Mp34-15 the Association Between Individual and Population-Level Social Determinants of Health and Clinical Trials Awareness: A Hints-Seer Analysis

You have accessJournal of UrologyDiversity, Equity & Inclusion: Health Equity & Outcomes II (MP34)1 May 2024MP34-15 THE ASSOCIATION BETWEEN INDIVIDUAL AND POPULATION-LEVEL SOCIAL DETERMINANTS OF HEALTH AND CLINICAL TRIALS AWARENESS: A HINTS-SEER ANALYSIS Rishi Sekar, Lindsey Herrel, Kristian Stensland, and Avinash Maganty Rishi SekarRishi Sekar , Lindsey HerrelLindsey Herrel , Kristian StenslandKristian Stensland , and Avinash MagantyAvinash Maganty View All Author Informationhttps://doi.org/10.1097/01.JU.0001008876.78012.90.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Individual-level social determinants of health (race, ethnicity, socioeconomic status, etc.) have been identified as key drivers of disparities in clinical trials participation, however the dynamic between these factors and attributes of the community, or population-level SDOH, remain unknown. Elucidating the relationship between individual and population-level SDOH may guide further efforts to improve representation and equity in cancer clinical trials. For these reasons, we evaluate the association between individual and population-level SDOH and clinical trial awareness and participation. METHODS: We performed a cross-sectional analysis of the 2021 Health Information National Trends – Surveillance, Epidemiology, and End Results (HINTS-SEER), a nationally representative survey of cancer survivors, identifying a subpopulation of patients with urologic cancers. The primary outcomes of interest included awareness of clinical trial ("Has a doctor or other member of your medical team discussed clinical trials as a possible treatment option for your cancer?"). Independent variables included a population-level measure of SDOH, the Centers for Disease Control and Prevention Social Vulnerability Index (SVI), and individual-level measures of SDOH including age, sex, race/ethnicity, income-level, and education-level derived from the survey. Cancer stage was also included as an independent variable. Survey-weighted multivariable logistic regression analyses were performed to test the association between individual and population-level SDOH and clinical trial awareness. RESULTS: We identified 348 patients with urologic cancers (282 prostate, 41 kidney, and 25 bladder), representing a population of approximately 100,000. On survey weighted analysis, 12.1% of patients were aware of clinical trials. On multivariable logistic regression, the most socially vulnerable patients had significantly lower odds of clinical trials awareness (OR 0.12, CI 0.02 – 0.85) compared to the least socially vulnerable patients, with a dose-effect with increasing SVI. No individual-level measures of SDOH (age, sex, race/gender, education, and income) were significantly associated with clinical trial awareness, even in a model excluding SVI. CONCLUSIONS: Rates of clinical trial awareness among patients with urologic cancers is concerningly low. Notably, population-level SDOH was strongly influential, independent of individual-level SODH. These findings suggest that disparities in clinical trials awareness are driven by community-level factors, and initiatives for equity-driven expansion of clinical trial opportunities and infrastructure in these socially vulnerable communities may be an impactful strategy towards equitable representation in cancer clinical trials. Source of Funding: Rishi Sekar received research support from the National Cancer Institute institutional training grant T32-CA-236621 and a Bladder Cancer Advocacy Network Young Investigator Award © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e576 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rishi Sekar More articles by this author Lindsey Herrel More articles by this author Kristian Stensland More articles by this author Avinash Maganty More articles by this author Expand All Advertisement PDF downloadLoading ...