Factors that influence Spanish-and English speaking participants’ decision to enroll in cancer randomized clinical trials.

Posted: Jan 17, 2013
Psychooncology. 15. 4. 273-84.
KEYWORDS: Knowledge/Attitudes/Beliefs, Language or Cultural Barriers, Non-English Speaking, Provider-Patient Relationship, Minority Groups, Hispanic or Latino, Cancer


Emotions and spirituality are more important to Spanish speakers than to English speakers in discussions of treatment options and trial participation.

Why this item may be useful

Most studies of minority trial participation have focused on financial and logistical barriers. This study used focus groups to elicit information from both Spanish-speaking and English-speaking individuals (some of whom were cancer patients) about what factors influence their decisions about trial participation. Spanish and English speakers were similarly concerned about the patient-physician relationship as a major factor in making decisions, but Spanish speakers were more likely to want their emotions and spirituality to be acknowledged as they told their stories. If providers learn how to communicate with patients of diverse cultures, positive decision-making experiences are likely to result.


  • Both groups identified mutual respect between patient and doctor as a key factor in decision making, but Spanish speakers emphasized decisions in the context of family and community, while English speakers stressed autonomous decisions.
  • Both groups perceived collecting information to be a key factor, but among Spanish speakers, the better educated placed a heavier stress on information.
  • Better-educated Spanish speakers were more likely than less-educated Spanish speakers to perceive cultural discrimination. Many English speakers perceived discrimination based on educational level and ability to pay for care.
  • Providers who learn how to communicate with patients from various cultures will be better able to help patients.
  • The English and Spanish focus group guides that were used are included in the article.