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Dassum SR, Ferguson R, Woods P, Flynn M, Visnaw K, Holmberg E, Schiller S, Shannon C, Brophy M, Monach P, Leatherman S, Branch-Elliman W. Patient- reported reasons for non-participation in a COVID-19 therapeutics clinical trial: Findings from a multi-center investigation. Contemp Clin Trials 2023; 126:107082. [PMID: 36632925 PMCID: PMC9827740 DOI: 10.1016/j.cct.2023.107082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/15/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Early in the pandemic, there were no evidence-based treatments for SARS-CoV-2, creating an urgent need to identify effective therapeutics. However, public participation in medical research is low; trial enrollment in the US is typically 10-20%. Thus, the aim of this study was to identify common themes underpinning patient reasons to decline participation and evaluate the impact of specific contextual factors. METHODS This sub-study was conducted in five VISN-1 Clinical Trials Network participating facilities from 4/10/2020-2/3/2021. The trial evaluated the addition of the IL-6-inhibitor, Sarilumab, to the current standard of care for inpatients with moderate-to-severe SARS-CoV-2. Consent procedures varied by site and included fully in-person and fully remote processes. Reasons for declining enrollment were collected among eligible patients who declined to participate but agreed to answer a short follow-up question. Qualitative data were analyzed using directed content analysis. Enrollment rates were assessed using simple, descriptive statistics. RESULTS N = 417 COVID-19 positive inpatients were screened and 53/162 eligible patients enrolled. Enrollment varied across study sites and by study period. Prior to identification of effective treatment, the enrollment rate was 10/11 (91%) versus 43/144 (30%) during the later period of the study. N = 85/102 patients who did not enroll answered the follow-up question. The most commonly reported responses were: concerns about the study drug and participation in clinical research in general, comorbidity concerns, competing priorities, external factors, and external advice and influence from family members and clinicians. CONCLUSIONS Identifying reasons behind declining to enroll may help investigators develop strategies to increase research participation.
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Affiliation(s)
- Samira Reyes Dassum
- Beth Israel Deaconess Medical Center, Department of Infectious Disease, Boston, MA, United States.
| | - Ryan Ferguson
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States; Boston University School of Medicine, Boston, MA, United States of America; Boston University School of Public Health, Boston, MA, United States of America
| | - Patricia Woods
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Maura Flynn
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Karen Visnaw
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Erika Holmberg
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Sara Schiller
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Colleen Shannon
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Mary Brophy
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States; Boston University School of Medicine, Boston, MA, United States of America
| | - Paul Monach
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States; VA Boston Healthcare System, Department of Medicine, Boston, MA, United States; Harvard Medical School, Boston, MA, United States of America
| | - Sarah Leatherman
- VA Boston Healthcare System, Cooperative Studies Program, Boston, MA, United States
| | - Westyn Branch-Elliman
- VA Boston Healthcare System, Department of Medicine, Boston, MA, United States; VA Boston Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, United States; Harvard Medical School, Boston, MA, United States of America
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Winslow BD, Kwasinski R, Hullfish J, Ruble M, Lynch A, Rogers T, Nofziger D, Brim W, Woodworth C. Automated stress detection using mobile application and wearable sensors improves symptoms of mental health disorders in military personnel. Front Digit Health 2022; 4:919626. [PMID: 36082233 PMCID: PMC9445306 DOI: 10.3389/fdgth.2022.919626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Leading causes in global health-related burden include stress, depression, anger, fatigue, insomnia, substance abuse, and increased suicidality. While all individuals are at risk, certain career fields such as military service are at an elevated risk. Cognitive behavioral therapy (CBT) is highly effective at treating mental health disorders but suffers from low compliance and high dropout rates in military environments. The current study conducted a randomized controlled trial with military personnel to assess outcomes for an asymptomatic group (n = 10) not receiving mental health treatment, a symptomatic group (n = 10) using a mHealth application capable of monitoring physiological stress via a commercial wearable alerting users to the presence of stress, guiding them through stress reduction techniques, and communicating information to providers, and a symptomatic control group (n = 10) of military personnel undergoing CBT. Fifty percent of symptomatic controls dropped out of CBT early and the group maintained baseline symptoms. In contrast, those who used the mHealth application completed therapy and showed a significant reduction in symptoms of depression, anxiety, stress, and anger. The results from this study demonstrate the feasibility of pairing data-driven mobile applications with CBT in vulnerable populations, leading to an improvement in therapy compliance and a reduction in symptoms compared to CBT treatment alone. Future work is focused on the inclusion of passive sensing modalities and the integration of additional data sources to provide better insights and inform clinical decisions to improve personalized support.
