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Effectiveness of strategies to recruit underrepresented populations into cancer clinical trials

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

Tiffany L Gary

Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. E6531, Baltimore, MD 21205, USA; tgary{at}jhsph.edu

Jon Tilburt

Shari Bolen

Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Charles Baffi

Cancer Prevention Fellowship Program, National Cancer Institute, Bethesda, Maryland, USA

Renee F Wilson

Evidence-based Practice Center, Johns Hopkins University, Baltimore, Maryland, USA, Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Mollie W Howerton

Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

M Chris Gibbons

Urban Health Institute, Johns Hopkins University, Baltimore, Maryland, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Teerath Peter Tanpitukpongse

Evidence-based Practice Center, Johns Hopkins University, Baltimore, Maryland, USA

Neil R Powe

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Eric B Bass

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Evidence-based Practice Center, Johns Hopkins University, Baltimore, Maryland, USA; Urban Health Institute, Johns Hopkins University, Baltimore, Maryland, USA

Jean G Ford

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Background Certain populations, including racial and ethnic minorities and older persons, have had a history of low participation in cancer-related trials, yet there has been little information reported on recruitment strategies tailored to improve their enrollment.

Methods We conducted a systematic literature review to examine the methods used to study recruitment of underrepresented populations into cancer prevention and treatment trials and examined the studies that compared the efficacy and/or effectiveness of different recruitment strategies. We performed an electronic search through multiple databases including PubMed and a hand search of 34 journals. Potential studies were pulled and underwent title, abstract, and article review by at least two investigators.

Results Fourteen articles examined recruitment of underrepresented populations into cancer trials and, of these, five compared efficacy or effectiveness of different strategies for recruitment of underrepresented populations into randomized or concurrent controlled trials. These five studies used various strategies but only three reported that specific recruitment strategies, such as media campaigns and churchbased project sessions, resulted in improvement in accrual to cancer trials.

Conclusion There is limited evidence for efficacious or effective strategies to recruit underrepresented populations in cancer-related trials. The available evidence cannot be generalized to these heterogeneous groups. Further study is needed on efficacious strategies for recruitment of underrepresented populations into cancerrelated trials.

Clinical Trials, Vol. 3, No. 2, 133-141 (2006)
DOI: 10.1191/1740774506cn143oa


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