Abstract B09: Partnering around cancer clinical trials: Preliminary report of an intervention to improve patient-physician communication and clinical trial enrollment of Black and White men with prostate cancer
Authors: Hamel Lauren M. , Penner Louis A. , Heath Elisabeth , Lansey Dina , Carducci Michael , Albrecht Terrance L. , Barton Ellen , Manning Mark , Foster Tanina , Wojda Mark , Eggly Susan 
Published: February 2019

Background: Few patients, especially racial/ethnic minorities, enroll in clinical trials (CTs) in the United States, in part due to factors related to patient-physician interactions. We describe a theory-based patient intervention to improve communication and enrollment of Black and White men in prostate cancer CTs. We also report on preliminary baseline data comparing Black and White participants' demographic and social characteristics and their willingness to discuss a CT with a physician.

Method: A team of communication scientists, psychologists, and clinicians collaborated to create a theory-based, patient-focused intervention. Theories included the common ingroup identity model, which suggests people from different social groups can better achieve goals when they see themselves as members of the same team, and patient-centered communication, which suggests that patient active participation improves clinical communication. The intervention is in the form of a booklet given to patients prior to meeting with their oncologist. The booklet includes a) encouragement to view the patient and physician as a team and participate actively in clinical interactions, and b) 33 questions about participating in a CT. Preliminary data from one data collection site (Detroit, Michigan) include 72 Black (n=40) and White (n=32) men with prostate cancer who completed baseline measures assessing age; education; income; breadwinner status; marital status; health literacy; perceived economic burden (e.g., how difficult is it for you to live on your total household income right now?); general trust in physicians; group-based medical mistrust (including three subscales--suspicion, perceived racial health care disparities, and perceived health care provider support); and willingness to discuss a CT with a physician. Chi-square and independent samples t-tests were conducted to determine racial differences.

Results: Black patients were younger (p=.04), had less education (p=.006) and lower annual incomes (p&lt;.001) than White patients, but were equally likely to be the breadwinner. Blacks were more likely to be single than Whites (p&lt;.001). Blacks reported significantly higher economic burden (p=.02), greater group-based medical mistrust (p=.001), greater suspicion of health care (p=.003), greater perceived racial disparities in health care (p=.001), and less perceived support from health care providers (p=.002). Blacks and Whites did not differ in health literacy or general trust in physicians. Regarding willingness to discuss CTs with their physician, high means for both Blacks and Whites (4.2 and 4.7, respectively, on a 5-point scale) indicated that both groups were very willing to discuss a CT with their physician, but Whites were significantly more willing (p=.03).

Discussion: Black and White patients differed in many demographic and social characteristics. Both groups indicated they were very willing to discuss a CT with their physician, although Whites were significantly more willing. This finding suggests the intervention may be especially beneficial for Black patients, who are disproportionately under-represented in CTs. Next steps involve analysis of the effect of the intervention and addition of a physician-focused intervention.

Citation Format: Lauren M. Hamel, Louis A. Penner, Elisabeth Heath, Dina Lansey, Michael Carducci, Terrance L. Albrecht, Ellen Barton, Mark Manning, Tanina Foster, Mark Wojda, Susan Eggly. Partnering around cancer clinical trials: Preliminary report of an intervention to improve patient-physician communication and clinical trial enrollment of Black and White men with prostate cancer [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B09.