Patient-Related Issues

Guest Expert: Sandra Swain, M.D. - ASCO President Takes Aim at Minority Recruitment Barriers with Culturally-Targeted Video

Last Updated: Aug 30, 2012

Originally posted by: Ellen Richmond, AccrualNet Co-Moderator, on the former AccrualNet site on Jul 25, 2012.



We are fortunate to have Dr. Sandra Swain, current president of the American Society of Clinical Oncology (ASCO) and Medical Director of the Washington Cancer Institute (WCI) of the MedStar Washington Hospital Center in Washington, D.C. as the AccrualNet guest expert for July. Dr. Swain, an authority on breast cancer treatment, is internationally known for her cutting-edge clinical research and widely recognized for her significant focus on cancer care disparities. For the ASCO Annual Meeting this year she co-authored an educational manuscript reviewing the enrollment of African Americans in cancer clinical trials and chaired a session addressing this topic - which included the presentation of her study, "Use of Culturally-Targeted Video for Changing Attitudes Towards Clinical Trials." In describing the video study, Dr. Swain explained:

This research is a perfect example of health disparity research that could lead to better patient outcomes by providing access to newer, more promising treatments on clinical trials. The MedStar Washington Hospital Center team . . . developed a 15-minute video to address barriers to African American (AA) participation in cancer trials, and a 30-item questionnaire to measure patients’ attitudinal barriers to participation. Participants included 108 AA oncology patients in active treatment at WCI. The primary outcome of interest was their intention to enroll in a therapeutic clinical trial.

The study demonstrated the proportion of participants expressing intention to enroll in a trial significantly increased after viewing the video. Fifty-nine participants (54.6%) indicated initially they would decline enrollment in a trial prior to viewing the video; of these, 66% changed their mind after viewing the video. Thus, overall 36% of the original sample had a positive change in intention after the video intervention. Secondary outcomes measured the video’s impact on known attitudinal barriers to clinical trial participation among AA patients, including: 1) fear and distrust of the medical establishment, 2) concern about the ethical conduct of investigators, 3) fear of loss of rights, 4) worry about being treated poorly, 5) concern about privacy, and 6) lack of knowledge and awareness. In each of these areas, a shift from negative to positive attitudes toward clinical trial participation was noted.

Deliya Banda, PhD, who coordinated the study said,  “Our findings represent an important contribution to understanding the role of attitudinal barriers in the clinical trials decision-making process for AA patients   . . . This video is promising as a simple yet effective means to shift attitudes, dispel myths and improve the accrual of AAs to clinical trials. Building on these findings, we are pursuing further funding to replicate the pilot study in a multicenter randomized design, to demonstrate an actual increase in enrollment of AA to therapeutic trials nationally using this video in interventions within the cooperative group system.”

*Of note, perhaps in keeping with Dr. Swain's commitment to improving access to care, ASCO accepted almost a dozen accrual-related abstracts this year.  You can find these abstracts on AccrualNet on the VIEW ALL RESOURCES page.  As always, feel free to let us know what you think of the abstracts.

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