Abstract A16: Asian immigrants' perception of clinical trials
Authors: Lam Helen , Quinn Michael , Chandrasekar Edwin , Patel Reena , Kim Karen 
Published: March 2017

Background Racial/ethnic minorities constitute more than 30% of the U.S. population, and yet represent less than 18% of clinical trial (CT) participation. The participation of minorities in CTs is a critical link between scientific innovation and improvement in health care delivery, as well as the provision of evidence-based medicine. Although Asian Americans (AAs) are the fastest growing minority group in the U.S., they are the least represented in CTs. Specifically, more than 65% of AAs are foreign-born, and greater than 30% have limited English proficiency. Little is known about AA immigrants' willingness to participate in CTs. The purpose of this study was to examine (1) AA immigrants' perception of CTs and (2) how sociodemographic factors might influence their perception.

Methods This study used a cross-sectional design and quota sampling. Participants were recruited through seven AA community-based organizations and from six AA subgroups (Cambodian, Chinese, Filipino, Korean, Laotian, South Asians, and Vietnamese). An eight-item survey tool was developed to measure perceived benefits and cost of participating in CTs. The survey tool consisted of four positive statements and four negative statements. Participants were asked to rate each statement on a 5-likert scale. A total perception score was calculated by adding all eight items. A higher score indicates a more positive perception. The score can range from 0 to 40. The survey tool was translated, back translated in participants' native language.

Results 470 participants completed the survey and 459 (98%) were immigrants. 48% of the participants had family income less than $20,000/year, 32% had less than 9 years of education, 39% reported less than average English proficiency. 26% of the participants were less than 50 years old (mean age = 56) and 27% were in the U.S. less than 10 years (mean years = 20). The Cronbach's Alpha for the perception scale was 0.64. The average perception score was 28.5 (SD = 4.03) and ranged from 18 to 40. There was a significant differences in the perception score across the seven subgroups. Both Vietnamese and Cambodian communities had the lowest perception scores (mean = 26.58 and 26.83, respectively); while Filipinos community had the highest perception score (mean = 30.20). The majority believed CTs could be beneficial to their community (83%) and helpful to advance medical knowledge and improve treatment (87%), as well as provide patients with an opportunity to try new treatment (86%). 70% of participants indicated that they would consider participation in clinical trials if they knew more about it. Participants who had less than 9 years education had significantly lower perception score than participants who had more than 9 years education (p &lt;.0005). Participants whose family income &lt; $20,000/years had significantly lower perception score, compared to participants with family income &gt;$20,000/year (p = .003). Participants whose English proficiency less than average also had significantly lower perception score (p &lt; .0005). While age did not have significant effect on CT perception, participants who lived in the U.S. less than 10 years had a significant lower score than participant who lived in the U.S. longer (p =.017).

Conclusion The inclusion of AAs in clinical trials is critical for the mitigation of disparities and for realizing the true promise of precision medicine in cancer prevention and treatment. It is often argued that racial/ethnic minorities do not participate in CTs because they don't understand the importance of CTs or distrust the system. However, our findings challenge these assumptions. It will require greater effort and commitment on the part of institutions and researchers to recruit and enroll hard-to-reach populations in CTs. Steps must be taken to assure the inclusion and representation of racial/ethnic minorities.

Citation Format: Helen Lam, Michael Quinn, Edwin Chandrasekar, Reena Patel, Karen Kim. Asian immigrants' perception of clinical trials. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A16.