1. Evaluating Adaptation of a Cancer Clinical Trial Decision Aid for Rural Cancer Patients: A Mixed-Methods Approach
- Author
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Mary C. Politi, Nerissa George, Kathy Robinson, Denise Monti, and Swati Pathak
- Subjects
Adult ,Male ,Rural Population ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Decision Making ,Population ,Decisional conflict ,Choice Behavior ,Article ,Decision Support Techniques ,03 medical and health sciences ,0302 clinical medicine ,Cancer Survivors ,Patient Education as Topic ,Neoplasms ,Surveys and Questionnaires ,Humans ,Medicine ,030212 general & internal medicine ,Adaptation (computer science) ,education ,Qualitative Research ,Aged ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,education.field_of_study ,business.industry ,Communication ,Rural health ,Public Health, Environmental and Occupational Health ,Cancer ,Usability ,Middle Aged ,medicine.disease ,Self Efficacy ,United States ,Test (assessment) ,Clinical trial ,Oncology ,030220 oncology & carcinogenesis ,Family medicine ,Female ,Patient Participation ,business - Abstract
PURPOSE: Rural-residing cancer patients often do not participate in clinical trials. Many patients misunderstand cancer clinical trials and their rights as participant. The purpose of this study is to modify a previously developed cancer clinical trials decision aid (DA), incorporating the unique needs of rural populations and test its impact on knowledge and decision outcomes. METHODS: The study was conducted in two phases. Phase I recruited 15 rural-residing cancer survivors in a qualitative usability study. Participants navigated the original DA and provided feedback regarding usability and implementation in rural settings. Phase II recruited 31 newly-diagnosed rural-residing cancer patients. Patients completed a survey before and after using the revised DA, R-CHOICES. Primary outcomes included decisional conflict, decision self-efficacy, knowledge, communication self-efficacy, attitudes towards and willingness to consider joining a trial. FINDINGS: In Phase I, the DA was viewed positively by rural-residing cancer survivors. Participants provided important feedback about factors rural-residing patients consider when thinking about trial participation. In Phase II, after using R-CHOICES, participants had higher certainty about their choice (mean post-test = 3.10 v. pre-test = 2.67; P = 0.025) and higher trial knowledge (mean percent correct at post-test = 73.58 v. pre-test = 57.77; P < 0.001). There was no significant change in decision self-efficacy, communication self-efficacy, attitudes towards or willingness to join trials. CONCLUSION: The R-CHOICES improved rural-residing patients’ knowledge of cancer clinical trials and reduced conflict about making a trial decision. More research is needed on ways to further support decisions about trial participation among this population.
- Published
- 2018
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