Telemedicine electronic consenting preference among clinical trial participants.

Abstract

516 Background: Telemedicine (TM) disparities in the US during the pandemic are well-reported; however, its use by diverse participants providing electronic informed consent (eIC) for clinical trials in oncology remains unexplored. Our previous research found eIC comparable to in-person paper-based visits across participants: stress, technology burden, comprehension, and agency for complex clinical genetic and Phase I-II clinical trial discussions. Based on this work, we hypothesized that our implementation of eIC via TM would be well received, and we evaluated participant characteristics associated with their consent method preferences. Methods: Research participants with in-person clinic and TM eIC visits from Aug 2021- Jan 2023 received anonymous, uncompensated surveys electronically. We assessed age, sex, primary language, ethnicity, race, and 3 groups of survey questions generated from factor analysis: 1) TM usability, 2) TM satisfaction and 3) eIC process comfort (comfort using TM for eIC) (Table). A multivariable multinomial regression model evaluated associations between factors and eIC preference, a survey item assessing overall preference for eIC via TM or in-person or no preference. Results: Among 1,154 respondents (28% response rate), 52% preferred TM for eIC, 29% had no preference, and 19% preferred in-person. Respondent median age was 65; 51% were male; 97% English speaking; 6% were Hispanic; 84% White, 7.7% Asian-Far East/Indian Subcontinent, 5.3% Black, 2.6% other. Non-native English speakers (odds ratio (OR) 0.31; 95% confidence interval (CI) (0.1, 0.93), p=0.037) and Black participants (OR 0.37; 95% CI (0.16, 0.83), p=0.016) had decreased odds of preferring TM to in-person for eIC. Similarly, increased age (OR 0.98; 95% CI (0.96, 0.99), p=0.008) was associated with a decrease in no preference compared to in-person preference for eIC. Conclusions: Most participants preferred TM for eIC or had no preference. However, adjusting for eIC process comfort, TM satisfaction, and other demographics, participants who were Black, older, or non-native English speakers were more likely to prefer in-person for eIC. Our future research will target these areas to help support equitable consenting standards and care.[Table: see text]