Background and Aim: Culturally and linguistically diverse (CALD) Australians experience poorer healthcare access and outcomes. These inequities are compounded by the exclusion and underrepresentation of CALD communities in cancer clinical trials on potentially life-saving treatments. Research has often overlooked systemic and structural inequalities, focusing instead on community-level barriers. This study explored barriers and enablers to cancer clinical trial participation among Arabic-speaking Australians through healthcare professional and researcher perspectives, aiming to provide insights for improving access and inclusion of Arabic-speaking patients in cancer clinical trials and to inform a bilingual trial navigator (BTN) role.
Methods: A qualitative study comprising focus groups with healthcare professionals working with Australian Arabic-speaking adults who have cancer. Participants were recruited via social media and professional networks. Participants were asked about their experiences recruiting Australian Arabic-speaking patients to cancer clinical trials and their input on designing a BTN role. Focus groups were recorded, transcribed and analysed thematically by two researchers.
Results: Fourteen participants were recruited (10 Clinicians, 2 Nurses, 1 Clinical Trial Coordinator and 1 Researcher). Participants highlighted several challenges in recruiting Arabic-speaking patients for cancer clinical trials including consultation time constraints, trial inclusion/exclusion criteria, limited resources (e.g., funding and translated materials), and access to interpreters. Arabic-speaking participants noted difficulties with accurately translating clinical trial terminology. Additionally, there were instances of clinician bias which may have resulted in the exclusion of certain individuals from trials. Participants supported the BTN idea to address some of these challenges and emphasised the importance of distinguishing this role from existing roles (e.g., interpreter and care coordinator), and ensuring seamless integration within the clinical workflow.
Conclusion: Findings underscore significant sponsor, site and clinician-level barriers to recruiting Arabic-speaking patients for cancer clinical trials. Further research and resourcing of strategies like a BTN role may be helpful to enhance access to these trials.