Patient's beliefs and attitudes about participating in cancer clinical trials

Background: Cancer patient beliefs can affect attitudes and subsequent willingness to participate in cancer clinical trials (CCT), according to the theory of reasoned action. Since generalizability of CCT is dependent on adequate participation, the objective of this study was to determine what attitudes patients have about CCT and how they are influenced by beliefs. Methods: A cross-sectional survey design from the Florida Cancer Data System registry was utilized (N=1,100). Behavioral beliefs (BB; beliefs about consequences of participation) and normative beliefs (NB; what participants believe others think) were examined via a telephone questionnaire. Means and standard deviations (SD) of each belief, strength of belief, and their product (“evaluation of belief” multiplied by “strength of belief”) were rated on a seven-point scale (-3 to +3). Odds ratios (OR) and 95% confidence intervals (CI) were computed for attitude and subjective norms (SN; significance individuals attribute to others' opinions) with logistic regression analyses. Results: For BB, altruistic beliefs were rated of highest importance: “helping others” [mean product: 5.36 (SD 3.55)], “benefiting future patients” [5.34 (3.79)], and “finding if the drug works” [5.34 (3.66)]. For NB, participants reported believing that their surgeon [3.37 (4.11)] and family doctor [2.80 (4.00)] would want them to participate. There was a significant relationship between: (1) BB and attitude [OR=1.25; (CI= 1.11-1.40)], and (2) NB and SN [1.25; (1.11-1.40)]. Discussion: Because altruistic beliefs and physician opinions were most important to patients, physicians should inform patients that joining CCT is philanthropic. This doctor/patient communication may result in increased willingness to participate.