Training Programs for Improving Communication about Medical Research and Clinical Trials: A Systematic Review

Objectives: The aim of this article is to provide recommendations on the structure, materials, and outcomes that should be adopted for communication training programs designed to improve clinical trial education for patients

Prevalence and Correlates of Invitation to Participate in Clinical Trials among US Adults

Clinical trials are essential to modern medicine, but several barriers, including poor communication, hamper their successful completion. We examined the prevalence and correlates of invitation to participate in clinical trials among a nationally-representative sample of US adults using survey responses from the 2020 HINTS (Cycle 5). Analyses were conducted in 2021. Overall, 9% of respondents reported being invited to a clinical trial, a prevalence that is nearly half of previously reported rates in convenience samples recruited from health care settings. Compared to non-Hispanic Whites, Black respondents reported the higher prevalence of invitation (16.0%) whereas Asian respondents reported the lowest (2%). Prevalence of clinical trial invitation was significantly higher for the 65–74 age and the 75 + age groups. Prevalence of invitation was significantly higher among college graduates (12.0%) and lower for those residing in rural areas/small towns compared to metropolitan areas. Invitation was significantly higher among cancer patients/survivors (16.0%), patients with diabetes (11.7%) and with chronic lung disease (16.7%). Provider and patient factors there were associated with higher invitation rates included using web devices to communicate with providers or to aid health-related discussions, having a specific medical provider, and looking for health information online. This study establishes a population-based prevalence of clinical trial communication that can be monitored as health care providers/organizations increase their focus on enrollment activities. Targeted interventions to improve communication about clinical trials are needed to address socio-demographic disparities and are particularly important for Asian patients, patients with lower income, and those living in rural areas

Mobile phone messaging to promote uptake of HIV testing among migrant African communities in the UK

Background: In the UK, African communities are a focus of public health efforts to increase uptake of HIV testing. Mobile phone interventions may be an innovative way of reaching migrant groups who are known to face multiple obstacles in accessing mainstream health services. This paper presents findings from a feasibility study that used participatory approaches to investigate the use of a text messaging intervention to encourage HIV testing among migrant African communities. Methods: Participants were recruited in the city of Nottingham by a team of community researchers. They were sent two text messages per week (one on HIV and one on general health) for 12 weeks. Baseline and follow-up questionnaires were completed to measure HIV testing behaviour, HIV related knowledge and attitudes and general health. Participants’views on the intervention were solicited. Results: One hundred and sixty-nine participants were enrolled in the study. Follow up data on HIV testing was obtained for 76 participants (45%) and complete follow up measures were available from 60 participants (36%). Eight reported seeking an HIV test during the study period. There were statistically significant positive changes in attitudes about HIV, and a trend towards increased knowledge about HIV. One third of participants reported improvements in physical activity levels, diet, and stress management following the intervention. The intervention messages and structure were positively evaluated. Conclusions: Well-designed mobile phone messaging proved to be a feasible and acceptable intervention to promote both HIV testing and lifestyle behaviours among African migrant communities in the UK. When co-constructed with communities, they hold considerable promise for overcoming some of the health-related barriers faced by migrant populations in new countries. Future research and service development should focus on exploiting and evaluating this potential in relation to other key health priorities

Assessing Communication Practice during Clinical Trial Recruitment and Consent: The Clinical Trial Communication Inventory (CTCI)

The development and evaluation of training programs with the potential to improve informed consent and accrual to clinical trials depend heavily on the ability to measure outcomes of these trainings. In this chapter, we present the development of an instrument, the clinical trial communication inventory (CTCI). Data were collected from 87 clinical research professionals at three academic medical centers, which were analyzed using factor analytic methods and reliability testing procedures. This testing resulted in eight subscales representing verbal, nonverbal, and privacy protection behaviors. While the final CTCI instrument would benefit from further validity testing, it represents a resource that can be used to evaluate future trainings of research professionals

Animated Messages for Clinical Trial Education: The Mediating Role of Cognitive Absorption on the Effect of Multimedia Communication Strategies

The ability of clinical trials and research studies to produce valid and generalizable results are harmed by low accrual rates. While there are a number of barriers which impede participation, it is important to improve potential participants’ understanding of concepts related to clinical trials to ensure informed consent or refusal. Animations were proposed as a medium to help patients to better understand and navigate clinical trials. The present study consisted of an experiment comparing several communication strategies (animations, brochures with visuals, brochure without visuals, and materials from the NIH), with several key concepts useful to understand inform consent and trial participation (placebo, randomization, patient protection, steps to enroll). The experiment was based on the principles of the Cognitive Affective Theory of Multimedia Learning, the Elaboration Likelihood Model, The Heuristic Systematic Model, and the literature on technology acceptance. Several hypotheses assessed the effects of animation on individuals’ perceptions and cognitive responses. Cognitive absorption was proposed as a mediating variable to explain the discriminant effects of animations over traditional communication strategies. A total of 1194 cancer patients’ and survivors’ responses were analyzed. Overall, all of the experimental conditions were more effective than the materials from the NIH. There are four other key findings from this research. First, lay language proved to be fundamental to improving both knowledge and attitudes toward clinical trials, regardless of the channel used. Second, animations were an effective strategy to communicate about clinical trials and medical research concepts, particularly for individuals with low motivation to process this information. Third, animations elicited more positive emotional responses in comparison with the materials from the NIH. Finally, cognitive absorption mediated the relationship between the channel used and how individuals responded to the messages. The dissertation concludes with the a discussion of the implications of these findings as well as a trajectory for future research

