The Roles of Trust and Respect in Patient Reactions to Race-based and Personalized Medicine Vignettes: An Experimental Study
| Status: | Completed |
|---|---|
| Conditions: | High Blood Pressure (Hypertension), Peripheral Vascular Disease, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | May 2009 |
| End Date: | March 2011 |
The Roles of Trust and Respect in Patient Reactions to Race-Based and Personalized Medicine Vignettes: An Experimental Study
Background:
- Genetic research has implications for drug development and marketing. Race-based
medicine may be able to provide specific treatment for populations with increased
disease-specific morbidity and mortality. However, contemporary genetic research
refutes the idea that races are genetically distinct populations, even as drugs
designed for use in specific races are being promoted.
- Studies have shown high levels of public suspicion for race-based and personalized
genetic medicine. Concerns related to not only the potential performance of race-based
drugs, but also the motives of those offering these drugs. Many participants have
suggested conspiracy theories in which race-based medicine was disguising an attempt to
provide inferior medications or deliberately harm certain populations. Concerns about
personalized medicine often have to do with privacy and other personal concerns.
- Public suspicions of race-based medicine, and to a lesser extent, personalized genetic
medicine, make it important to examine and understand the theoretical and empirical
literature on trust and health care.
Objective:
- To describe the perspective of participants evaluating the medicine offer.
Eligibility:
- Males and females ages 18 and older who are visiting the John Hopkins clinics
(primarily the adult care clinics).
- Participants must be able to take a literacy screen and respond to a short survey.
Design:
- Participants will be asked to take a researcher-administrated literacy screen, read one
of three randomly assigned vignettes, and fill out a survey. The first page of the
survey will provide information about the study.
- Participants will respond to initial questions about demographics, experiences with
discrimination, and trust in the medical profession and institutions.
- Each participant will receive a random vignette in which he/she will imagine
him/herself being diagnosed with a common, chronic condition and offered a conventional
drug, a race-based drug, or a genetically personalized drug.
- After being presented with the vignette, participants will be asked to respond to a
survey that asks about their levels of trust in the vignette doctor, perceived respect
given to the patient by the vignette physician, emotional response to the vignette,
their belief in the effectiveness and safety of the drug prescribed in the vignette,
information sufficiency, and their hypothetical behavioral intention to take the drug.
- Participants will be debriefed after completing the survey, and will be offered a small
amount of compensation for participating.
- Genetic research has implications for drug development and marketing. Race-based
medicine may be able to provide specific treatment for populations with increased
disease-specific morbidity and mortality. However, contemporary genetic research
refutes the idea that races are genetically distinct populations, even as drugs
designed for use in specific races are being promoted.
- Studies have shown high levels of public suspicion for race-based and personalized
genetic medicine. Concerns related to not only the potential performance of race-based
drugs, but also the motives of those offering these drugs. Many participants have
suggested conspiracy theories in which race-based medicine was disguising an attempt to
provide inferior medications or deliberately harm certain populations. Concerns about
personalized medicine often have to do with privacy and other personal concerns.
- Public suspicions of race-based medicine, and to a lesser extent, personalized genetic
medicine, make it important to examine and understand the theoretical and empirical
literature on trust and health care.
Objective:
- To describe the perspective of participants evaluating the medicine offer.
Eligibility:
- Males and females ages 18 and older who are visiting the John Hopkins clinics
(primarily the adult care clinics).
- Participants must be able to take a literacy screen and respond to a short survey.
Design:
- Participants will be asked to take a researcher-administrated literacy screen, read one
of three randomly assigned vignettes, and fill out a survey. The first page of the
survey will provide information about the study.
- Participants will respond to initial questions about demographics, experiences with
discrimination, and trust in the medical profession and institutions.
- Each participant will receive a random vignette in which he/she will imagine
him/herself being diagnosed with a common, chronic condition and offered a conventional
drug, a race-based drug, or a genetically personalized drug.
- After being presented with the vignette, participants will be asked to respond to a
survey that asks about their levels of trust in the vignette doctor, perceived respect
given to the patient by the vignette physician, emotional response to the vignette,
their belief in the effectiveness and safety of the drug prescribed in the vignette,
information sufficiency, and their hypothetical behavioral intention to take the drug.
- Participants will be debriefed after completing the survey, and will be offered a small
amount of compensation for participating.
This study proposes to describe participants' attitudinal, emotional, cognitive, and
hypothetical behavioral responses to randomized hypothetical vignettes illustrating the
prescription of conventional, race-based, and genetically personalized medicine for a common
chronic condition. This study is theoretically guided by conceptualizations of
relationship-centered care and the risk information seeking and processing model. These
theories recognize the importance of interpersonal influence within health care
interactions, underscore the moral dimensions of patient-physician relationships, and
describe the predictors of how information is attended to and processed. An experimental,
mixed methods design will be used to randomly assign 357 patients at the Johns Hopkins
clinics to one of three vignettes illustrating conventional, race-based, and genetically
personalized medication offers. This study aims to examine the effects of the type of
medication offer (conventional, race-based, and genetically personalized) and certain
participant characteristics (race, literacy, background healthcare trust/experience with
discrimination) on attitudinal, emotional, cognitive, and hypothetical behavioral responses;
to determine if the relationships among the type of medication offer and the four categories
of outcomes are moderated by race and mediated by trust; and to describe the participants'
perspective on the vignette, through targeted open-ended questions.
hypothetical behavioral responses to randomized hypothetical vignettes illustrating the
prescription of conventional, race-based, and genetically personalized medicine for a common
chronic condition. This study is theoretically guided by conceptualizations of
relationship-centered care and the risk information seeking and processing model. These
theories recognize the importance of interpersonal influence within health care
interactions, underscore the moral dimensions of patient-physician relationships, and
describe the predictors of how information is attended to and processed. An experimental,
mixed methods design will be used to randomly assign 357 patients at the Johns Hopkins
clinics to one of three vignettes illustrating conventional, race-based, and genetically
personalized medication offers. This study aims to examine the effects of the type of
medication offer (conventional, race-based, and genetically personalized) and certain
participant characteristics (race, literacy, background healthcare trust/experience with
discrimination) on attitudinal, emotional, cognitive, and hypothetical behavioral responses;
to determine if the relationships among the type of medication offer and the four categories
of outcomes are moderated by race and mediated by trust; and to describe the participants'
perspective on the vignette, through targeted open-ended questions.
- INCLUSION CRITERIA:
Participants are primarily African American or white, have a high prevalence of chronic
disease, and a moderate prevalence of limited literacy.
Participants must be 18 or older.
EXCLUSION CRITERIA:
Participants who do not speak English and cannot read the survey (due to linguistic
barriers) will be excluded.
We found this trial at
1
site
9000 Rockville Pike
Bethesda, Maryland 20892
Bethesda, Maryland 20892
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