• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jnmaLink to Publisher's site
J Natl Med Assoc. Jul 2002; 94(7): 609–618.
PMCID: PMC2594312

Participation of African Americans in a smoking cessation trial: a quantitative and qualitative study.


African Americans (AAs) have been considered a hard to reach research population. In a clinical trial of bupropion for smoking cessation, failure to return for randomization was concerning during the initial phase of recruitment. There were three study goals: to review the research on clinical trial participation barriers, to use quantitative analyses to identify differences between randomized (n = 66) and non-randomized (n = 54) participants, and to use focus groups and interviews (2 groups and 2 interviews, 17 participants) to elicit participation barriers and suggestions for participation enhancement. Randomized participants were older (44.1 vs. 37.6; p = 0.0019), predominately female (81.8% vs. 63.0%; p = 0.0201), more likely to have some college (33.3% vs. 16.7%; p = 0.0380), and less likely to be employed full time (32.4% vs. 53.7%; p = 0.0347). Randomized participants reported higher motivation to quit smoking (8.3 vs. 7.3; p = 0.0083) and higher confidence to quit (8.2 vs. 7.3; p = 0.0357). A logistic regression model specified age, gender, and motivation to quit, as predictors of randomization. Focus groups identified transportation, lack of readiness to quit, inadequate reminders, and employment conflicts as barriers to participation. Knowledge of differences between those who return for enrollment and those who do not may be used to increase AA enrollment in clinical trials.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Roberson NL. Clinical trial participation. Viewpoints from racial/ethnic groups. Cancer. 1994 Nov 1;74(9 Suppl):2687–2691. [PubMed]
  • Holcombe RF, Jacobson J, Li A, Moinpour CM. Inclusion of black Americans in oncology clinical trials: the Louisiana State University Medical Center experience. Am J Clin Oncol. 1999 Feb;22(1):18–21. [PubMed]
  • Swanson GM, Ward AJ. Recruiting minorities into clinical trials: toward a participant-friendly system. J Natl Cancer Inst. 1995 Dec 6;87(23):1747–1759. [PubMed]
  • el-Sadr W, Capps L. The challenge of minority recruitment in clinical trials for AIDS. JAMA. 1992 Feb 19;267(7):954–957. [PubMed]
  • Millon-Underwood S, Sanders E, Davis M. Determinants of participation in state-of-the-art cancer prevention, early detection/screening, and treatment trials among African-Americans. Cancer Nurs. 1993 Feb;16(1):25–33. [PubMed]
  • Kaluzny A, Brawley O, Garson-Angert D, Shaw J, Godley P, Warnecke R, Ford L. Assuring access to state-of-the-art care for U.S. minority populations: the first 2 years of the Minority-Based Community Clinical Oncology Program. J Natl Cancer Inst. 1993 Dec 1;85(23):1945–1950. [PubMed]
  • Diaz T, Chu SY, Sorvillo F, Mokotoff E, Davidson AJ, Samuel MC, Herr M, Doyle B, Frederick M, Fann SA, et al. Differences in participation in experimental drug trials among persons with AIDS. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Dec 15;10(5):562–568. [PubMed]
  • Richardson MA, Post-White J, Singletary SE, Justice B. Recruitment for complementary/alternative medicine trials: who participates after breast cancer. Ann Behav Med. 1998 Summer;20(3):190–198. [PubMed]
  • Moorman PG, Newman B, Millikan RC, Tse CK, Sandler DP. Participation rates in a case-control study: the impact of age, race, and race of interviewer. Ann Epidemiol. 1999 Apr;9(3):188–195. [PubMed]
  • Kviz FJ, Crittenden KS, Warnecke RB. Factors associated with nonparticipation among registrants for a self-help, community-based smoking cessation intervention. Addict Behav. 1992 Nov-Dec;17(6):533–542. [PubMed]
  • Schwartz CE, Fox BH. Who says yes? Identifying selection biases in a psychosocial intervention study of multiple sclerosis. Soc Sci Med. 1995 Feb;40(3):359–370. [PubMed]
  • Brown DR, Fouad MN, Basen-Engquist K, Tortolero-Luna G. Recruitment and retention of minority women in cancer screening, prevention, and treatment trials. Ann Epidemiol. 2000 Nov;10(8 Suppl):S13–S21. [PubMed]
