{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:08:43Z","timestamp":1785514123078,"version":"3.56.0"},"reference-count":63,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Perspectives of families from historically marginalized groups regarding pediatric oncology clinical trial participation are not well-represented in the literature.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe clinician- and parent-perceived facilitators and barriers to clinical trial participation.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This single-center cross-sectional study with an explanatory sequential mixed-methods design enrolled parents of Black and Hispanic children with cancer as well as pediatric oncology clinicians from a large pediatric cancer center in Boston, Massachusetts. Parent participants completed single\u2013time point surveys, and a subset, purposively sampled based on self-identified race and ethnicity, language, and household material hardship (HMH; ie, food, housing, transportation, or utility insecurity), completed semistructured interviews from September to December 2021. Clinicians completed semistructured interviews from February to March 2022. Data were analyzed from April 2022 to October 2025.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Key factors influencing clinical trial participation in pediatric oncology among parents from historically marginalized groups. Quantitative data were summarized descriptively. Interview transcripts were analyzed using thematic analysis and integrated along key domains.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 60 parents completed the questionnaire; self-identified race and ethnicity included 5 Hispanic Black (8%), 10 Hispanic White (17%), 21 Hispanic other (35%), 21 non-Hispanic Black (35%), and 3 non-Hispanic White (5%) parents; most were mothers (51 [85%]). Twenty parents participated in interviews. Fifteen clinicians (10 [67%] female participants; 10 [67%] with \u226510 years caring for children with cancer) were interviewed, including 12 (80%) attendings and 3 (20%) advanced practice practitioners; most identified as non-Hispanic White (14 [93%]). Most families experienced HMH (44 [73%]) and reported high trust in their oncology team (mean [SD] score, 4.63 [0.65] of 5.00). Qualitatively, parents and clinicians aligned in identifying altruism and trustworthiness as facilitators to trial participation, while the informed consent discussion, non-English language preference, trial materials, and study requirements were participation barriers. Unlike clinicians, parents did not identify HMH or the experimental nature of trials as significant barriers to participation. Parents identified the desire for representation as a facilitator to participation, and clinicians identified gatekeeping as a barrier.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study of pediatric oncology families from historically marginalized groups and clinicians, clinician- and parent-perceived barriers identified opportunities to increase equitable trial participation. Next steps include standardization of trial eligibility screening and systematic HMH screening and support to reduce gatekeeping.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.26538","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:30:20Z","timestamp":1785511820000},"page":"e2626538","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Oncology Clinical Trial Participation Among Families From Historically Marginalized Groups"],"prefix":"10.1001","volume":"9","author":[{"given":"Puja J.","family":"Umaretiya","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas"},{"name":"Department of Social and Behavioral Sciences, Peter O\u2019Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas"},{"name":"Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan A.","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Valenzuela","sequence":"additional","affiliation":[{"name":"Division of Pediatric Intensive Care, Children\u2019s Hospital Colorado, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Hawkins","sequence":"additional","affiliation":[{"name":"University of Miami Leonard M. Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C.","family":"Revette","sequence":"additional","affiliation":[{"name":"Division of Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Nava-Coulter","sequence":"additional","affiliation":[{"name":"Division of Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ijeoma Julie","family":"Eche-Ugwu","sequence":"additional","affiliation":[{"name":"The Phyllis Cantor Center for Research in Nursing and Patient Care, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Snaman","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Dana-Farber\/Boston Children\u2019s Cancer and Blood Disorders Center, Boston, Massachusetts"},{"name":"Department of Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahela","family":"Aziz-Bose","sequence":"additional","affiliation":[{"name":"Division of Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Dana-Farber\/Boston Children\u2019s Cancer and Blood Disorders Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen A.