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Affiliation(s)
- Brent D. Winslow
- Design Interactive, Inc., Orlando, FL, United States
- Correspondence: Brent D. Winslow
| | | | | | | | - Adam Lynch
- Design Interactive, Inc., Orlando, FL, United States
| | - Timothy Rogers
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Debra Nofziger
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - William Brim
- Department of Medical and Clinical Psychology, Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Craig Woodworth
- Department of Behavioral Health, Brook Army Medical Center, Fort Sam Houston, TX, United States
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How many minors are participating in clinical research today? An estimate and important lessons learned. J Clin Transl Sci 2021; 5:e179. [PMID: 34849254 PMCID: PMC8596071 DOI: 10.1017/cts.2021.844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 11/25/2022] Open
Abstract
Little is known about the number of minors enrolled in clinical research today. IRB administrators at leading pediatric medical centers were surveyed regarding studies with minors. Analyses were descriptive in nature with adaptive Bayesian bootstrap imputation used with missing data. Officials from 17/41 (41.5%) pediatric research centers responded: 74,204 active studies were estimated, 29,078 (39%) included minors, and 6574 (23%) were “more than minimal risk.” Minors accounted for 0.7–2.87M research subjects. Pediatric medicine desperately needs a more accurate and reliable reporting system for tracking the recruitment, retention, and involvement of minors in clinical research.
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Karampatakis D, Kakavouti-Doudos A, Oikonomidis P, Voultsos P. Translation and validation of the greek version of a questionnaire measuring patient views on participation in clinical trials. BMC Health Serv Res 2021; 21:1135. [PMID: 34674689 PMCID: PMC8530543 DOI: 10.1186/s12913-021-07111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background The increasing number of clinical research opportunities requires increasing numbers of participants in clinical trials. However, it may become increasingly problematic, as protocols have become increasingly complex. Better understanding of patients’ attitudes towards their potential participation in clinical trials is essential for developing effective clinical trial recruitment strategies. In Greece, limited research has been conducted on this topic so far. This study aims to contribute to filling this gap. Methods A cross-sectional study was conducted. Purposive sampling was used to select participants. The Greek version of a recently developed questionnaire measuring patient views on participation in clinical trials, a 27-item scale distributed into four factors, was tested. In addition, participants were asked to provide information regarding their socio-demographics. A demographic comparison was conducted. Results The four-factor solution derived in our study consisted of the same 27 items and it was different from the six-factor solution that Arnetz et al. proposed. The factors risks and benefits, that consisted of 5 and 3 items respectively in the six-factor solution, were merged into one factor that consisted of 10 items in the four-factor solution. The four factors produced were Risks and benefits (ten items, α = 0,867), Patient’s expectations (six items, α = 0.864), Patient’s participation (five items, α = 0.827), and Cost and convenience (five items, α = 0,770). We found that demographic factors did not impact patients’ opinions about clinical trials participation, except for gender. The participants reported as important for participating in clinical trial: receiving clear and adequate information (95,5 %) and being given the opportunity to ask questions (97,8 %), take part in discussions regarding their own treatment (94,6 %), and voice their concerns and opinions (91,1 %). As factors strongly associated with participants’ willingness to participate in a clinical trial were reported: concerns about the risks of being in a clinical trial (87,5 %), the possible side effects of clinical trials (86,3 %), the type of treatment given in a clinical trial (83,7 %), and whether participation would improve their quality of life (QoL) (81,5 %). Conclusions The preliminary validation of the Greek version of the questionnaire measuring patient perceptions and expectations of participating in clinical trials demonstrated acceptable validity and reliability and could be further tested in larger samples. The findings that emerged from this study are in line with previous literature. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07111-x.
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Affiliation(s)
- Dimitrios Karampatakis
- 1st University Eye Clinic, School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Angeliki Kakavouti-Doudos
- 1st University Eye Clinic, School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Panagiotis Oikonomidis
- 1st University Eye Clinic, School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Polychronis Voultsos
- Laboratory of Forensic Medicine & Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece.
