Relationships among Functional Ability, Social Interaction, and Transportation that Predict Clinical Research Participation among Church-going African American Seniors Open Access

Abstract

Black/African American seniors experience disproportionately higher incidence of morbidity and mortality related to chronic diseases. They also have reduced access to health care and lower rates of early treatment. Clinical trials benefit black seniors by validating the efficacy of interventions for their population as well as provide individual-level advantages by acting as an alternative access point to health care. Currently, black seniors are significantly underrepresented in clinical research compared to white seniors. This study examined individual and interpersonal levels of the social ecological model, including sociodemographics, functional impairment, and social support to determine which factors influenced the likelihood of joining a clinical trial in the next six months among a sample of black church-going adults over the age of 50. Results from multiple logistic regression models demonstrated that higher degrees of three components of functional impairment, Basic Abilities, Errand Transportation, and Social Abilities were associated with lower likelihood of joining a clinical trial. An interaction between age and Crisis Support was also significant indicating that older adults with higher levels of crisis support were more likely to join clinical trials. Implications for these results indicate that clinical trials should consider the basic abilities and disabilities of their potential participants in recruitment and enrollment efforts and should utilize novel venues such as nursing homes, hospitals, and other senior communities to access this population. In addition, special attention should be paid to adults over 65 as they may require more intensive support from their peers in order to participate in trials.

Table of Contents

Table of Contents

Introduction 1
Problem Definition and Justification 1
Theoretical Framework 2
Research Question 5
Literature Review 7
Racial Health Disparities 7
Racial Disparities in Morbidity and Disability among Seniors 8
Health Outcomes of Seniors with Disabilities 10
The Role of Clinical Trials 11
Benefits of Social Support 13
Social Support in the Black Church 14
Methods 17
"Delivering a Dose of Hope" 17
Study Procedures 18
Participants 20
Measures 21
Analysis 24
Results 26
Participants 26
Descriptives 28
Church Differences 30
Correlations 32
Logistic Models 34
Discussion 36
Findings 36
Conclusions 38
Strengths 39
Limitations 40
Implications and Recommendations 41
Appendices 43
Appendix A: Functional Impairment Instrument 43
Appendix B: Social Support Instrument 45
References 47

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	seniors social support disability Black church clinical trials elderly social ecological model African American functional impairment
Committee Chair / Thesis Advisor	Frew, Paula, Emory University
Committee Members	Parker, Kimberly, Texas Woman's University
Partnering Agencies	Religious-based organization Emory University schools, faculty or affiliated programs

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