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Division of Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Dana-Farber\/Boston Children\u2019s Cancer and Blood Disorders Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandi L.","family":"Pruitt","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Peter O\u2019Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas"},{"name":"Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Mass General Brigham Hospital for Children, Massachusetts General Hospital, Department of Pediatrics, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira","family":"Bona","sequence":"additional","affiliation":[{"name":"Division of Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Dana-Farber\/Boston Children\u2019s Cancer and Blood Disorders Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"issue":"14","key":"zoi260728r1","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1200\/JCO.2011.37.8018","article-title":"Improved survival for children and adolescents with acute lymphoblastic leukemia between 1990 and 2005: a report from the children\u2019s oncology group.","volume":"30","author":"Hunger","year":"2012","journal-title":"J Clin Oncol"},{"issue":"32","key":"zoi260728r2","doi-asserted-by":"publisher","first-page":"3009","DOI":"10.1200\/JCO.19.00812","article-title":"Survival by race and ethnicity in pediatric and adolescent patients with Hodgkin lymphoma: a Children\u2019s Oncology Group study.","volume":"37","author":"Kahn","year":"2019","journal-title":"J Clin Oncol"},{"issue":"1","key":"zoi260728r3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1182\/blood-2005-10-4004","article-title":"Ethnicity and survival in childhood acute myeloid leukemia: a report from the Children\u2019s Oncology Group.","volume":"108","author":"Aplenc","year":"2006","journal-title":"Blood"},{"issue":"6","key":"zoi260728r4","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1182\/blood-2002-02-0395","article-title":"Racial and ethnic differences in survival of children with acute lymphoblastic leukemia.","volume":"100","author":"Bhatia","year":"2002","journal-title":"Blood"},{"issue":"2","key":"zoi260728r5","doi-asserted-by":"publisher","first-page":"e129","DOI":"10.1016\/S2352-3026(22)00371-4","article-title":"Racial and ethnic disparities in childhood and young adult acute lymphocytic leukaemia: secondary analyses of eight Children\u2019s Oncology Group cohort trials.","volume":"10","author":"Gupta","year":"2023","journal-title":"Lancet Haematol"},{"issue":"24","key":"zoi260728r6","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1001\/jama.2024.6281","article-title":"Survival benefit associated with participation in clinical trials of anticancer drugs: a systematic review and meta-analysis.","volume":"331","author":"Iskander","year":"2024","journal-title":"JAMA"},{"issue":"4","key":"zoi260728r7","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/j.jamcollsurg.2012.12.036","article-title":"Does enrollment in cancer trials improve survival?","volume":"216","author":"Chow","year":"2013","journal-title":"J Am Coll Surg"},{"issue":"3","key":"zoi260728r8","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1097\/AOG.0000000000005298","article-title":"Association of clinical trial participation with improved overall survival for recurrent, platinum-resistant ovarian cancer.","volume":"142","author":"Morton","year":"2023","journal-title":"Obstet Gynecol"},{"issue":"5","key":"zoi260728r9","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1038\/bjc.2017.462","article-title":"Enrolling children with acute lymphoblastic leukaemia on a clinical trial improves event-free survival: a population-based study.","volume":"118","author":"Strahlendorf","year":"2018","journal-title":"Br J Cancer"},{"issue":"14","key":"zoi260728r10","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1056\/NEJMp2215609","article-title":"Why diverse clinical trial participation matters.","volume":"388","author":"Schwartz","year":"2023","journal-title":"N Engl J Med"},{"issue":"19","key":"zoi260728r12","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.1200\/JCO.22.00754","article-title":"Increasing racial and ethnic diversity in cancer clinical trials: an American Society of Clinical Oncology and Association of Community Cancer Centers Joint Research Statement.","volume":"40","author":"Oyer","year":"2022","journal-title":"J Clin Oncol"},{"issue":"9","key":"zoi260728r13","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1080\/10428194.2019.1574002","article-title":"Disparities