Cancer trials participation risk and numeracy
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Cancer Trials Participation, Risk and Numeracy. Donna L. LaVallie, DO, MPH Acting Instructor, Medical Education and Biomedical Informatics University of Washington March 12, 2007. Overview. Topic significance Projects Review Elders 2006 Ft. Peck Elders 2007

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Cancer Trials Participation, Risk and Numeracy

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Cancer trials participation risk and numeracy

Cancer Trials Participation, Risk and Numeracy

Donna L. LaVallie, DO, MPH

Acting Instructor, Medical Education and Biomedical Informatics

University of Washington

March 12, 2007


Overview

Overview

  • Topic significance

  • Projects Review

    • Elders 2006

    • Ft. Peck

    • Elders 2007

    • Northwest Indian College/Lummi

  • Summary


Topic significance

Topic Significance

  • Disproportionate cancer burden, cancer trial under representation for ethnic minorities

  • Risk information commonly encountered--- Understood?


Risk statements of chance

“Risk” : statements of chance

  • “Medication XX lowers your cholesterol by 30%”

  • “Smokers are 10 times more likely to develop lung cancer”.

  • “Your chance of developing breast cancer in the next 10 years is 0.4%”.


Numeracy

Numeracy

  • Numeracy: “ability to handle basic probability and numerical concepts”

  • Numeracy skills—strong influence in accurately assessing risk

  • Inadequate numeracy skills not uncommon—found to be common among “educated” segments of population


Cancer trials participation risk and numeracy

NWIC, Lummi

Visual, narrative risk; Numeracy

Randomization

Tailoring visual

Younger population

Trials participation

Numeracy

Visual, narrative risk

Numeracy

Randomization

Elders 2007

Elders 2006

Visual, narrative risk

Numeracy

Adult population

Ft. Peck 2006


Elders survey 2006

Elders survey 2006

  • “Cancer trials participation and numeracy”

  • Factors influencing participation in cancer trial: 38 questions

  • Numeracy: 6 questions

  • Demographics


Elders 2006 promoters to participation

Elders 2006: promoters to participation

  • Lead researcher of Native descent

  • Study physician experienced in working with American Indians/Alaska Natives

  • Personal experience with cancer being studied

  • Family support for participation

  • Belief/hope study leads to new Rx


Elders 2006 barriers to participation

Elders 2006: barriers to participation

  • Distance from study site

  • High risk for breach of confidentiality


Ft peck survey 2006

Ft. Peck survey 2006

  • T32 collaboration—medical student research program

  • Anonymous survey, 25 questions, 4 versions

  • Textual/narrative vs visual risk information

  • Numeracy/risk questions


Visual risk image

Visual Risk Image


Visual risk image1

Visual Risk Image

do not develop cancer

develop cancer


Ft peck survey 2006 results

Ft. Peck survey 2006: results

  • 209 completed surveys

  • Odds of correct answer significantly increased for those who received risk information in a textual/narrative PLUS visual format as opposed to textual/narrative ONLY

  • OR=2.7, CI=1.6-4.5


Elders survey 2007

Elders survey 2007

  • “Cancer risk perceptions and understanding of visual risk information”

  • 6 survey versions, 30 questions

  • Visual vs narrative risk information

  • Attitudes to randomization

  • Numeracy/risk questions


Elders survey 2007 results

Elders survey 2007: results

  • 84 surveys completed

  • Analysis, results pending


Northwest indian college lummi 2007

Northwest Indian College, Lummi 2007

  • Examine several facets relating to participation in biomedical research

  • Anonymous survey, registration

  • Main campus, 6 distance sites

  • Focus groups


Northwest indian college lummi 20071

Northwest Indian College, Lummi 2007

  • Strongest predictors of willingness to participate in cancer trial

  • Attitudes to randomization

  • Textual vs visual risk information

  • Focus group input for “visual”


Conclusions

Conclusions

  • Need to increase American Indian/Alaska Natives’ participation in cancer trials

  • We need to LEARN HOW to present risk information


Future

Future ?

  • Designing health promotion, disease prevention materials that incorporate “user friendly” risk information

  • Partnerships with Native communities

  • Culturally competent research professionals


Thank you for your attention

THANK YOU FOR YOUR ATTENTION


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