Background: People from culturally and ethnically diverse communities are underrepresented in cancer clinical trials, contributing to ongoing inequities in access to research and potentially life-extending treatments [1,2]. Previous research has focused on individual-level barriers, with limited attention to how social determinants of health shape participation [3,4]. This study explored healthcare professionals’ (HCPs) perspectives on determinants influencing cancer clinical trial participation among Arabic-speaking cancer patients (ASCPs) in Australia.
Methods: A qualitative study using online focus groups and interviews with Australian HCPs experienced in recruiting ASCPs to cancer clinical trials. Recruitment was through professional networks and social media using purposive and snowball sampling. Data analysis used the Best Fit framework approach, guided by the Sociocultural Framework for Health Service Disparities.
Results: Fourteen HCPs participated, including medical specialists, nurses, a clinical trial coordinator, and a researcher. Barriers and enablers were identified across three levels. Structural factors included limited consultation time, lack of translated trial materials, difficulties accessing interpreters, restrictive eligibility criteria, and limited workforce diversity. Healthcare provider factors included language discordance reducing confidence in patients’ understanding of trial information and informed consent processes. Environmental factors included family involvement, research scepticism, and cancer stigma. Family support networks acted as barriers and enablers by facilitating communication, while sometimes influencing patient autonomy. Strategies perceived to support participation included translated resources, interpreter engagement, longer consultations, workforce diversity, cultural competence, and proactive advocacy by HCPs.
Conclusions: Cancer clinical trial participation among ASCPs extends beyond individual factors, reflecting broader environmental and structural-level inequities. Many barriers, though described in terms of language, may represent wider shortcomings in cultural competency within healthcare and research systems. Addressing the barriers through culturally responsive trial design, workforce diversity, interpreter support, and translated resources may improve research inclusivity and equity for Arabic-speaking and other culturally diverse communities.