Abstract A077: The role of social determinants of health on beliefs around the benefits of clinical trials
Authors: Austin Jessica D. , Huschka Todd , Barwise Amelia , Allyse Megan , Phelan Sean 
Published: December 2023

Background: Individuals from diverse racial/ethnic and disadvantaged backgrounds are underrepresented in cancer clinical trials, compounding the difficulty of adequately understanding, addressing, and reversing health inequities. Social determinants of health (SDOH) factors likely contribute to disparities in cancer trial enrollment. While the presence of SDOH has shown to be associated with clinical trial participation, few studies have explored the role of SDOH in shaping beliefs around the benefits of clinical trials. Thus, this study aims to identify SDOH factors associated with beliefs around the benefits of clinical trial participation. Methods: This is a cross-sectional study of data from the Community Health Assets and Resilience Measures survey. The survey was administered in Fall 2021 to community members (N=3593; 98% &gt; 50 years of age, 68% male, 52% racial/ethnic minority) residing in three states within the Mayo Clinic catchment area. Survey items assessed SDOH factors including financial instability, childcare, transportation, food insecurity, safety, literacy, social isolation, and perceived discrimination. Participant beliefs around the benefits of clinical trial participation was measured by rating level of agreement to 4 statements: ‘People in my community can benefit from participating in clinical trials’, ‘Participation in clinical trials benefits society’, ‘Participation in clinical trials is risky’, ‘I would personally benefit’, and ‘People in my community would benefit’. Response options were dichotomized as ‘agree’ and ‘disagree’ and adjusted stepwise logistic regression analyses were performed to assess factors associated with beliefs about clinical trials. Results:  Race/ethnicity was significantly associated with all beliefs with Indigenous populations being significantly more likely to agree that people in their community could benefit from clinical trials, clinical trials benefit society, participation in clinical trials is risky, and that they would personally benefit.  In adjusted analyses, financial instability, food insecurity, transportation, childcare, safety, social isolation, literacy, and discrimination were significantly associated with beliefs about the benefits of clinical trial participation. Neighborhood safety was most strongly associated with the belief that ‘People in my community can benefit from participating in clinical trials’ and ‘I would personally benefit from clinical trials’. Health literacy was most strongly associated with the belief that clinical trials benefit society and the community.  Finally, the experience of 'people act as if they think you are not smart' (discrimination) was most strongly associated with the belief that clinical trials are risky. Conclusion: Clinical trials are the cornerstone to advancing equitable cancer care. Innovative, multifaceted, community-driven strategies are needed that address negative beliefs around the benefits of clinical trial participation to address existing recruitment and retention shortcomings.

Citation Format: Jessica D. Austin, Todd Huschka, Amelia Barwise, Megan Allyse, Sean Phelan. The role of social determinants of health on beliefs around the benefits of clinical trials [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A077.