Willingness to participate in various nontherapeutic cancer research activities among urban and rural African American and Latinx healthy volunteers

Meaning in Life as a Potential Protective Factor for Tobacco Abstinence Among Adult Rural Residents: A Pilot Study in Alabama

U.S. rural counties have been shown to demonstrate higher rates of tobacco use, however, there is limited understanding concerning protective factors that may decrease the likelihood of tobacco use in these settings. The increased presence of the sense that one's life is meaningful has been found to be associated with engagement in health behaviors, including refraining from tobacco use. However, comprehensive population-based assessments are required to examine the association between meaning in life and tobacco abstinence. This is especially pertinent among sub-populations that are underrepresented in research, including Black and White rural residents. The purpose of this study was to examine if increased meaning in life would be associated with current tobacco abstinence among residents of rural Alabama. A population-based in-person survey was administered to 268 adults representing all census tracts within a rural Alabama county. Participants were provided a comprehensive list of tobacco products with product photos and queried about use, including use within the previous 30 days. Meaning in life was measured using the 10-item Meaning in Life Questionnaire. Increased meaning in life was associated with a greater likelihood of current abstinence from tobacco products while controlling for multiple demographic variables including sex, age, race, and educational attainment. This study identified meaning in life as a potential protective factor against current tobacco use that may generalize beyond rural settings. This finding has relevant research and public health implications within rural settings, providing preliminary evidence that this understudied construct may play an important role in protecting rural residents from engagement in an addictive behavior. Further research is needed to elucidate mechanisms that may underlie the protective capacity of meaning in life to inform interventions to boost this construct.

Enrollment of Racial and Ethnic Minoritized Groups in Gynecologic Oncology Clinical Trials: A Review of the Scope of the Problem, Contributing Factors, and Strategies to Improve Inclusion

Racial inequities are well-documented across the gynecologic oncology care continuum, including the representation of racial and ethnic minoritized groups (REMGs) in gynecologic oncology clinical trials. We specifically reviewed the scope of REMG disparities, contributing factors, and strategies to improve inclusion. We found systematic and progressively worsening under-enrollment of REMGs, particularly of Black and Latinx populations. In addition, race/ethnicity data reporting is poor, yet a prerequisite for accountability to recruitment goals. Trial participation barriers are multifactorial, and successful remediation likely requires multi-level strategies. More rigorous, transparent data on trial participants and effectiveness studies on REMG recruitment strategies are needed to improve enrollment.

Researching minoritised communities in palliative care: An agenda for change

BACKGROUND

Palliative care access, experiences and outcomes of care disadvantage those from ethnically diverse, Indigenous, First nation and First people communities. Research into this field of inquiry raises unique theoretical, methodological, and moral issues. Without the critical reflection of methods of study and reporting of findings, researchers may inadvertently compromise their contribution to reducing injustices and perpetuating racism.

AIM

To examine key evidence of the place of minoritised communities in palliative care research to devise recommendations that improve the precision and rigour of research and reporting of findings.

METHODS

Narrative review of articles identified from PubMed, CINAHL and Google Scholar for 10 years augmented with supplementary searches.

RESULTS

We identified and appraised 109 relevant articles. Four main themes were identified (i) Lack of precision when working with a difference; (ii) 'black box epidemiology' and its presence in palliative care research; (iii) the inclusion of minoritised communities in palliative care research; and (iv) the potential to cause harm. All stymie opportunities to 'level up' health experiences and outcomes across the palliative care spectrum.

CONCLUSIONS

Based on the findings of this review palliative care research must reflect on and justify the classification of minoritised communities, explore and understand intersectionality, optimise data quality, decolonise research teams and methods, and focus on reducing inequities to level up end-of-life care experiences and outcomes. Palliative care research must be forthright in explicitly indentifying instances of structural and systemic racism in palliative care research and engaging in non-judgemental debate on changes required.