TY - JOUR
T1 - Increasing Diversity of Patients in Radiation Oncology Clinical Trials
AU - Roy, Emily
AU - Chino, Fumiko
AU - King, Benjamin
AU - Madu, Chika
AU - Mattes, Malcolm
AU - Morrell, Rosalyn
AU - Pollard-Larkin, Julianne
AU - Siker, Malika
AU - Takita, Christiane
AU - Ludwig, Michelle
N1 - Funding Information:
Sources of support: This work had no specific funding. Disclosures: E.R.: none. F.C.: NIH/NCI support grant P30 CA008748, ASCO Quality Steering Committee, ASTRO: Counsel of Health Equity, Diversity, and Inclusion. B.K.: none. C.M.: vice chair, advocacy committee, HEDI, ASTRO. M.M.: Radiation Oncology Institute research funding, Bristol Myers Squibb Foundation Diversity in Clinical Trials Career Development Program, New Jersey Health Foundation Research funding. R.M.: none. J.P.-L.: board member of American Association of Physicists in Medicine (AAPM). M.S.: none. C.T.: none. M.L.: none.
Funding Information:
Disclosures: E.R.: none. F.C.: NIH/NCI support grant P30 CA008748, ASCO Quality Steering Committee, ASTRO: Counsel of Health Equity, Diversity, and Inclusion. B.K.: none. C.M.: vice chair, advocacy committee, HEDI, ASTRO. M.M.: Radiation Oncology Institute research funding, Bristol Myers Squibb Foundation Diversity in Clinical Trials Career Development Program, New Jersey Health Foundation Research funding. R.M.: none. J.P.-L.: board member of American Association of Physicists in Medicine (AAPM). M.S.: none. C.T.: none. M.L.: none.
Funding Information:
When providing translated material to non-English speaking patients, ensure the translations are culturally sensitive. 46 This includes avoiding direct translation of American colloquial terms; these issues can be managed by either hiring a patient navigator who can accurately and effectively translate the information from the physicians or by using the same software as Spanish ResearchMatch. 87 Patient navigators who are trained to support individuals from underrepresented groups can also serve as a liaison to provide more culturally competent care. 101 The recruitment and support of patient navigators trained in culturally responsive and affirming care should be prioritized and appropriately resourced, which may include funding from the Department of Health and Human Services through the Diversifying Investigations Via Equitable Research Studies for Everyone Trials Act. Cultural sensitivity can also improve with the recruitment of a more diverse staff of the research team. Culturally sensitive communication with patients from underrepresented sexual and gender groups can be assured with the use of proper pronouns and elimination of cis or hetero-normative language; this can be achieved by including gender identity, preferred pronouns, and sexual identity on intake forms. However, it is not enough to hire individuals from diverse backgrounds. These teams need the requisite resources and training to provide patients from underrepresented groups equitable and culturally responsive care.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Radiation oncology clinical trials lack full representation of the ethnic and racial diversity present in the general United States and in the cancer patient population. There are low rates of both recruitment and enrollment of individuals from underrepresented ethnic and racial backgrounds, especially Black and Hispanic patients, people with disabilities, and patients from underrepresented sexual and gender groups. Even if approached for enrollment, barriers such as mistrust in medical research stemming from historical abuse and contemporary biased systems, low socioeconomic status, and lack of awareness prohibit historically marginalized populations from participating in clinical trials. In this review, we reflect on these specific barriers and detail approaches to increase diversity of the patient population in radiation oncology clinical trials to better reflect the communities we serve. We hope that implementation of these approaches will increase the diversity of clinical trials patient populations in not only radiation oncology but also other medical specialties.
AB - Radiation oncology clinical trials lack full representation of the ethnic and racial diversity present in the general United States and in the cancer patient population. There are low rates of both recruitment and enrollment of individuals from underrepresented ethnic and racial backgrounds, especially Black and Hispanic patients, people with disabilities, and patients from underrepresented sexual and gender groups. Even if approached for enrollment, barriers such as mistrust in medical research stemming from historical abuse and contemporary biased systems, low socioeconomic status, and lack of awareness prohibit historically marginalized populations from participating in clinical trials. In this review, we reflect on these specific barriers and detail approaches to increase diversity of the patient population in radiation oncology clinical trials to better reflect the communities we serve. We hope that implementation of these approaches will increase the diversity of clinical trials patient populations in not only radiation oncology but also other medical specialties.
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U2 - 10.1016/j.ijrobp.2022.11.044
DO - 10.1016/j.ijrobp.2022.11.044
M3 - Review article
C2 - 36526234
AN - SCOPUS:85149850207
SN - 0360-3016
VL - 116
SP - 103
EP - 114
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -