Influence of social and cultural capital on participation in clinical trials among African American elders in faith-based settings in Atlanta, Georgia Open Access

Salazar, Luis (Spring 2018)

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Introduction: Under-representation of minorities particularly, elder African Americans in clinical trials (CT) remains to be a current issue in the United States (US) impeding adequate generalizability of results. Social Capital (SC) and Cultural Capital (CC) have been associated with improved health and good health outcomes. Faith-based settings (black churches) are points of gathering for elder African Americans where social support is high (SC and CC).

Goal: The purpose of the study is to understand to what extent SC and CC influence the decision-making process of participating in clinical trials among elder African Americans in faith-based settings.

Methods: Sample population consisted of 221 African American elders (over 50 years old) who attended church regularly. Secondary analysis of questionnaire-data collected after an educational session about health risks was given by the researchers at the faith-based setting. Periodic enrollment was made accessible to all participants during the study period. Three multiple logistic regression models were used to assess the relationship of outcomes with SC and CC predictors.

Results: 221 elder African Americans, mean age=64.0 (SD 7.7). 78.3% were female, 98.2% were African Americans. The outcomes where: 1. “Already being in contact with a CT” regressed with cultural capital predictors; 2. “Likelihood of contacting a CT” regressed with social capital predictors; and 3. “Likelihood of joining a CT” regressed with social capital predictors. Cultural capital predictors significantly associated with “Already being in contact with a CT”, were “attended art, music or dance classes as a child”, and “like listening to music”. SC predictors statistically associated with “Likelihood of contacting a CT” were “frequently visiting friends”; and SC predictors associated with “Likelihood of joining a CT” were “Attended frequent public meetings” and “Voted in last presidential elections”.

Conclusions: SC and CC influence the decision-making process that takes you from contacting to joining a CT, therefore, being a facilitator for participation in CTs.

Table of Contents

Table of  Contents

Chapter 1: Introduction          1

Chapter 2: Literature review  3

Social and Cultural Capital    3

Social/Cultural capital, health, and African Americans         6

Social/Cultural capital and health      6

Social/Cultural Capital and African Americans         7

Health disparities, clinical trials, and African Americans     8

Health disparities and African Americans     8

Clinical trials and African Americans            9

Faith-based organizations, Social/Cultural capital and African Americans  9

Chapter 3: Methods    11

Introduction    11

“Delivering a Dose of Hope” 11

Population and sample           12

Research design          12

Procedures      13

Instruments     13

Data analysis  14

Ethical considerations 15

Chapter 4: Results      16

Study participants      16

Multivariate Logistic Models 16

Model 1: Being in contact with Emory about a medical research study        18

Model 2: Likelihood of contacting a medical research study 18

Model 3: Likelihood of joining a medical research study      18

Chapter 5: Discussion 21

Findings          21

Conclusions    25

Chapter 6: Implications and Recommendations        26

References      27

Appendices     31

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