Assessing feasibility and utility of an implicit bias training program for addressing disparities in cancer clinical trial participation.

Authors

null

Nadine Barrett

Office of Health Equity and Disparities, Duke Cancer Institute, Duke University, Durham, NC

Nadine Barrett , Leigh Boehmer , Janelle Schrag , Al Bowen Benson III, Sybil Green , Leila Hamroun , Alexandra Howson , Khalid Matin , Randall A. Oyer , Lori J. Pierce , Sanford Earl Jeames , Karen Marie Winkfield , Eddy Shih-Hsin Yang , Victoria Zwicker , Suanna Steeby Bruinooge , Patricia A. Hurley , Jen Hanley Hanley Williams , Carmen Guerra

Organizations

Office of Health Equity and Disparities, Duke Cancer Institute, Duke University, Durham, NC, Association of Community Cancer Centers, Rockville, MD, Northwestern Medicine, Chicago, IL, ASCO, Alexandria, VA, Oncology Patient Advocates for Clinical Trials - Christiana Care Health System, Newark, DE, Thistle Editorial, LLC, Snoqualmie, WA, VCU/Massey Cancer Center, Richmond, VA, Ann B. Barshinger Cancer Institute, Penn Medicine at Lancaster General Health, Lancaster, PA, University of Michigan, Ann Arbor, MI, Huston Tillotson University, Austin, TX, Meharry-Vanderbilt Alliance, Nashville, TN, University of Alabama at Birmingham, Birmingham, AL, American Society of Clinical Oncology, Alexandria, VA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

Research Funding

Conquer Cancer Foundation of the American Society of Clinical Oncology

Background: Low participation of Black, Hispanic, Latinx and other underrepresented racial/ethnic groups in clinical research remains a problem across the U.S. Recent studies have highlighted that stereotypes, assumptions, and bias play a role in lack of diversity in cancer trial participation. To help address this, the Association of Community Cancer Centers (ACCC) and American Society of Clinical Oncology (ASCO) piloted an implicit bias training program for clinical research teams. Methods: Adapted from the Duke University Just Ask™ program, the pilot program is comprised of eLearning modules which can be completed in about 60 minutes. Features include education on diversity, equity, and bias in clinical trial participation, case vignettes, and strategies to mitigate disparities. A call was issued to members of both organizations. After completing the training, all individual participants were asked to complete a retrospective pre/post survey to assess change in knowledge and attitude. Focus groups explored participants’ experience with the training. Another survey was administered 6 weeks later to assess sustainability of changes. Results: Research teams from 50 programs were selected for the pilot. 129 individuals consented, and 126 completed the training and evaluations (98% response rate). 48% of participants reported that they had completed training on implicit bias and/or related topics prior to the pilot. Increased levels of knowledge were reported across all key training concepts, with an average % increase from 19% to 45%. Similar increases were observed for strategies for addressing implicit bias, with an average % increase from 10% to 31%. At 6 weeks post-training, there was a slight decrease in knowledge across most items, from -1% to -8%. Most (92%) participants reported satisfaction with the course, and most (92%) indicated they would recommend it to a colleague and would recommend implementing it at their program. Suggestions to improve the course included streamlining content and providing additional tools and resources. Conclusions: Pilot findings support the feasibility and utility of the training, which can help cancer programs to address disparities in clinical research. Next steps include modifying the course based on participant feedback, disseminating the training and supplementary resources, and exploring options for assessing the impact on upstream outcomes such as diversity in trial participation.

Participant pre/post-training knowledge on key concepts.

Key Concept
Mean Score Pre*
Mean Score Post*
Average % Change
Factors that result in lack of diversity in research
3.5
4.5
30%
Diversity and equity in health
3.6
4.5
26%
Difference between equity and equality
3.2
4.6
45%
Causes of health disparities
3.7
4.4
19%
How power dynamics shape interactions
3.5
4.2
21%

* Likert Scale (1 = none, 5 = excellent)

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Access to Care

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e18599)

DOI

10.1200/JCO.2022.40.16_suppl.e18599

Abstract #

e18599

Abstract Disclosures

Funded by Conquer Cancer

Similar Abstracts

Abstract

2022 ASCO Quality Care Symposium

Racial and ethnic disparities in the cervical cancer screening cascade in three U.S. health care settings.

First Author: Jennifer C. Spencer

First Author: Alyssa Pereslete