  • Corbie-Smith G, Thomas SB, Williams MV, Moody-Ayers S. Attitudes and beliefs of African Americans toward participation in medical research. J Gen Intern Med. 1999 Sep;14(9):537–546. [PMC free article] [PubMed]
  • Mouton CP, Harris S, Rovi S, Solorzano P, Johnson MS. Barriers to black women's participation in cancer clinical trials. J Natl Med Assoc. 1997 Nov;89(11):721–727. [PMC free article] [PubMed]
  • Harris Y, Gorelick PB, Samuels P, Bempong I. Why African Americans may not be participating in clinical trials. J Natl Med Assoc. 1996 Oct;88(10):630–634. [PMC free article] [PubMed]
  • Koblin BA, Avrett S, Taylor PE, Stevens CE. Willingness to participate in HIV-1 vaccine efficacy trials and the effect of media events among gay and bisexual men in New York City: Project ACHIEVE. J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Jun 1;15(2):165–171. [PubMed]
  • Gorelick PB, Harris Y, Burnett B, Bonecutter FJ. The recruitment triangle: reasons why African Americans enroll, refuse to enroll, or voluntarily withdraw from a clinical trial. An interim report from the African-American Antiplatelet Stroke Prevention Study (AAASPS). J Natl Med Assoc. 1998 Mar;90(3):141–145. [PMC free article] [PubMed]
  • Tangrea JA. Patient participation and compliance in cancer chemoprevention trials: issues and concerns. Proc Soc Exp Biol Med. 1997 Nov;216(2):260–265. [PubMed]
  • MacQueen KM, Vanichseni S, Kitayaporn D, Lin LS, Buavirat A, Naiwatanakul T, Raktham S, Mock P, Heyward WL, Des Jarlais DC, et al. Willingness of injection drug users to participate in an HIV vaccine efficacy trial in Bangkok, Thailand. J Acquir Immune Defic Syndr. 1999 Jul 1;21(3):243–251. [PubMed]
  • Morse EV, Simon PM, Besch CL, Walker J. Issues of recruitment, retention, and compliance in community-based clinical trials with traditionally underserved populations. Appl Nurs Res. 1995 Feb;8(1):8–14. [PubMed]
  • Mansour EG. Barriers to clinical trials. Part III: Knowledge and attitudes of health care providers. Cancer. 1994 Nov 1;74(9 Suppl):2672–2675. [PubMed]
  • Crosson K, Eisner E, Brown C, Ter Maat J. Primary care physicians' attitudes, knowledge, and practices related to cancer clinical trials. J Cancer Educ. 2001 Winter;16(4):188–192. [PubMed]
  • Simon MS, Brown DR, Du W, LoRusso P, Kellogg CM. Accrual to breast cancer clinical trials at a university-affiliated hospital in metropolitan Detroit. Am J Clin Oncol. 1999 Feb;22(1):42–46. [PubMed]
  • Lara PN, Jr, Higdon R, Lim N, Kwan K, Tanaka M, Lau DH, Wun T, Welborn J, Meyers FJ, Christensen S, et al. Prospective evaluation of cancer clinical trial accrual patterns: identifying potential barriers to enrollment. J Clin Oncol. 2001 Mar 15;19(6):1728–1733. [PubMed]
  • Pohl JM, Martinelli A, Antonakos C. Predictors of participation in a smoking cessation intervention group among low-income women. Addict Behav. 1998 Sep-Oct;23(5):699–704. [PubMed]
  • Harris ML. III. The Operative Treatment of Old Unreduced and Irreducible Dislocations of the Hip. Ann Surg. 1894 Sep;20(3):318.2–354. [PMC free article]
  • Weissman MM, Sholomskas D, Pottenger M, Prusoff BA, Locke BZ. Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol. 1977 Sep;106(3):203–214. [PubMed]
  • Romano PS, Bloom J, Syme SL. Smoking, social support, and hassles in an urban African-American community. Am J Public Health. 1991 Nov;81(11):1415–1422. [PMC free article] [PubMed]
  • Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991 Sep;86(9):1119–1127. [PubMed]
  • Damron D, Langenberg P, Anliker J, Ballesteros M, Feldman R, Havas S. Factors associated with attendance in a voluntary nutrition education program. Am J Health Promot. 1999 May-Jun;13(5):268–275. [PubMed]
  • Woods MN, Harris KJ, Ahluwalia JS, Schmelzle KH, Mayo MS. Smoking in urban African Americans: behaviors, gender differences, and motivation to quit. Ethn Dis. 2001 Autumn;11(3):532–539. [PubMed]
  • Paskett ED, DeGraffinreid C, Tatum CM, Margitić SE. The recruitment of African-Americans to cancer prevention and control studies. Prev Med. 1996 Sep-Oct;25(5):547–553. [PubMed]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • Compound
    PubChem Compound links
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...