation. Positive attitude was associated with trial participation for both survey cohorts (TBCRC: bTot = 0.22, p = 0.0002; PAF: bTot = 0.13, p = 0.01). Furthermore, clinical trial knowledge was associated with attitudes (TBCRC: bTot = 0.27, p = < 0.0001; PAF: bTot = 0.15, p = 0.003). Discussion Although we found that positive attitudes and high knowledge were associated with clinical trial participation, it is unknown if the trial itself directly affected this. However, trial enrollment may be increased and diversified via future interventions focused on promotion of positive attitudes toward clinical trials, potentially through increased trial education and knowledge.https://doi.org/10.1002/cam4.71010attitudes toward trialsbreast cancercancer clinical trialsclinical trial knowledgevulnerable populations |
| spellingShingle | Nicole E. Caston Luqin Deng Courtney P. Williams Emily B. Levitan Andres Azuero Russell Griffin Karen L. Smith Antonio C. Wolff Michelle E. Melisko Eileen H. Shinn Kathleen Gallagher Rebekah Angove Stephanie B. Wheeler Gabrielle B. Rocque Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial Cancer Medicine attitudes toward trials breast cancer cancer clinical trials clinical trial knowledge vulnerable populations |
| title | Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial |
| title_full | Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial |
| title_fullStr | Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial |
| title_full_unstemmed | Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial |
| title_short | Understanding Associations Between Patient‐Level Factors and Participation in a Breast Cancer Clinical Trial |
| title_sort | understanding associations between patient level factors and participation in a breast cancer clinical trial |
| topic | attitudes toward trials breast cancer cancer clinical trials clinical trial knowledge vulnerable populations |
| url | https://doi.org/10.1002/cam4.71010 |
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