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Vanderlinden JA, Holden RM, Scott SH, Boyd JG. Cerebral Perfusion in Hemodialysis Patients: A Feasibility Study. Can J Kidney Health Dis 2021; 8:20543581211010654. [PMID: 34017595 PMCID: PMC8114747 DOI: 10.1177/20543581211010654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background Patients on hemodialysis (HD) are known to exhibit low values of regional cerebral oxygenation (rSO2) and impaired cognitive functioning. The etiology of both is currently unknown. Objective To determine the feasibility of serially monitoring rSO2 in patients initiating HD. In addition, we sought to investigate how rSO2 is related to hemodynamic and dialysis parameters. Design Prospective observational study. Setting Single-center tertiary academic teaching hospital in Ontario, Canada. Participants Six patients initiating HD were enrolled in the study. Methods Feasibility was defined as successful study enrollment (>1 patient/month), successful consent rate (>70%), high data capture rates (>90%), and assessment tolerability. Regional cerebral oxygenation monitoring was performed 1 time/wk for the first year of dialysis. A neuropsychological battery was performed 3 times during the study: before dialysis initiation, 3 months, and 1 year after dialysis initiation. The neuropsychological battery included a traditional screening tool: the Repeatable Battery for the Assessment of Neuropsychological Status, and a robot-based assessment: Kinarm. Results Our overall consent rate was 33%, and our enrollment rate was 0.4 patients/mo. In total 243 rSO2 sessions were recorded, with a data capture rate of 91.4% (222/243) across the 6 patients. Throughout the study, no adverse interactions were reported. Correlations between rSO2 with hemodynamic and dialysis parameters showed individual patient variability. However, at the individual level, all patients demonstrated positive correlations between mean arterial pressure and rSO2. Patients who had more than 3 liters of fluid showed significant negative correlations with rSO2. Less cognitive impairment was detected after initiating dialysis. Limitation This small cohort limits conclusions that can be made between rSO2 and hemodynamic and dialysis parameters. Conclusions Prospectively monitoring rSO2 in patients was unfeasible in a single dialysis unit, due to low consent and enrollment rates. However, rSO2 monitoring may provide unique insights into the effects of HD on cerebral oxygenation that should be further investigated. Trial Registration Due to the feasibility nature of this study, no trial registration was performed.
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Affiliation(s)
| | - Rachel Mary Holden
- Division of Nephrology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Stephen Harold Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - John Gordon Boyd
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada.,Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada
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Jin H, Cui M, Liu J. Factors affecting people's attitude toward participation in medical research: a systematic review. Curr Med Res Opin 2020; 36:1137-1143. [PMID: 32329364 DOI: 10.1080/03007995.2020.1760807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective: Human participants play an important role in medical care advances. Recruiting enough participants is perhaps the most significant procedure that determines the success of medical research, and high participation rate brings about many benefits. Therefore, acquiring enough participants is important for medical researchers. To understand how to improve participation rate, we need to clarify factors affecting the public's attitude toward medical research. Through this review, we aim to examine which factors affect the attitude of human participants toward medical research.Methods: The relevant data were searched by using the keywords "Public," "Participants," "Medical" and "Research" in PubMed (MEDLINE), International Pharmaceutical Abstracts, Web of Science, Science Direct, CINAHL Plus, EMBASE, and China Knowledge Resource Integrated databases. A manual search was done to acquire peer-reviewed articles and reports about participation in medical research.Results: Sixty-three studies were identified for inclusion after full text screening. The included studies were of variable quality. Some factors affecting people's attitude toward participating in medical research have been identified and discussed in our review.Conclusion: This review demonstrated that willingness of participants to take part in medical research was influenced by a variety of factors. These factors may be used to predict the public's willingness to take part in medical research and may potentially be used in developing strategies aimed at improving participation rate.
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Affiliation(s)
- Hao Jin
- The Second Department of General Surgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
| | - Min Cui
- Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
| | - Junwei Liu
- Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
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Choi YK, López JE, Meeker D, Ohno-Machado L, Kim KK. Engaging heart failure patients from a clinical data research network: A survey on willingness to participate in different types of research. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2020; 2019:305-312. [PMID: 32308823 PMCID: PMC7153117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The willing participation of patients in clinical research is a critical element in national efforts to collect health data for precision medicine and large cohort studies. However, recruiting patients is challenging. Clinical data research networks (CDRN) have primarily been used for observational studies, but may be able to enhance recruitment efforts. We need a better understanding of patient motivation and preferences for research participation and their interest in different types of research activities, particularly among those who are already represented in CDRNs. We surveyed a heart failure patient cohort constructed from EHRs in a CDRN to assess research participation. Results showed that CDRN recruitment is feasible. Respondents were most interested in completing a one-time survey and giving a blood sample one time. They were least interested in a study about weight control that require surgery. We found statistically significant associations between race and research activity interests.
