Indian health care continues represent unique barriers to clinical trials participation.
- Most of these barriers are not recognized by health care professionals.
- Contracted Health Services delays referrals to trials.
- Clinical trials are not offered at most tribal / IHS / urban clinics.
Some examples of barriers to Native American participation in clinical trials:
- Patients not informed of the availability of trials
- Need approvals from the Tribal / IHS Institutional Review Board and the Tribal Research Committee for a trial offered by the tribal clinic
- Some Tribal Research Committees forbid taking part due to:
- Lack of resources for cancer care if the tribal member has to withdraw from the clinical trial
- Inability to use participatory research design that provides tribal Nation as an equal partner in all decisions
- Distrust of the research agency
- Some believe that Native Americans are guinea pigs
- The Community Health Representative (CHR) unable to give rides to and from the clinic for all of the required appointments
- Possible problems and tribal clinic unable to help, from
- The clinical trial treatment
- Other health problems in combination with the cancer (like diabetes)
- The approval of Tribal Research Committees may be needed before Natives can particpate in a clinical trial.
Example: Cherokee Nation delayed approval of the STAR prevention trial until
tribal health care providers were comfortable that there were resources available
so that any women diagnosed with breast cancer would be able to access quality cancer care.
- STAR is the Study of Tamoxifen and Raloxifene for the prevention of breast cancer.
- A prevention trial is for people who have not been diagnosed with cancer but may be at risk for developing a particular type of cancer.