FACTORS RELATED TO ENROLLMENT IN THE BREAST-CANCER PREVENTION TRIAL AT A COMPREHENSIVE CANCER CENTER DURING THE FIRST YEAR OF RECRUITMENT

Background. Using an a priori theoretic model of behavior change, fact ors predicting enrollment in a randomized chemoprevention trial during the first year of recruitment were assessed prospectively. Methods. E ligible participants were asked to complete a 90-item semistructured q uestionnaire after attendance at an informational meeting. Components of the Health Belief Model (including perceived susceptibility, percei ved severity, perceived benefits and barriers, cues to action, and hea lth motivation), health status, preventive health behaviors, and socia l influence were assessed in relation to enrollment. Results. Overall, 331 women attended one of the meetings, and 73% completed a questionn aire; 45% enrolled on the trial and 55% did not. In bivariate analyses , all but one of the perceived barriers were associated negatively wit h enrollment; however, items assessing perceived susceptibility, perce ived severity, and perceived benefits were not. Nonparticipants also w ere more likely to be over 49 years of age, to be currently or to have been on estrogen replacement therapy, and to have had hot flashes, In logistic regression analysis, not being able to take estrogen replace ment therapy was the strongest predictor of nonparticipation (odds rat io [OR], 12.13, 95% confidence interval [CI], 3.63, 40.60). Other fact ors associated with nonparticipation were concern about side effects o f tamoxifen (OR, 5.06; CI, 2.37, 10.80); the possibility of getting a placebo (OR, 7.75; CI, 1.51, 39.67); the costs associated with the tri al (OR, 3.21; CI, 1.12, 9.24); and absence of concern that significant others would be reassured if the respondent was taking tamoxifen (OR, 2.58; CI, 1.04, 6.41). Conclusions. These findings support the view t hat recruitment efforts for chemoprevention trials should address barr iers specific to their circumstances, In addition, increasing the supp ort available from personal social networks may enhance recruitment to chemoprevention trials for breast cancer.