Barriers and facilitators to recruitment to a culturally-based dietary intervention among urban Hispanic breast cancer survivors.

Abstract

The purpose of this study was to understand factors related to recruitment to behavioral intervention trials among Spanish-speaking urban Hispanic breast cancer (BC) survivors. Potentially eligible Hispanic BC survivors were recruited from the Columbia University Breast Oncology Clinic, signed informed consent, and completed a screening interview on demographics, medical history, acculturation (Short Acculturation Scale for Hispanics), quality of life (QOL), and perceived benefits/risks of research participation. Trial eligibility criteria included stage 0-III BC, completion of adjuvant treatment, Hispanic, fluency in Spanish, willing to be randomized to active arm (9-session in-person culturally-based ¡Cocinar para su salud! dietary modification program) or control arm (written materials). We compared characteristics between eligible women who did and did not enroll in the trial. 102 women completed the screening interview and were eligible to participate. Overall mean age was 57.3 ± 9.5 years, mean time since diagnosis was 3.4 ± 2.1 years, 71% reported annual household income <$15,000 and mean acculturation index score was 1.6 ± 0.6 (scale 1-5, low-high). Of the 102 women, 70 enrolled and 32 declined participation. Reasons stated for non-participation included lack of interest in dietary change, illness, and work constraints. Compared to women who enrolled, women who did not enroll were less likely to be employed (P=0.03) and more likely to only read/speak Spanish (P=0.02). Compared to women who enrolled, non-enrollers were more likely to state that research is costly to participants (P=0.03). Lower participation was associated with unemployment, monolingualism, and the perception that research is costly to participants. Future behavioral intervention trials among minority BC survivors need to account for these and other factors that may be related to trial participation.