Date of Award

8-2020

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Laura L. Hayman

Second Advisor

Janice B. Foust

Third Advisor

Meghan L. Blazey

Abstract

Clinical trials are the established research mechanism designed to examine how new medical therapies are tested for safety, efficacy and effectiveness. Despite federal policy aimed at generating greater inclusivity of minorities in clinical trials, disparity in clinical trial enrollment persists. Specifically, non-Hispanic White patients still account for most clinical trial participants, including cancer clinical trials and Black patient participation has declined over the past decade. Clinical Research Nurses (CRNs) whose scope of practice includes the recruitment of participants for clinical trials, have the potential to significantly increase minority participation in cancer clinical trials. Therefore, the aim of this phenomenological study was to describe adult oncology CRNs’ lived experiences of recruiting minority cancer patients to participate in clinical trials. The Conceptual Model of Nursing and Population Health (CMNPH) guided the approach of this study and was used to help conceptualize the interview questions. A total of 19 nurses participated in semi-structured one-to-one interviews and data analysis was based on Colaizzi’s method. The themes from the interviews illustrate the CRN’s role in the recruitment of adult minority patients to cancer clinical trials. The participants described unique considerations for minority patients including a history of past research injustices, disparate access to care and provider-based implicit biases that lead to lack of enrollment in clinical trials. The role of the CRN was described an advocate who coordinates care, establishes trust and provides education for clinical trial patients within physician-driven recruitment structures. The CRN’s role was also described as self-taught or learn on the go with no formalized recruitment training and lack of robust cultural training. To achieve diverse patient enrollment in cancer clinical trials, CRNs and study staff will need to receive training on culturally competent clinical research care and the diversity of CRNs and study teams must be increased. Further, meaningful federal and hospital policy change must occur so that minority patients have equitable access to novel cancer therapies and the role of the CRN is delineated from other healthcare staff to optimize research patient care.

Comments

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