Abstract: An Examination of Patient-Provider Communication through Recollections of Black Breast Cancer Clinical Trial Participants

◆ Katherine E. Ridley-Merriweather, Indiana University Simon Comprehensive Cancer Center

Despite the indisputable presence of strong barriers to research participation for Black and Brown women, evidence exists that clearly supports the possibility of nearly equal levels of participation among members of minoritized populations in past breast cancer clinical trials, demonstrating that while these participation barriers do undoubtedly exist, they are not always insurmountable. The current project takes a grounded practical theory approach to engage with Black women who have been diagnosed with breast cancer and have participated in a breast cancer clinical trial and explores their recollections of conversations with their providers. The aim of this work was to investigate and analyze those patient-provider conversations to try to illuminate how providers can better engage these women in ways that will positively influence their perceptions of breast cancer clinical trial participation. The current study was part of a larger project examining the recruitment of Black women to breast cancer clinical trials. Fourteen women (N=14) from six different states in the U.S., all of whom self-identified as Black, Black American, or African American, agreed to be interviewed as part of a larger study. All participants had participated or were currently participating in a breast cancer clinical trial. The interviews yielded a wealth of interesting and potentially important additional data about Black female breast cancer patients and their communication experiences with their providers. Employing grounded practical theory as a framework helped increase insight into the patient-provider communication needs of Black women who have participated in a BC CT. Findings were summarized into four categories. The first category focused on the differing perspectives and personal impressions the participants held toward their providers. In the second category, the women reflect on their individual breast cancer journeys through richly described incidences, describing searching for and finding trials on their own, or being guided by healthcare providers who suggested a clinical trial for them. The shared details of each participant’s unique communication relationship with medical and research providers are shared in the third category. Finally, category four highlights the cultural aspects of participants’ patient-provider communication, focusing primarily on their expressions of faith. Each of these findings has important implications for health communication scholars, healthcare providers, and BC CT research PIs and team members. A major reflection of this work centers on how a majority of published explanations for low racial/ethnic minority CT presence could be interpreted as placing blame on the members of underserved populations who possess undeniably sound reasons for not participating in clinical trials of any kind. A final conclusion is the suggestion that researchers take greater strides to remove the onus of recruitment responsibility from those racialized population members, and instead leave it with the members of the healthcare industry, who hold enough power to make change.