Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: enhancing minority participation in clinical trials (EMPaCT)

Abstract

Background: The study of disparities in minority recruitment to cancer clinical trials has focused primarily on inquiries among minority populations. Yet very little is known about the perceptions of individuals actively involved in minority recruitment to clinical trials within cancer centers. Therefore, the authors assessed the perspectives of cancer center clinical and research personnel on barriers and facilitators to minority recruitment.

Methods: In total, 91 qualitative interviews were conducted at 5 US cancer centers among 4 stakeholder groups: cancer center leaders, principal investigators, research staff, and referring clinicians. All interviews were recorded and transcribed. Qualitative analyses of response data was focused on identifying prominent themes related to barriers and facilitators to minority recruitment.

Results: The perspectives of the 4 stakeholder groups were largely overlapping with some variations based on their unique roles in minority recruitment. Four prominent themes were identified: 1) racial and ethnic minorities are influenced by varying degrees of skepticism related to trial participation, 2) potential minority participants often face multilevel barriers that preclude them from being offered an opportunity to participate in a clinical trial, 3) facilitators at both the institutional and participant level potentially encourage minority recruitment, and 4) variation between internal and external trial referral procedures may limit clinical trial opportunities for racial and ethnic minorities.

Conclusions: Multilevel approaches are needed to address barriers and optimize facilitators within cancer centers to enhance minority recruitment for cancer clinical trials.

Keywords: cancer; clinical trials; minority; recruitment.

Figure 1

A. High-frequency codes for barriers among 4 stakeholder groups* *Missing bars for some codes indicate instances when that code was not among the high-frequency codes (mentioned by ≥ 50%) for that stakeholder group. B. High frequency codes for facilitators among 4 stakeholder groups *Missing bars for some codes indicate instances when that code was not among high-frequency codes (mentioned by ≥ 50%) for that stakeholder group.

Figure 1

A. High-frequency codes for barriers among 4 stakeholder groups* *Missing bars for some codes indicate instances when that code was not among the high-frequency codes (mentioned by ≥ 50%) for that stakeholder group. B. High frequency codes for facilitators among 4 stakeholder groups *Missing bars for some codes indicate instances when that code was not among high-frequency codes (mentioned by ≥ 50%) for that stakeholder group.