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Affiliation(s)
- Yong K Choi
- University of California Davis, Sacramento, CA
| | - Javier E López
- University of California Davis, Sacramento, CA
- Division of Cardiovascular Medicine, University of California Davis, Sacramento, CA
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Abu Farha R, Alzoubi KH, Khabour OF, Mukattash TL. Factors Influencing Public Knowledge and Willingness to Participate in Biomedical Research in Jordan: A National Survey. Patient Prefer Adherence 2020; 14:1373-1379. [PMID: 32801667 PMCID: PMC7415452 DOI: 10.2147/ppa.s261903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/10/2020] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Recruitment of adequate numbers of research participants is important for advancement in biomedical fields. Awareness and knowledge of the population about biomedical research are expected to enhance willingness to participate in such research. Therefore, in the current study, participants' awareness, knowledge, and willingness to participate in scientific research in Jordan were examined. METHODS This was a survey-based, cross-sectional study conducted from December 2019 to February 2020 among the public in Jordan. After written informed consent had been obtained from study participants, a structured questionnaire was used to survey research participants. The final questionnaire contained three parts: part I was about demographics and general information, part II assessed participants' awareness and willingness to participate in biomedical research, and part III assessed participants' knowledge about biomedical research studies. RESULTS A total of 2,000 subjects agreed to participate, of which 67.4% were female (n=1339). More than half the respondents were aware of biomedical research (58.6%), of which 18.1% had previously participated in biomedical research. In addition, 55.5% reported that they were willing to participate in biomedical research, while a lower proportion (31.1%) were willing to volunteer in a clinical trial. The overall knowledge of participants about biomedical research was deemed moderate (total score 12.9 out of 20). Finally, willingness to participate in biomedical research was associated with being male, being married, having a biomedicine-related degree, and higher knowledge score. CONCLUSION A majority of Jordanians had moderate levels of awareness and knowledge about biomedical research. Such factors as sex, type of education, and knowledge contribute to willingness to participate in biomedical research.
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Affiliation(s)
- Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman11931, Jordan
- Correspondence: Rana Abu FarhaDepartment of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman11931, JordanTel +962 6-560-9957 ext 1496Fax +962 5232899 Email
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid22110, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid22110, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid22110, Jordan
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Al-Rawashdeh N, Damsees R, Al-Jeraisy M, Al Qasim E, Deeb AM. Knowledge of and attitudes toward clinical trials in Saudi Arabia: a cross-sectional study. BMJ Open 2019; 9:e031305. [PMID: 31641002 PMCID: PMC6830621 DOI: 10.1136/bmjopen-2019-031305] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Clinical trials (CTs) are considered an important method for developing new treatments and providing access to potentially effective drugs that are still under investigation. Measuring the public's knowledge of and attitudes toward CTs is important for assessing their readiness for and acceptance of human drug testing, which has previously not been assessed in the Kingdom of Saudi Arabia (KSA). The objective of this study is to explore the Saudi public's knowledge of and attitudes toward CTs as well as participation in trials to test new or approved drugs. DESIGN Cross-sectional. SETTING The 2016 Al Jenadriyah cultural/heritage festival in Riyadh, KSA. PARTICIPANTS Participating booths and exhibition halls, as well as festival visitors, were approached to participate in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Knowledge of and attitudes toward CTs. RESULTS The final number of participants was 938. The responses were converted to a percentage mean score (out of 100) for each knowledge-related response and attitude. The total mean knowledge score was 56.8±24.8 and the attitude-related score was 61.5±28.0. Although most of the participants supported testing approved or off-label and new drugs on adult and paediatric patients, only a third (30.5%) agreed that new drugs could be tested on healthy volunteers. The results indicated that gender, educational level, income, medical background, age and health insurance were independently associated with the level of knowledge of CTs. In terms of attitudes toward CTs, the factors that were independently associated were gender, educational level and medical background. CONCLUSIONS The Saudi public has a low level of knowledge and a moderately positive attitude toward CTs. There is a moderate positive correlation between the two factors such that as knowledge of CTs increases, the Saudi public will hold more positive attitudes toward CTs.
