Washington Week: Student Voices (O)

Clinical trials lacking in minority participants
By Joe Weagraff
The Lantern (Ohio State U.)
03/06/2006

(U-WIRE) COLUMBUS, Ohio — The clinical trials of today result in the medicines of tomorrow.

Persuading blacks and other minorities to participate in the trials, however, is a challenge. This troubles many researchers who know minorities must be included in trials to achieve effective cures that serve all members of the population.

Blacks have the highest cancer-death rates overall, according to the National Cancer Institute.

Research has shown individuals from underserved communities are more likely to be diagnosed and die from preventable cancers, be diagnosed with late-stage diseases, receive no or inadequate treatment, and suffer from terminal cancers with no pain-management options.

William Hicks, oncologist, professor of clinical medicine, and co-director of the Diversity Enhancement Program at the Arthur G. James Cancer Hospital and Richard J. Solove Institute, is troubled by this problem.

The National Cancer Institute awarded his team of researchers, doctors, nurses and participants a two-year, $1.8 million grant to study ways to overcome barriers in early clinical trials, according to the Ohio State University Comprehensive Cancer Center.

But the medical field is having problems getting blacks and other minorities to participate in clinical trials, Hicks said.

"One has to really look at it from a standpoint of how urban areas evolve," he said.

Even though all Americans share many of the same genes, they are expressed in different ways because of diverse cultures, Hicks said.

"Some of us have more access to quality care than others, some make choices based on thoughtful decisions and logic and some don't have the ability to make these choices," he said.

This is why every minority group needs to participate in clinical research trials.

"African-Americans have been not trusting of the medical community," he said, possibly because of mistreatment of test subjects in the early part of the 20th century.

"People being experimented on in our country without their consent happened too often," he said.

Chasity Washington, program manager for the Diversity Enhancement Program at the James Cancer Hospital, said the group is willing to help people who may be wary.

"Basically, we are enablers in assisting minorities when it comes to minorities participating in clinical trials," she said.

Washington trains the staff who conduct clinical trials to understand minorities' hesitation and obstacles.

"We make sure that the staff is culturally sensitive," she said. The staff is also prepared to deal with any cultural barriers that may arise, such as language.

The diversity enhancement program contains three tiers, Hicks said.

"Think of the Diversity Enhancement Program as a way to increase participation, increase diversity and increase awareness," he said.

Prevention is a key component of the program — one that Barbara Beckwith knows well.

Beckwith is a member of the Diversity Enhancement Program's specific outreach program Grandma's Hands. She has been active in the community for seven years and was diagnosed with cancer 12 years ago. After her treatment, the Diversity Enhancement Program asked her to be an educator.

The group is a grassroots campaign with the goal of educating women about the benefits and need for blacks to participate in clinical trials.

"I am one of the grandmas, and I go out in the community to women over 50-years-old and share information with them about clinical trials," she said. "In the African-American communities, the grandmas have traditionally been the storytellers."

Beckwith encourages minorities to participate in the trials early on, so if they are ever diagnosed with cancer, they are not hearing about treatment options for the first time.

"Most clinical trials have had problems with recruiting African-Americans and other minorities; I think it has been because they haven't had people in their community talking about the trials," she said.

She draws women to informational meetings by arranging photo-collage-making sessions, or brings a group together by sharing recipes.

Beckwith, a former smoker, now participates in national lung trials across the state, along with many other trials because she likes the fact that in addition to helping research efforts, her health is being screened.

"The fact that I am a breast-cancer survivor and just being able to tell my story causes people to listen because I am robust, very well, and I look healthy," she said.

Overall, Washington said the Diversity Enhancement Program is going quite well. It has been fully staffed for 3 years and has researched about 15,000 people around the state.

Hicks is confident the program is going well, and said they will continue to study ways to overcome barriers when doing clinical trials.

"Without clinical trials, no progress in medicine would be made," he said.

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