Acceptability of a narrative video intervention to promote clinical trial decision-making among Black women with breast cancer.

Abstract

e23192 Background: Black women are more likely to present with advanced stage disease and to die following a breast cancer (BC) diagnosis compared with women from other racial and ethnic groups. This persistent health inequity is in part driven by underrepresentation in clinical trials (CTs), as well as structural and social drivers of health. The overall objective of this study is to pilot-test a narrative decision aid designed to support CT decision-making among Black breast cancer patients receiving care in safety-net oncology settings. Here, we report comparative outcomes from an acceptability study conducted at two safety-net oncology practices among end-users. Methods: We conducted a pre/post-intervention survey study at two safety-net oncology centers in Chicago, Illinois. Black women with a diagnosis of BC (any stage, any point during treatment or follow-up) were identified by their oncologist and invited to participate. Consenting participants completed a pre-survey, viewed the video intervention on an electronic device, and completed a post-survey. The survey included items related to demographics, prior exposure to CTs, CT knowledge, self-efficacy, and video acceptability. We calculated descriptive statistics (mean, standard deviation) for pre- and post-intervention scores and used paired t-tests to analyze the change in scores from pre- to post-intervention. We defined prior CT exposure as self-reporting ever being invited to participate and/or participating in a CT. Results: Thirty patients participated. Across both sites, 19 patients reported prior CT exposure. Among all participants, the mean CT knowledge score numerically increased from 83.8% at baseline to 86.7% post-viewing (p = 0.4). Across 11 items assessing self-efficacy regarding decision-making about CTs, mean scores rose for all participants from 3.41 to 3.59 (p = 0.008). After viewing the video, in regards to the statement “I feel confident I can understand the information enough to be able to make a choice about participating in CTs,” self-rated efficacy scores numerically rose from 68.4% to 84.2% (p = .08) for those CT-exposed and from 45.5% to 81.8% (p = .052) for those CT non-exposed. The video was highly acceptable: 100% of participants previously exposed and 91% of participants not previously exposed indicated they were extremely or somewhat likely to share it with family or friends. Conclusions: This study demonstrated that a culturally tailored, narrative-based video intervention is acceptable to Black breast cancer patients and is associated with numerical improvements in CT knowledge as well as decision-making self-efficacy, regardless of previous CT exposure or clinic site. These findings support the feasibility of implementing such interventions across diverse safety-net oncology settings and indicate a call to further test this intervention on a larger scale.