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Affiliation(s)
- Nedal Al-Rawashdeh
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Rana Damsees
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Majed Al-Jeraisy
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Eman Al Qasim
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ahmad M Deeb
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
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Kane C, Takechi K, Chuma M, Nokihara H, Takagai T, Yanagawa H. Perspectives of non-specialists on the potential to serve as ethics committee members. J Int Med Res 2019; 47:1868-1876. [PMID: 30678503 PMCID: PMC6567771 DOI: 10.1177/0300060518823941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/18/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE In Japan, under the new Clinical Trials Act pertaining to investigator-initiated clinical trials that came into effect on 1 April 2018, review boards should review proposed clinical trials while considering written opinions from specialists. Additionally, involvement of non-specialists is mandatory, and attention is being placed on their effective contributions. This study was performed to determine representative key issues with which to promote these contributions. METHODS This qualitative study was conducted in 2018 using a focus group interview of six non-specialists regarding perspectives on clinical research itself and research ethics committees. RESULTS For perspectives on clinical research itself, 33 codes were established and sorted into 2 categories and 6 subcategories relating to ambivalence toward clinical research. For perspectives on research ethics committees, 54 codes were established and sorted into 3 categories and 10 subcategories relating to the theme "knowledge and an environment that promotes non-specialist members' participation." One notable result was the willingness of participants to obtain details about a study should they be selected. CONCLUSIONS The results suggest that detailed explanation of a particular study would encourage non-specialist members to participate in a clinical research review committee. Education aimed at non-specialist participation should therefore be considered in future studies.
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Affiliation(s)
- Chikako Kane
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Kenshi Takechi
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Masayuki Chuma
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Hiroshi Nokihara
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Tomoko Takagai
- Division of Nursing, Tokushima University Hospital, Tokushima, Japan
| | - Hiroaki Yanagawa
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
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Sun IC. Significant differences on submission lag following regulation reform for registration of novel therapeutic drugs in Taiwan. Invest New Drugs 2019; 37:1094-1106. [PMID: 30612310 DOI: 10.1007/s10637-018-00715-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/12/2018] [Indexed: 11/24/2022]
Abstract
Drug lag, which delays patients' access to medicinal products, is typically associated with pharmaceutical regulations. To shorten drug lag, health authorities may establish new policies to liberalize the regulations, a step that is important in countries, such as Taiwan, with consumer demand for imported novel therapeutic agents. Taiwan's government enacted Articles 38-1 and 38-2 of Regulations for Registration of Medicinal Products to relax the regulatory barriers for new drug submission, thus conditionally exempting the requirement for the Certificate of Pharmaceutical Product (CPP). This study examined whether the enacted regulations reduce submission lag by analyzing the time gap of submission between Taiwan and the United States during 2014-2017. The results indicated that the enacted regulations substantially affected submission lag. Submission lag was significantly shorter for applications not requiring a CPP than those requiring one CPP, which in turn was significantly shorter than those requiring two CPPs. This conclusion can be applied to biological, chemical, non-orphan, and oncology drugs and also applications filed by subsidiary companies, but not orphan drugs and applications filed by contract agents. Among applications requiring one CPP, oncology drugs showed the shortest submission lag. Certain factors, such as clinical studies recruiting over-threshold Taiwanese participants and those performed before the submission of new drug application in the United States, may shorten submission lag. In summary, this study justifies the policy of the exemption from CPP requirements, which supports the hypothesis that relaxing regulatory barriers can reduce submission lag in Taiwan.
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Affiliation(s)
- I-Chen Sun
- Division of Pharmaceutical Science, Center for Drug Evaluation, Taipei, Taiwan, Republic of China. .,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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12
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Liu HE, Li MC. Factors influencing the willingness to participate in medical research: a nationwide survey in Taiwan. PeerJ 2018; 6:e4874. [PMID: 29876147 PMCID: PMC5987748 DOI: 10.7717/peerj.4874] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/10/2018] [Indexed: 11/20/2022] Open
Abstract
Background Participation rate is one of the main challenges medical researchers face. We examined how demographic background and trust in medical research affect the willingness of people to participate in medical research in Taiwan. Methods Data from the 2011 Taiwan Genomic Survey (a nationwide representative face-to-face survey) were analyzed. The survey included a vignette of a researcher conducting a clinical trial of an investigative medicinal product, and questions for interviewees regarding their willingness to participate in research after they were informed of the scenario description. A total of 3,159 people, aged 18 to 70 years, were sampled, and 1,538 of them completed the survey. With missing data excluded, a total of 1,389 respondents were included in the final analysis. Results About 12 percent of the respondents answered that they would be willing to participate in medical research. Respondents who had college degrees or above and were married or lived with significant others were less likely to participate in medical research. By contrast, male respondents, and respondents whose household family members had biomedicine-related degrees or had one themselves were more likely to participate in medical research. After adjustment for demographic factors, respondents were more likely to participate in medical research if: (1) they expressed trust in doctors conducting medical research; (2) they agreed that doctors would never ask them to join medical research studies that might harm them; (3) they thought that participating in a medical research study would be safe; and (4) they agreed that researchers had no selfish reasons for doing the medical research. Discussion Some of our findings, such as the effects of education level and marital status on participation in medical research, are different from most findings of previous studies conducted in other countries. This study is useful for developing strategies to improve participant recruitment. Relevant discussions on research ethics and policies, such as the importance of public trust in medical researchers, could also be based on this study.