in pediatric acute myeloid leukemia (AML) clinical trial enrollment.","volume":"60","author":"Winestone","year":"2019","journal-title":"Leuk Lymphoma"},{"issue":"8","key":"zoi260728r14","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1002\/pbc.25472","article-title":"Participation in pediatric oncology research protocols: racial\/ethnic, language and age-based disparities.","volume":"62","author":"Aristizabal","year":"2015","journal-title":"Pediatr Blood Cancer"},{"issue":"7","key":"zoi260728r15","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31051","article-title":"Enrollment on upfront high-risk neuroblastoma trials by race, ethnicity, and poverty status: a report from the Children\u2019s Oncology Group.","volume":"71","author":"Umaretiya","year":"2024","journal-title":"Pediatr Blood Cancer"},{"issue":"16","key":"zoi260728r16","doi-asserted-by":"publisher","first-page":"3808","DOI":"10.1002\/cncr.24437","article-title":"Racial\/ethnic diversity in children\u2019s oncology clinical trials: ten years later.","volume":"115","author":"Lund","year":"2009","journal-title":"Cancer"},{"issue":"16","key":"zoi260728r17","doi-asserted-by":"publisher","first-page":"10005","DOI":"10.1200\/JCO.2022.40.16_suppl.10005","article-title":"Racial, ethnic, and socioeconomic survival disparities among children with high-risk neuroblastoma treated on upfront Children\u2019s Oncology Group clinical trials.","volume":"40","author":"Umaretiya","year":"2022","journal-title":"J Clin Oncol"},{"issue":"4","key":"zoi260728r18","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"zoi260728r19","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"issue":"2","key":"zoi260728r20","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"zoi260728r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners.","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"8","key":"zoi260728r22","first-page":"588","article-title":"Brief questions to identify patients with inadequate health literacy.","volume":"36","author":"Chew","year":"2004","journal-title":"Fam Med"},{"issue":"5","key":"zoi260728r23","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1007\/s11606-008-0520-5","article-title":"Validation of screening questions for limited health literacy in a large VA outpatient population.","volume":"23","author":"Chew","year":"2008","journal-title":"J Gen Intern Med"},{"issue":"4","key":"zoi260728r24","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1177\/27527530221140076","article-title":"Health literacy in parents of children newly diagnosed with cancer and comprehension of key concepts related to their child\u2019s care.","volume":"40","author":"Keith","year":"2023","journal-title":"J Pediatr Hematol Oncol Nurs"},{"issue":"6","key":"zoi260728r25","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/0277-9536(91)90150-B","article-title":"The MOS social support survey.","volume":"32","author":"Sherbourne","year":"1991","journal-title":"Soc Sci Med"},{"issue":"10","key":"zoi260728r26","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.jclinepi.2012.04.007","article-title":"The eight-item modified Medical Outcomes Study Social Support Survey: psychometric evaluation showed excellent performance.","volume":"65","author":"Moser","year":"2012","journal-title":"J Clin Epidemiol"},{"issue":"9","key":"zoi260728r27","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.11578","article-title":"Effect of the Promoting Resilience in Stress Management Intervention for Parents of Children With Cancer (PRISM-P): a randomized clinical trial.","volume":"2","author":"Rosenberg","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"11","key":"zoi260728r28","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29933","article-title":"Feasibility of oncology clinical trial-embedded evaluation of social determinants of health.","volume":"69","author":"Aziz-Bose","year":"2022","journal-title":"Pediatr Blood Cancer"},{"issue":"10","key":"zoi260728r29","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1093\/jnci\/djad099","article-title":"Disparities in parental distress in a multicenter clinical trial for pediatric acute lymphoblastic leukemia.","volume":"115","author":"Umaretiya","year":"2023","journal-title":"J Natl Cancer Inst"},{"issue":"4","key":"zoi260728r30","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1177\/0272989X03256005","article-title":"Validation of a decision regret scale.","volume":"23","author":"Brehaut","year":"2003","journal-title":"Med Decis Making"},{"issue":"33","key":"zoi260728r31","doi-asserted-by":"publisher","first-page":"4023","DOI":"10.1200\/JCO.2016.69.1634","article-title":"Decisional regret among parents of children with cancer.","volume":"34","author":"Mack","year":"2016","journal-title":"J Clin