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Impact of Race Versus Education and Race Versus Income on Patients’ Motivation to Participate in Clinical Trials

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Abstract

Our study investigates whether levels of motivation and barriers to participation in clinical trials vary with patients’ education and income. A self-administered survey asked outpatients to rank potential influential factors on a “0” to “4” significance scale for their motivation to participate in clinical trials. Principal component analysis (PCA), analysis of variance (ANOVA), Kruskal-Wallis, and Mann-Whitney U tests analyzed the impact of race, education, and income on their motivation to participate. Analysis included 1841 surveys; most respondents had a high school education or some college, and listed annual income < $30,000. There was a significant interaction between race and income on our motivation scale 1 scores (p = .0261). Compared with their counterparts, subjects with less education/lower income ranked monetary compensation (p = .0420 and p < .0001, respectively) as a higher motivator. Minorities and patients with less education and lower income appear to be more influenced by their desire to please the doctor, the race and sex of the doctor, and the language spoken by the doctor being the same as theirs. For all races, education appeared to have a direct relationship with motivation to participate, except for African-Americans, whose motivation appeared to decline with more education. Income appeared to have an inverse relationship with motivation to participate for all races.

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Acknowledgements

We acknowledge Tyler Adams, BS for figure development as well as Micaela Wilson, BA and Manuel Colón, BS for editing and formatting material for this manuscript. We also thank Matthew Meyers, BS for his help with data entry and maintenance of the database.

Funding

This study was supported by an unrestricted research grant funding from a non-philanthropic trust, the Anne and Carl Anderson Trust.

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Authors and Affiliations

  1. Lehigh Valley Health Network, Cedar Crest Boulevard and I-78, Allentown, PA, 18103, USA

    Anita Kurt, Hope Kincaid, Lauren Semler, Jeanne L. Jacoby, Melanie B. Johnson, Beth A. Careyva, Brian Stello, Timothy Friel, John C. Smulian & Mark C. Knouse

  2. LVHN-Muhlenberg, Emergency Medicine Research, 4th Floor, South Wing, 2545 Schoenersville Road, Bethlehem, PA, 18107, USA

    Anita Kurt

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  1. Anita Kurt
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Correspondence to Anita Kurt.

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All persons listed as authors meet the criteria for authorship established by the ICMJE and take responsibility for the article’s content.

Ethical Approval

All procedures performed in this study involving human subjects were in accordance with the ethical standards of the IRB and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

This anonymous and voluntary survey study was IRB-approved as “exempt;” therefore, an alteration of informed consent was granted.

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Kurt, A., Kincaid, H., Semler, L. et al. Impact of Race Versus Education and Race Versus Income on Patients’ Motivation to Participate in Clinical Trials. J. Racial and Ethnic Health Disparities 5, 1042–1051 (2018). https://doi.org/10.1007/s40615-017-0452-z

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