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Affiliation(s)
- Hung-En Liu
- Graduate Institute of Law and Interdisciplinary Studies, National Chengchi University, Taipei, Taiwan
| | - Ming-Chieh Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
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A content analysis of Clinical and Translational Science Award (CTSA) strategies for communicating about clinical research participation online. J Clin Transl Sci 2018; 1:340-351. [PMID: 29707256 PMCID: PMC5915806 DOI: 10.1017/cts.2018.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction There is a dearth of literature providing guidance on how to effectively communicate about clinical research (CR). Methods Using the transactional model of communication, a content analysis of the investigator (n=62) and participant (n=18) Web sites of institutions funded through the National Institutes of Health Clinical and Translational Science Award (CTSA) was conducted to identify their strategies (e.g., messages) for communicating about CR participation. Results CTSAs targeted investigators with CR participation content across the main Web sites, although most CTSAs (n=55; 88.7%) also included CR participation content for participants. In total, 18 CTSAs (29%) hosted participant Web sites. Participant sites included 13 message types about CR participation (e.g., registry enrollment) and 5 additional channels (e.g., email, phone number) to communicate about CR. However, many CTSA participant Web sites excluded information explaining the CR process and offered CR content exclusively in English. Conclusion CTSAs should identify their target audience and design strategies (e.g., messages, channels) accordingly.
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Smart A, Harrison E. The under-representation of minority ethnic groups in UK medical research. ETHNICITY & HEALTH 2017; 22:65-82. [PMID: 27174778 DOI: 10.1080/13557858.2016.1182126] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
UNLABELLED Objectives . The paper investigates differences in engagement with medical research between White British and Black, Asian and Minority Ethnic (BAME) groups in the UK, using data from the Wellcome Trust Monitor (WTM). DESIGN The study used two waves of the WTM (n = 2575) to examine associations between ethnic group and participation in medical research, and willingness to participate (WP) in medical research. Logistic regression models controlled for socio-economic and demographic factors, and relevant outlooks and experiences that are assumed to be markers of engagement. RESULTS Respondents from the BAME group were less likely to have participated in medical research compared to those from the White British group, but there was only patchy evidence of small ethnic group differences in WP. Influences on engagement with medical research varied somewhat between the White British and BAME groups, in particular in relation to occupation, education, health, attitudes to medical science and belief. CONCLUSIONS These findings consolidate previously context-specific evidence of BAME group under-representation in the UK, and highlight heterogeneity in that group. Efforts to address the under-representation of those from BAME groups might benefit from targeted strategies for recruitment and advocacy, although improved data sets are required to fully understand ethnic differences in engagement with medical research.
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Affiliation(s)
- Andrew Smart
- a Department of Social Sciences , Bath Spa University , Bath , UK
| | - Eric Harrison
- b Department of Sociology , City University London , London , UK
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15
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Perinatal Preparation for Effective Parenting Behaviors: A Nationally Representative Survey of Patient Attitudes and Preferences. Matern Child Health J 2016; 20:298-305. [PMID: 26525554 DOI: 10.1007/s10995-015-1829-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To characterize patient preferences about parenting preparation during pregnancy and the role of healthcare providers. METHODS A nationally representative, cross-sectional survey was administered to parents of children 0-3 years old. Respondents (N = 459 non-institutionalized US adults from the GfK Knowledge Panel®) completed an online survey about parenting preparation (response rate = 61.2 %). Primary outcomes were perceived importance of parenting, regret about opportunities to prepare for parenting, acceptability of parenting support from healthcare workers, and preferred healthcare setting for perinatal parenting support. Statistical analyses included descriptive statistics, Chi square analyses and logistic regression. RESULTS A majority of respondents (87.6 %, 95 % CI 83.3-90.8) believed that parenting had an equal or greater effect on early childhood behavior than the child's personality. Overall, 68.7 % (63.5-73.5 %) wished there were more opportunities during pregnancy to prepare for parenting, and a large majority (89.2, 84.9-92.4 %) believed that it would be helpful to receive parenting information from healthcare providers during pregnancy, with no differences across demographic groups. The preferred clinical encounters for receiving parenting education were at "a visit with my ObGyn/midwife" during pregnancy (58.2, 52.5-63.7 %) and at "a visit with my child's doctor/nurse practitioner" during 0-2 months postpartum (60.7, 55.0-66.2 %). CONCLUSION A majority of US parents of young children express interest in receiving parenting support at perinatal healthcare visits. Preferences for parenting support at prenatal visits during pregnancy and at pediatric visits in the immediate postpartum period should guide clinicians, community-based outreach organizations, and governmental stakeholders seeking to design and evaluate parenting preparation interventions.
