Caban-Holt Leads Recruitment and Retention
A relevant message, a trusted messenger, honesty and transparency – all these elements are crucial for recruiting patients to clinical trials. They’re particularly important for recruiting people of color, Allison Caban-Holt says. So is the ability to recognize, and manage, discomfort with the medical system. People of color, particularly African Americans, may have personal experiences of being ignored, offended, or simply misunderstood by doctors, nurses, or other medical professionals.
Dr. Caban-Holt notes the experience of a colleague at Wake Forest University, another black woman with a doctoral degree. Her colleague had brought her child into her pediatrician’s office, and a nurse asked about the child’s “baby daddy.” If she was white, Caban-Holt asked, would that term be used to describe the child’s father?
“It’s important to recognize, as health care professionals, that not everyone is comfortable with the health care system,” she says. “And it’s not just discomfort about historical unethical treatment. Some people feel leery about the medical system as it is today.”
Earlier this month, I promoted Caban-Holt, an active leader in our recruitment and retention committee, to chairwoman of that group, which is charged with improving diversity in SWOG membership and leadership and the patients we enroll on our cancer trials. Founding recruitment and retention Chair Dr. Elise Cook stepped down in December, when she retired from M.D. Anderson Cancer Center after a nearly 20-year career in teaching and research, with a focus on minority recruitment to clinical trials. Elise was a pioneer here at SWOG, leading recruitment and retention from its founding as a full committee in 2016.
Since then, recruitment and retention members have assisted with strategic advice on nearly a dozen SWOG trials. For our Lung-MAP precision medicine trial, for example, they spoke with site coordinators about how to handle distrust of clinical trials among African-American men being treated for lung cancer at Veterans Affairs medical centers. For S1614, they worked extensively on accrual tactics, including advising outreach to Asian and Pacific Islander communities, who disproportionally suffer from chronic hepatitis B infections, a population of cancer patients who are the focus of that symptom control and quality of life study.
Dr. Caban-Holt led the recruitment working group of the recruitment and retention committee, and I – and others – have been impressed with her consistent contributions. I know she will lead the full committee with success. She has almost 20 years of experience in clinical trials, with a concentration in clinical psychology, and an impressive research portfolio, much of it in memory disorders, such as Alzheimer’s disease, and other diseases common in older adults. She has also worked with children, teens, and adults, conducting evaluations and providing treatment for a variety of disorders, from PTSD to ADHD, major depression to sleep disorders. Along the way, she has worked with a variety of patient populations of all races and socioeconomic status – from individuals dealing with drug addiction to clergy, from college students to nursing home residents. Currently, Dr. Caban-Holt serves as associate director of the Maya Angelou Center for Health Equity at Wake Forest, where, among other tasks, she is collaborating with colleagues throughout North Carolina to enhance a racially and ethnically diverse patient registry for clinical trials in brain health.
This year, Dr. Caban-Holt plans to implement a tracking and planning system for the recruitment and retention committee consult requests, a system that will also include follow-up reporting to gauge whether suggested trial strategies and tactics were implemented – and effective. She will oversee a significant survey to get baseline diversity data on our membership, and, unfortunately, will have to select a new patient advocate for her committee. Our much-beloved recruitment and retention advocate, Sandra Hamilton, just resigned due to significant injuries incurred during an auto accident two months ago. She will be difficult to replace.
Like Sandy, Dr. Caban-Holt came to SWOG through our SELECT trial, and oversaw training and trial oversight for the ancillary PREADViSE trial studying the effects of vitamin E and selenium on Alzheimer’s disease prevention. She enjoyed working with SWOG staff, and, best of all, SWOG patients.
“That was an amazing group of men,” she said. “Now, all these years later, it will be good to spread my wings and see what else we can do together.”
My thanks to Allison for taking on her new role, and my thanks to Elise Cook and Sandy Hamilton. These women are pioneers and their commitment to communities of color, and to SWOG, is unshakable. Our team is better for their contributions.
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