Grounded Practical Theory Analysis of Patient-Provider Communication with Black Women Participating in Breast Cancer Clinical Trials

Abstract

Background:
Previous literature suggests breast cancer clinical trial participation among Black women has declined in recent years by as much as 35%. Though the literature identifies barriers to participation for this population, little has been studied about how researchers can address these barriers. This study investigates the communication between healthcare providers and Black women to reveal how providers and researchers can positively influence their perceptions of breast cancer clinical trial participation.

Methods:
Fourteen women (n=14) who self-identified as Black, Black American, or African American, were interviewed about their communication experiences with healthcare providers regarding breast cancer clinical trial participation. Each transcribed interview was coded using thematic analysis. Grounded Practical Theory was introduced to give insight into the patient-provider communication needs of Black breast cancer research participants.

Findings:
The findings fell into four categories: (1) impressions of participants toward their providers, (2) reflections on the clinical trial recruitment experience, (3) communication relationships with medical and research providers, and (4) cultural aspects of patient-provider communication. One major finding was that an important way women learn about clinical trials is through conversations with their oncologists. However, only 29% of Black women interviewed were informed of their clinical trial by a healthcare provider, suggesting that Black women may not be receiving the information they need to participate in clinical trials.

Conclusion:
By understanding existing patient-provider communication typologies, we can improve these methods of communication to increase the interest and participation of Black women in breast cancer clinical trials.

Implications:
Clinical trials provide data to healthcare providers about treatment options for breast cancer. If minoritized populations are continually underrepresented in clinical trials, these treatments might not prove to be efficacious in Black women. Researchers must make the necessary investment of resources and effort to better understand the needs of Black women in clinical trial recruitment.