Oncol"},{"issue":"3","key":"zoi260728r32","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s00520-016-3473-y","article-title":"Development and validation of an abbreviated version of the Trust in Oncologist Scale\u2014the Trust in Oncologist Scale\u2013short form (TiOS-SF).","volume":"25","author":"Hillen","year":"2017","journal-title":"Support Care Cancer"},{"issue":"6","key":"zoi260728r33","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s11606-010-1288-y","article-title":"Validation of the group-based medical mistrust scale among urban black men.","volume":"25","author":"Shelton","year":"2010","journal-title":"J Gen Intern Med"},{"issue":"4","key":"zoi260728r34","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1097\/PEC.0000000000000453","article-title":"Language matters: race, trust, and outcomes in the pediatric emergency department.","volume":"32","author":"Fields","year":"2016","journal-title":"Pediatr Emerg Care"},{"issue":"4","key":"zoi260728r35","first-page":"502","article-title":"Adapting the everyday discrimination scale to medical settings: reliability and validity testing in a sample of African American patients.","volume":"21","author":"Peek","year":"2011","journal-title":"Ethn Dis"},{"issue":"4","key":"zoi260728r36","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/1049732316665344","article-title":"Code saturation versus meaning saturation: how many interviews are enough?","volume":"27","author":"Hennink","year":"2017","journal-title":"Qual Health Res"},{"issue":"4","key":"zoi260728r39","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/1059924X.2017.1358971","article-title":"Breadth of the socio-ecological model.","volume":"22","author":"Kilanowski","year":"2017","journal-title":"J Agromedicine"},{"issue":"2","key":"zoi260728r40","doi-asserted-by":"publisher","first-page":"270","DOI":"10.5195\/jmla.2022.1271","article-title":"NVivo.","volume":"110","author":"Dhakal","year":"2022","journal-title":"J Med Libr Assoc"},{"issue":"6 Pt 2","key":"zoi260728r41","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.1111\/1475-6773.12117","article-title":"Achieving integration in mixed methods designs-principles and practices.","volume":"48","author":"Fetters","year":"2013","journal-title":"Health Serv Res"},{"issue":"10","key":"zoi260728r42","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.37646","article-title":"Barriers and facilitators to delivering cancer care in US prisons.","volume":"8","author":"Manz","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"10","key":"zoi260728r43","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.1016\/j.bbmt.2014.06.020","article-title":"Participation in clinical research: perspectives of adult patients and parents of pediatric patients undergoing hematopoietic stem cell transplantation.","volume":"20","author":"Keusch","year":"2014","journal-title":"Biol Blood Marrow Transplant"},{"issue":"4","key":"zoi260728r44","doi-asserted-by":"publisher","first-page":"e849","DOI":"10.1542\/peds.2006-2208","article-title":"Improving informed consent: suggestions from parents of children with leukemia.","volume":"119","author":"Eder","year":"2007","journal-title":"Pediatrics"},{"issue":"4","key":"zoi260728r45","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28907","article-title":"Parental decision making regarding consent to randomization on Children\u2019s Oncology Group AALL0932.","volume":"68","author":"Parker","year":"2021","journal-title":"Pediatr Blood Cancer"},{"issue":"4","key":"zoi260728r46","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28023","article-title":"Barriers and facilitators of clinical trial enrollment in a network of community-based pediatric oncology clinics.","volume":"67","author":"Russo","year":"2020","journal-title":"Pediatr Blood Cancer"},{"issue":"1","key":"zoi260728r47","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1186\/s12887-022-03635-1","article-title":"Parent values and preferences underpinning treatment decision-making in poor-prognosis childhood cancer: a scoping review.","volume":"22","author":"Pearson","year":"2022","journal-title":"BMC Pediatr"},{"issue":"35","key":"zoi260728r48","doi-asserted-by":"publisher","first-page":"5979","DOI":"10.1200\/JCO.2008.20.0204","article-title":"\u201cTrying to be a good parent\u201d as defined by interviews with parents who made phase I, terminal care, and resuscitation decisions for their children.","volume":"27","author":"Hinds","year":"2009","journal-title":"J Clin Oncol"},{"issue":"9","key":"zoi260728r49","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1016\/S0027-9684(15)31037-3","article-title":"Perceptions of pediatric clinical research among African American and Caucasian parents.","volume":"101","author":"Shaw","year":"2009","journal-title":"J Natl Med Assoc"},{"issue":"2","key":"zoi260728r50","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1001\/archpediatrics.2008.521","article-title":"Racial