Barriers to participation in clinical trials of rural older adult cancer survivors: A qualitative study

Authors

Evelyn Arana-Chicas, Division of Medical Oncology, Rutgers Cancer Institute of NJ, Rutgers University, New Brunswick, New Jersey, USA.
Laura M. Prisco, Geriatric Oncology Research Group, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Saloni Sharma, Geriatric Oncology Research Group, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Fiona Stauffer, Geriatric Oncology Research Group, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Serge Dauphin, Arnot Medical Center, Rochester, New York, USA.
Makiko Ban-Hoefen, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Jaime Navarette, Rochester Regional HealthFollow
Jason Zittel, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Ana Paula Cupertino, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Allison Magnuson, Geriatric Oncology Research Group, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Karen M. Mustian, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Supriya G. Mohile, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.

Department

Oncology and Hematology

Document Type

Article

Publication Title

The Journal of Rural Health

Abstract

Background: Currently, 64% of cancer survivors are aged 65+. Older cancer survivors have unique complications after chemotherapy and are often excluded from cancer clinical trials. Although there is research on barriers to clinical trial participation of older adult cancer survivors, to date no research has explored barriers to clinical trial participation unique to rural older adult cancer survivors.

Methods: This study is a secondary qualitative analysis from a study exploring survivorship challenges of rural older adults. Eligible participants were rural residents over age 65 who have completed curative-intent chemotherapy in the past 12 months. Participants (n = 27) completed open-ended semi-structured interviews that included questions on barriers to clinical trial participation. Transcripts were coded independently by two coders using thematic analysis. We have adhered to the standards for reporting qualitative research.

Findings: Participants reported a variety of barriers that included limited knowledge and fear about clinical trials, transportation challenges, their physicians not informing them of clinical trials, and thinking they are too old to participate in clinical trials. However, participants also reported facilitators to participating in clinical trials, including acknowledging benefits to their own health and society, and understanding the importance of clinical trials.

Conclusion: Rural older cancer survivors face numerous interpersonal, intrapersonal, and organizational barriers to clinical trial participation. Aging- and location-sensitive interventions that focus on patients, their caregivers, and health care providers may lead to improved participation of rural older adult survivors into clinical trials.

First Page

e12852

DOI

10.1111/jrh.12852

Volume

41

Issue

1

Publication Date

1-1-2025

Medical Subject Headings

Humans; Aged; Qualitative Research; Female; Male; Cancer Survivors (psychology, statistics & numerical data); Rural Population (statistics & numerical data); Clinical Trials as Topic; Aged, 80 and over; Patient Participation (psychology, statistics & numerical data, methods); Neoplasms (therapy, psychology); Interviews as Topic (methods)

PubMed ID

38847392

Recommended Citation

Arana-Chicas, E., Prisco, L. M., Sharma, S., Stauffer, F., Dauphin, S., Ban-Hoefen, M., Navarette, J., Zittel, J., Cupertino, A. P., Magnuson, A., Mustian, K. M., & Mohile, S. G. (2025). Barriers to participation in clinical trials of rural older adult cancer survivors: A qualitative study. The Journal of Rural Health, 41 (1), e12852. https://doi.org/10.1111/jrh.12852