ABSTRACT
Background: Minority and older adult patients remain underrepresented in cancer clinical trials (CCTs). The current study sought to examine sociodemographic inequities in CCT interest, eligibility, enrollment, decline motivation, and attrition across two psychosocial CCTs for gynecologic, gastrointestinal, and thoracic cancers. Methods: Patients were approached for recruitment to one of two interventions: (1) a randomized control trial (RCT) examining effects of a cognitive-behavioral intervention targeting sleep, pain, mood, cytokines, and cortisol following surgery, or (2) a yoga intervention to determine its feasibility, acceptability, and effects on mitigating distress. Prospective RCT participants were queried about interest and screened for eligibility. All eligible patients across trials were offered enrollment. Patients who declined yoga intervention enrollment provided reasons for decline. Sociodemographic predictors of enrollment decisions and attrition were explored. Results: No sociodemographic differences in RCT interest were observed, and older patients were more likely to be ineligible. Eligible Hispanic patients across trials were significantly more likely to enroll than non-Hispanic patients. Sociodemographic factors predicted differences in decline motivation. In one trial, individuals originating from more urban areas were more likely to prematurely discontinue participation. Discussion: These results corroborate evidence of no significant differences in CCT interest across minority groups, with older adults less likely to fulfill eligibility criteria. While absolute Hispanic enrollment was modest, Hispanic patients were more likely to enroll relative to non-Hispanic patients. Additional sociodemographic trends were noted in decline motivation and geographical prediction of attrition. Further investigation is necessary to better understand inequities, barriers, and best recruitment practices for representative CCTs.
ABSTRACT
Health-related quality of life (HQoL) is increasingly used as a measure of population health. The utility of HQoL lies in its ability to capture the subjectivity and totality of health-HQoL is an individual's subjective assessment of their physical, psychological, and social functioning. HQoL disparities exist in the United States, with some groups (e.g., individuals of low socioeconomic status [SES]) experiencing disproportionately low rates of HQoL, though little is known about the impact of perceived SES (PSES) on HQoL. Research is needed in order to (a) investigate the relationship of PSES on HQoL and (b) understand the mechanisms that may mitigate the adverse impact of PSES on HQoL. Therefore, the present study seeks to understand the role of resilience as a mediator in the relationship between PSES and HQoL among a sample (N = 284) of U.S. urban adults. Results from the present study indicate that resilience significantly mediates the relationship between PSES and physical and mental HQoL. The results of the present study have implications for researchers interested in behavioral health promotion interventions among individuals of low PSES. Resilience, a modifiable psychological variable, may be able to mitigate the adverse impact of PSES on HQoL and thus play a role in reducing HQoL disparities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Subject(s)
Quality of Life , Social Class , Adult , Humans , Surveys and QuestionnairesABSTRACT
Sleep disturbances in children with autism spectrum disorder (ASD) are significantly more prevalent than found in typically developing (TD) children. Given the detrimental impact of poor sleep on cognitive, emotional, and behavioral functioning, it is imperative to screen and assess for sleep disturbances in this population. In this paper, we describe the screening and assessment process, as well as specific measures commonly used for assessing sleep in children with ASD. Advantages and limitations for use in children with ASD are discussed. While subjective measures, such as parent-report questionnaires and sleep diaries, are the most widely used, more objective measures such as actigraphy, polysomnography, and videosomnography provide additional valuable information for both diagnostic purposes and treatment planning. These objective measures, nonetheless, are limited by cost, availability, and feasibility of use with children with ASD. The current review provides an argument for the complementary uses of both subjective and objective measures of sleep specifically for use in children with ASD.
