Testing the Effect of Culturally Targeted, Normative Messaging on Black Women’s Intentions to Participate in a Breast Cancer Clinical Trial

Abstract

Despite increasing disease incidence and remarkably high mortality rates, Black women are underrepresented in breast cancer (BC) clinical trials (CTs), likely limiting the generalizability of BC research findings to Black patients. Evidence demonstrates that the BC research community could exert more effort to ensure the recruitment of Black women into CTs. Although Black and white women have similar BC incidence rates, Black women are 40% more likely than all other races and ethnicities to die of the disease. Clear disparities exist even after controlling for socioeconomic inequalities. Black participation in CTs has been declining, which is particularly unfortunate given the increasing health problem of a lack of Black representation in medical research. Successfully swelling the percentages of Black women who participate in BC research is important and likely reliant on increasing group members’ motivations to surmount existing historical, cultural, and social barriers. Guided by normative and cultural theoretical frameworks, this study examined the effects of culturally informed messaging on Black women’s intention to participate in a CT focused on BC prevention. Six hundred thirty-five Black women aged 18 and over were recruited through Qualtrics to participate in an online, posttest only, control-group design message testing study using random assignment to condition (the control or one of four injunctive-, descriptive-, and/or legacy norm-focused messages). They answered survey questions designed to measure the messages’ effects on the women’s intention to participate in the CT. The study employed univariate and multivariate logistic regression and yielded statistically nonsignificant results; none of the four hypotheses were supported. However, the findings trended overall toward having higher probability of intending to perform the behavior (overall intention M = 3.35). All conditions had means higher than three (out of a five-point scale). A practical implication is that message content is affected by the medium through which it is delivered. Theoretical implications include the importance of overlaying cultural factors onto normative theories. Given that previous successful recruitment methods to this CT for this population were grounded in research practices involving face-to-face, interpersonal interactions, future research should consider employing a multi-level approach in testing these messages.