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16
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Selewski DT, Herreshoff EG, Gipson DS. Optimizing Enrollment of Patients into Nephrology Research Studies. Clin J Am Soc Nephrol 2016; 11:512-7. [PMID: 26185262 PMCID: PMC4791824 DOI: 10.2215/cjn.00500115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Advances in medical care and biomedical research depend on the participation of human subjects. Poor patient enrollment in research has limited past clinical and translational research endeavors in nephrology. Simultaneously, patients and their caregivers are seeking better diagnostic, monitoring, and therapeutic approaches to improve or restore kidney and overall health. This manuscript will discuss a framework and strategies to optimize patient enrollment within nephrology research and provide examples of success from existing nephrology research programs.
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Affiliation(s)
- David T Selewski
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
| | - Emily G Herreshoff
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
| | - Debbie S Gipson
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
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17
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Winslow BD, Chadderdon GL, Dechmerowski SJ, Jones DL, Kalkstein S, Greene JL, Gehrman P. Development and Clinical Evaluation of an mHealth Application for Stress Management. Front Psychiatry 2016; 7:130. [PMID: 27507949 PMCID: PMC4960497 DOI: 10.3389/fpsyt.2016.00130] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/12/2016] [Indexed: 11/29/2022] Open
Abstract
A large number of individuals experience mental health disorders, with cognitive behavioral therapy (CBT) emerging as a standard practice for reduction in psychiatric symptoms, including stress, anger, anxiety, and depression. However, CBT is associated with significant patient dropout and lacks the means to provide objective data regarding a patient's experience and symptoms between sessions. Emerging wearables and mobile health (mHealth) applications represent an approach that may provide objective data to the patient and provider between CBT sessions. Here, we describe the development of a classifier of real-time physiological stress in a healthy population (n = 35) and apply it in a controlled clinical evaluation for armed forces veterans undergoing CBT for stress and anger management (n = 16). Using cardiovascular and electrodermal inputs from a wearable device, the classifier was able to detect physiological stress in a non-clinical sample with accuracy greater than 90%. In a small clinical sample, patients who used the classifier and an associated mHealth application were less likely to discontinue therapy (p = 0.016, d = 1.34) and significantly improved on measures of stress (p = 0.032, d = 1.61), anxiety (p = 0.050, d = 1.26), and anger (p = 0.046, d = 1.41) compared to controls undergoing CBT alone. Given the large number of individuals that experience mental health disorders and the unmet need for treatment, especially in developing nations, such mHealth approaches have the potential to provide or augment treatment at low cost in the absence of in-person care.
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Affiliation(s)
| | | | | | | | - Solomon Kalkstein
- Philadelphia VA Medical Center, University of Pennsylvania , Philadelphia, PA , USA
| | - Jennifer L Greene
- Philadelphia VA Medical Center, University of Pennsylvania , Philadelphia, PA , USA
| | - Philip Gehrman
- Philadelphia VA Medical Center, University of Pennsylvania , Philadelphia, PA , USA
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18
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Cobb EM, Gebremariam A, Singer D, Davis MM. Public Interest in Medical Research Participation: Does It Matter if Patients or Community Members Have Helped Design the Study? Clin Transl Sci 2015; 8:502-5. [PMID: 26009983 DOI: 10.1111/cts.12278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE We determined national levels of public participation in medical research study design. We compared public interest in medical research participation (MRP) in studies overall, versus studies explicitly designed with public involvement. METHOD Cross-sectional household survey of US population in June 2013. Descriptive statistics estimated participation in medical research study design. Chi-square test compared levels of interest in MRP if respondent knew patients or community members helped design the study. RESULTS Of 2,048 respondents (participation rate 60%), 5% knew someone who had helped design a medical research study. There was no association between having known someone or personal participation in study design and willingness to engage in MRP. Although the overall proportion of respondents who would consider MRP initially (51%) was similar to the proportion who would consider MRP with community member involvement in study design (49%), the changes in respondents' views across the different scenarios were significantly greater than what would have been expected by chance. CONCLUSIONS We found similar levels of interest in MRP whether or not the public is involved in medical research study design. This finding may indicate that public involvement in study design, like community-based participatory research, may not affect overall rates of MRP.
