Review A systematic review of the factors influencing African Americans' participation in cancer clinical trials Desiree Rivers a, ⁎, Euna M. August b, d , Ivana Sehovic b , B. Lee Green a, b , Gwendolyn P. Quinn b, c a Center for Equal Health, 12901 Bruce B Downs Blvd., MDC 13, Tampa, FL 33612, USA b Moffitt Cancer Center & Research Institute, Health Outcomes & Behavior, 12902 Magnolia Drive, Tampa, FL 33612, USA c University of South Florida, College of Medicine, Department of Oncologic Science, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, USA d University of South Florida, College of Public Health, Department of Community & Family Health, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA article info abstract Article history: Received 12 December 2012 Received in revised form 8 March 2013 Accepted 22 March 2013 Available online 1 April 2013 Objective: This systematic review was conducted to synthesize the existing evidence regarding key considerations influencing African Americans' participation in cancer clinical trials (CCTs). Methods: The PubMed and PsycINFO databases were searched to identify peer-reviewed publications during the last decade (2002–2011) that met our inclusionary criteria. Our search utilized Boolean combinations of the following terms: “clinical trial”; “cancer”; “neoplasm”; “African American”; “Black”; “caregiver”; “decision making”; “recruitment”; “companion”; “family”; “significant other”; and “social support”. Results: A total of 267 articles were identified in the database searches. Of these articles, a total of 31 were determined to meet the inclusion criteria and were retained for review. Key issues that emerged as impediments to a successful recruitment of African Americans to CCTs included negative attitudes towards clinical trials, low levels of knowledge and awareness regarding CCTs, religious beliefs, and structural barriers, such as transportation, childcare, and access to health care. Recommendations from physicians, family members, and friends may promote CCT participation. Multimedia, and culturally-appropriate recruitment approaches may also be effective in soliciting participation among African Americans. Conclusion: Existing research underscores the importance of social support from family and friends, cultural appropriateness and sensitivity from physicians and in the design of the CCT, and enhanced education among African Americans in decision-making processes. As African Americans are underrepresented in CCTs, targeted strategies to enhance recruitment efforts and improve cancer treatment outcomes are essential. Published by Elsevier Inc. Keywords: Cancer clinical trials Recruitment Blacks African Americans Social support Education Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2. Material and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2.1. Search strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2.2. Data abstraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Contemporary Clinical Trials 35 (2013) 13–32 Abbreviations: CCT, cancer clinical trial; AA, African American ⁎ Corresponding author at: Center for Equal Health, 12901 Bruce B Downs Blvd., MDC 13, Tampa, FL 33612-4799, USA. Tel.: +1 813 974 2140; fax: +1 813 974 6295. E-mail address: drivers@health.usf.edu (D. Rivers). 1551-7144/$ – see front matter. Published by Elsevier Inc. http://dx.doi.org/10.1016/j.cct.2013.03.007 Contents lists available at SciVerse ScienceDirect Contemporary Clinical Trials journal homepage: www.elsevier.com/locate/conclintrial