differences in parents\u2019 distrust of medicine and research.","volume":"163","author":"Rajakumar","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"2","key":"zoi260728r51","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.cct.2012.11.001","article-title":"Initial development of a questionnaire evaluating perceived benefits and barriers to pediatric clinical trials participation.","volume":"34","author":"Barakat","year":"2013","journal-title":"Contemp Clin Trials"},{"issue":"6","key":"zoi260728r52","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s10903-011-9461-x","article-title":"Research participation among Asian American women at risk for cervical cancer: exploratory pilot of barriers and enhancers.","volume":"13","author":"Giarelli","year":"2011","journal-title":"J Immigr Minor Health"},{"issue":"3","key":"zoi260728r53","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkab027","article-title":"Barriers and facilitators to adolescent and young adult cancer trial enrollment: NCORP site perspectives.","volume":"5","author":"Siembida","year":"2021","journal-title":"J Natl Cancer Inst Cancer Spectr"},{"issue":"6","key":"zoi260728r54","doi-asserted-by":"publisher","first-page":"3017","DOI":"10.3390\/curroncol31060230","article-title":"Oncologist-reported barriers and facilitators to offering cancer clinical trials to their patients.","volume":"31","author":"Castillo","year":"2024","journal-title":"Curr Oncol"},{"issue":"12","key":"zoi260728r55","doi-asserted-by":"publisher","first-page":"4107","DOI":"10.1002\/cam4.3031","article-title":"Gatekeeping in cancer clinical trials in Canada: the ethics of recruiting the \u201cideal\u201d patient.","volume":"9","author":"Bell","year":"2020","journal-title":"Cancer Med"},{"issue":"1","key":"zoi260728r56","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ijrobp.2023.01.026","article-title":"Removing \u201cgatekeeping\u201d to improve Hispanic\/Latinx enrollment and participation in clinical trials.","volume":"116","author":"Franco","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"6","key":"zoi260728r57","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1136\/jme.2009.031716","article-title":"Clinician gate-keeping in clinical research is not ethically defensible: an analysis.","volume":"36","author":"Sharkey","year":"2010","journal-title":"J Med Ethics"},{"issue":"3","key":"zoi260728r58","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1093\/jnci\/djaa155","article-title":"\u201cWhen offered to participate\u201d: a systematic review and meta-analysis of patient agreement to participate in cancer clinical trials.","volume":"113","author":"Unger","year":"2021","journal-title":"J Natl Cancer Inst"},{"key":"zoi260728r59","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2024.101549","article-title":"\u201cDeveloping a manual clinical trials screening process in a diverse southern gynecologic oncology practice\u201d.","volume":"57","author":"Klein","year":"2024","journal-title":"Gynecol Oncol Rep"},{"issue":"6","key":"zoi260728r60","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-070319","article-title":"Psychosocial experiences of African American parents of children with cancer.","volume":"155","author":"Eche-Ugwu","year":"2025","journal-title":"Pediatrics"},{"issue":"20","key":"zoi260728r61","doi-asserted-by":"publisher","first-page":"3540","DOI":"10.1002\/cncr.35432","article-title":"Household material hardship and distress among parents of children with advanced cancer: a report from the PediQUEST Response trial.","volume":"130","author":"Eche-Ugwu","year":"2024","journal-title":"Cancer"},{"key":"zoi260728r62","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25675","author":"Wiener","year":"2015","journal-title":"Pediatr Blood Cancer"},{"issue":"1","key":"zoi260728r63","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1182\/hematology.2024000527","article-title":"Targeting hardship: poverty as a modifiable risk factor in childhood leukemia and lymphoma treatment.","volume":"2024","author":"Umaretiya","year":"2024","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"zoi260728r11"},{"key":"zoi260728r37","volume-title":"Successful Qualitative Research: A Practical Guide for Beginners","author":"Clarke","year":"2013"},{"key":"zoi260728r38","volume-title":"Qualitative Methods for Health Research","author":"Melendez-Torres","year":"2025","edition":"5th ed"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2852335\/umaretiya_2026_oi_260728_1784843204.09662.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:30:32Z","timestamp":1785511832000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2852335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":63,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.26538","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}