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Affiliation(s)
- Enesha M Cobb
- Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor VA Healthcare System, Ann Arbor, Michigan, USA.,Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Achamyeleh Gebremariam
- Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Dianne Singer
- Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew M Davis
- Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.,Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan, USA.,Division of General Medicine, Gerald R. Ford School of Public Policy and School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
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Aguilar-Gaxiola S, Ahmed S, Franco Z, Kissack A, Gabriel D, Hurd T, Ziegahn L, Bates NJ, Calhoun K, Carter-Edwards L, Corbie-Smith G, Eder MM, Ferrans C, Hacker K, Rumala BB, Strelnick AH, Wallerstein N. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:564-72. [PMID: 24556775 PMCID: PMC4124598 DOI: 10.1097/acm.0000000000000198] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.
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Affiliation(s)
- Sergio Aguilar-Gaxiola
- Dr. Aguilar-Gaxiola is professor of clinical internal medicine; director, Center for Reducing Health Disparities; director, Community Engagement Program, Clinical and Translational Science Center; and codirector, Latino Aging Research and Resource Center, University of California, Davis School of Medicine, Sacramento, California. Dr. Ahmed is senior associate dean for community engagement; director, Community Engagement Key Function, Clinical and Translational Science Institute of Southeast Wisconsin; professor, Department of Family and Community Medicine; professor, Institute for Health and Society; and director, Healthier Wisconsin Partnership Program, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Franco is assistant professor, Community Engagement Key Function, Clinical and Translational Science Institute of Southeast Wisconsin, Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Ms. Kissack is program manager, Community Engagement Key Function, Clinical and Translational Science Institute of Southeast Wisconsin, Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Ms. Gabriel is data integration and interoperability manager, Biomedical Informatics, Clinical and Translational Science Center, University of California, Davis School of Medicine, Sacramento, California. Dr. Hurd is associate professor of surgery, Division of Surgical Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Dr. Ziegahn is community engagement and research program manager, Clinical and Translational Science Center, University of California Davis School of Medicine, Sacramento, California. Dr. Bates is senior evaluation specialist, Evaluation and Tracking Program, Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, Illinois. Ms. Calhoun is clinical research associate and cofacilitator, Community Engagement Program, Michi
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Cobb EM, Singer DC, Davis MM. Public interest in medical research participation: differences by volunteer status and study type. Clin Transl Sci 2014; 7:145-9. [PMID: 24456538 DOI: 10.1111/cts.12142] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE We assessed national levels of public interest in medical research participation (MRP) and factors associated with interest as a healthy volunteer; as a diagnosed volunteer; and in seven study types. METHOD Cross-sectional, Web-based survey of the US population in June 2012. Descriptive statistics estimated interest in MRP and multivariable logistic regression determined associations between respondent-level predictors and interest in MRP. RESULTS Of 2,668 respondents (response rate = 61%), 41% were interested in MRP as healthy volunteers and 60% as diagnosed volunteers. Respondents with some college (OR = 1.54, 1.09-2.19) or higher education (OR = 1.86, 1.29-2.70) had higher adjusted odds of interest as healthy volunteers. Non-Hispanic black race (OR = 0.56, 0.37-0.86) and education below high school (OR = 0.57, 0.35-0.92) were associated with lower adjusted odds of interest as diagnosed volunteers. Non-Hispanic black race was associated with lower odds of interest in medication trials as diagnosed volunteers (OR = 0.61, 0.40-0.93). CONCLUSIONS We found high levels of interest in MRP that contrast with low levels of prior research participation. Interest is higher in medical research involving noninvasive designs. Comparatively lower levels of interest in MRP among non-Hispanic blacks and those with less education raise concerns about disparities in future study enrollment.
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Affiliation(s)
- Enesha M Cobb
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan, USA; Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA; Department of Veterans Affairs, VA Center for Clinical Management and Research, Ann Arbor VA Healthcare System, Ann Arbor, Michigan, USA
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