Introduction: Participation by American Indian and Alaska Natives (AI/AN) in clinical research may improve AI/AN health outcomes and generalizability of the research.
Hypothesis: Cultural beliefs have a strong impact on willingness of AI/AN to participate in research.
Methods: We developed a survey to identify if cultural beliefs impact perception of clinical research and the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2) protocol. Stroke neurologists and CREST-2 investigators participated in the design of the survey. Participants were stratified based on AI/AN self-identification and level of education. Likert-scale responses were tested with the Mann Whitney-U test and dichotomous responses with the Chi-Square test.
Results: There were 102 participants: 61% female, mean age 39, and 37% AI/AN. Eight questions evaluated understanding of research concepts within CREST-2; 89% of these responses were correct, with no significant difference in responses between AI/AN and non-AI/AN or between low (n=42) and high (n=60) education. Compared to other ethnic groups, AI/AN identify more with their culture (p=0.002) and consider cultural beliefs when making health care decisions (p=0.005), including participating in a research study (p=0.002). Using the same questions, we found no difference between respondents with low or high education.(Figure 1)
Conclusion: These data support our hypothesis that cultural beliefs have a strong impact on AI/AN willingness to participate in research. It is important for researchers to consider cultural beliefs when designing recruitment strategies for AI/AN populations. Future work will address how cultural beliefs affect AI/ANs’ understanding of and willingness to participate in clinical research.