Feasibility and Acceptability of Symptom Management Research in Black Advanced Lung Cancer Patients.

Abstract

Patients from historically marginalized racial and ethnic groups are often underrepresented in symptom management research, but little is known about how to improve inclusivity and reach of these studies. This mixed-methods study aimed to: 1) establish the feasibility and acceptability of study procedures for assessing symptoms and shared decision-making (SDM) among Black patients with advanced lung cancer; and 2) elicit participants' suggestions for improving study procedures. Black patients with advanced lung cancer were recruited from three thoracic oncology clinics. Participants completed a baseline survey (T0), optional audio-recording of a routine oncology outpatient appointment, follow-up surveys one week (T1) and one month (T2) postappointment, and a semistructured exit interview examining experiences in the study and suggestions for improving future research. At each timepoint, participants completed the Treatment Acceptability and Preferences Questionnaire (TAPQ). We approached 69 potentially eligible patients, 40 (58%) completed the eligibility screener, 35 (88%) were eligible, 30 (86%) consented, and 27 (90%) were retained through T2, exceeding our a priori thresholds of ≥70% enrollment and retention through T2. Participants rated study procedures as acceptable (TAPQ scores ≥3) in 88% of observations, exceeding our a priori threshold of ≥70%. Qualitative analysis identified three categories of themes: participants' motivation for participating, their overall experiences in the study, and recommendations for future research. Research practices common in communication, palliative, and SDM studies were acceptable to most participants. Opportunities to improve were also identified. Findings can inform best practices in conducting inclusive palliative care and communication research.