Improving Communications For Patient Accrual In Clinical Trials To Promote Informed Health Decision Making
This dissertation applies a risk communication theoretical framework, the Risk Information Seeking and Processing Model (RISP), to address a health communication challenge that aims to promote informed decision making about clinical trial enrollment. A review of theoretical development and empirical evidence suggests several pathways to refine the model, which guides subsequent analyses. To compare the general patterns of information seeking among prospective healthy volunteers and cancer patients and their caregivers, Chapter 3 tests how risk perceptions, affective responses, and normative beliefs motivate routine and non-routine information seeking. Specifically focused on prospective healthy volunteers, Chapter 4 examines the applicability of the central part of the RISP model to account for more active information seeking and higher-level information processing. Linking the RISP model to the Theory of Planned Behavior, Chapter 5 investigates how cognitive processing styles, affective responses, and normative beliefs influence cancer patients' general attitudes and intentions to enroll in a future trial. Through a comparative analysis using multiple-sample structural equation modeling, the final substantive chapter demonstrates that even though cognitive processing styles and normative beliefs mainly shape prospective healthy volunteers' decisions about clinical trial enrollment, emotional factors have a greater impact on cancer patients and their caregivers. Since the most fundamental mechanism that the RISP model proposes, a cognitive need to achieve information sufficiency, fails to influence information seeking and processing throughout the different chapters, the final chapter proposes an adjusted version of the model that allows for a change in contextualization across research settings. Findings from this dissertation also offer evidence-based recommendations to improve patient accrual for clinical trials.
dissertation or thesis