Comparing trial communication between patients from the most and least socio-economically disadvantaged backgrounds: qualitative findings from three studies embedded in cancer-related trials

Popa, Mariana, Rousseau, Nikki, Cherry, Mary G, Jenkins, Isobel, Cloke, Jane ORCID: 0000-0001-6332-9186, Pettitt, Andrew, Jenkinson, Michael D ORCID: 0000-0003-4587-2139, Young, Bridget and Sherratt, Frances ORCID: 0000-0003-4147-9305 (2022) Comparing trial communication between patients from the most and least socio-economically disadvantaged backgrounds: qualitative findings from three studies embedded in cancer-related trials. In: 6th International Clinical Trials Methodology Conference, 2022-10-3 - 2022-10-6, Harrogate, UK.

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Abstract

Introduction Patients from socio-economically disadvantaged areas are under-represented in cancer research, yet cancer incidence and mortality are highest among patients from such backgrounds. It is crucial to address this inequality to ensure that data from trials is representative of, and generalisable to, the target population. Improving how trials are verbally communicated is an unexplored strategy to make trials more inclusive. This study aimed to establish if and how trial communication differs by patient socio-economic status. Methods Secondary analysis of data from three qualitative studies embedded in their respective cancer-related trials. We analysed 51 trial consultations from 41 patients, purposively sampled to reflect patients from the most (n=18) and least (n=23) socio-economically disadvantaged areas (determined using English Indices of Multiple Deprivation scores). Analysis drew on thematic and content approaches. Results Initially, recruiters uniformly introduced most trial concepts, such as voluntariness and standard of care. However, they provided patients from disadvantaged backgrounds with less information regarding confidentiality. Recruiters provided patients from disadvantaged backgrounds with less detail about the risks and side effects of intervention arms compared with patients from advantaged backgrounds. Patients from advantaged backgrounds asked more questions, expressed more opinions, and engaged in more talk generally. Patients from disadvantaged backgrounds expressed concerns that they were imposing on recruiters and taking up too much of their time. Conclusion Patients require sufficient information to make an informed decision about participating in a trial. Our findings suggest that recruiters adapt trial communication in response to how active the patient is in trial discussions, which we found to differ between patients from the least and most socio-economically disadvantaged backgrounds. This resulted in patients from disadvantaged backgrounds having less in-depth discussions about the trials than patients from advantaged backgrounds. Future research with patients and recruiters should explore the underlying reasons for the identified differences in trial communication by socio-economic status. The findings can be used to inform future strategies to enhance trial communication with patients from socio-economically disadvantaged backgrounds, to help recruiters to conduct research that better reflects the populations they serve.

Item Type:	Conference or Workshop Item (Unspecified)
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	17 Nov 2022 09:44
Last Modified:	18 Jan 2023 19:43
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3166253