The effects of knowledge, attitudes, and significant others on decisions to enroll in a clinical trial on osteoporosis: Implications for recruitment of older African-American women

This preliminary study explored the roles of knowledge, attitudes, and sign ificant others on decisions of older African-American women to enroll in a clinical trial involving estrogen and osteoporosis. Sixteen older African-A merican women (average age 75 years) participated in three focus groups. Tw elve of the women had enrolled in the clinical trial and four, although eli gible, refused to enroll, Discussions revealed that knowledge of osteoporos is and estrogen and expectations of personal rewards and group benefits fro m medical research appear to differentiate the women who participated in th e clinical trial from those who refused. The women who participated also pe rceived the research institution as accessible. In addition, assuring full disclosure of testing procedures and test results eased their apprehensions about participation. However, the women who refused to enroll saw no perso nal benefit and were unwilling to expose themselves, in part because of the ir age, to the risks of taking estrogen and the uncertain outcomes of the c linical trial. The study illustrates how focus groups can be used to develo p multiple strategies to enable recruitment of older African-American women with different demographic characteristics, levels of knowledge, and attit udes toward a disease and medical research.