Formative Research to Create Culturally Sensitive HPV Vaccine Messages for Middle-School Children

HPVs (Human Papilloma Viruses) are the cause of several diseases and types of cancer, but infections can be prevented through a vaccine that children are recommended to receive when they are about 12 years of age. Communicating with children about HPV is an important albeit underdeveloped task. This is especially critical in countries such as Italy, were the HPV vaccination rate is dropping. To understand Italian middle-school children’s communication challenges, needs and preferences, and to provide evidence to inform the development of targeted and culturally-sensitive messages about HPV for them, this study adopted a multi-method participatory approach consisting of focus group discussions and participatory drawings. Results indicated that children (N = 54) wanted to be actively engaged in decisions about their health but faced several communication challenges, including adults’ language and attitude. Children struggled to retrieve reliable information on their own. They provided specific information on the sources and the strategies they would want adults to adopt. Results helped to identify positive and negative behaviours among these themes, as well as key resources to be leveraged in the development of HPV-related messages. The communication strategies identified in this study may help parents, healthcare providers, and caregivers to improve their communication with children

The art and science of engaging patients into medical research: using professional recruiters' experiences to inform physicians and scientific directors' strategic choices.

In order to advance medical care, it is necessary to invest resources, both human and financial, in medical research. However, these investments sometimes are not sufficient to ensure the success of research studies. No progress can be made without the participation of patients in research studies and clinical trials. These potential participants are normally identified by their physicians, or by professional recruiters, depending on the patient clinical profile. However, often patients are intimidated by the idea of engaging in clinical trials for several reasons, including the fear of side effects, to the difficulty of understanding specific research-related terms. The main objective of this project was to identify the communication strategies used by recruiters to help patients enroll into medical research projects. Another goal of the study was to identify key information that would help PIs and researchers make more effective decisions in terms of design and methodology. A total of 11 focus groups were conducted in two large, ethnically diverse cities: Indianapolis and Miami (USA). Our analyses indicated that recruiters use a variety of verbal and nonverbal communication strategies to create a relationship with potential participants. In addition, recruiters consider the cultural background of the people they interact with, the environment in which they live, the resources available, and the possible support of family members

The role of cognitive absorption in the persuasiveness of multimedia messages

We propose cognitive absorption as a mental state that influences the processing of multimedia messages such as animations. An experiment was designed to assess (1) whether cognitive absorption is experienced when individuals view whiteboard animations; (2) the relationship between cognitive absorption and message elaboration; (3) the relationship between cognitive absorption and outcomes such as perceived argument strength, knowledge, and attitudes related to key concepts relevant to clinical trial participation. The study involved 927 cancer patients and survivors who were exposed to either whiteboard animations or brochures. Several interesting findings emerged. First, individuals experienced greater cognitive absorption while viewing the animations than when reading brochures. Second, cognitive absorption was associated with a systematic elaboration of the information provided by the animations. Third, cognitive absorption mediated the effect the animations had on individuals’ perceived argument strength and attitudes, but not knowledge. Theoretical explanations for the educational and persuasive effects of animations are provided. •Experimental study comparing whiteboard animations and brochures providing information about clinical research.•Individuals experience cognitive absorption when watching whiteboard animations.•Cognitive absorption and individuals' processing of the information from whiteboard animations are positively correlated.•Cognitive absorption mediates perceptions of the strength of the arguments presented.•Recommendations for research on, and practice with, whiteboard animations

Animations about Clinical Trial Participation for Cancer Patients and Survivors

Communicating about clinical trials and medical research is challenging. An appropriate communication is essential to reduce some of the barriers associated with poor patients' enrollment in clinical trials and with patients' uninformed consent or uninformed refusal. An experiment was conducted to assess the effects of educational animations compared to brochures with and without visuals, and with the materials currently used by the NIH. These materials focused on explaining placebos, randomization, the steps necessary to enroll in a clinical trial, and how and by who patients' protection is ensured. A total of 1194 cancer patients and survivors completed this 4 by 4 experiment through a Qualtrics panel. The findings showed that animations improved participants knowledge about and attitudes toward clinical trials and were more effective than brochures presenting information from the NIH, especially for those individuals with low motivation and low ability to comprehend health-related information. Several evidence-based theoretical explanations of the functioning of animations are provided