{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T18:25:39Z","timestamp":1767723939555,"version":"3.48.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K76AG068515"],"award-info":[{"award-number":["K76AG068515"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients aged 65+ are underrepresented in surgical clinical trials, and few studies have explored the unique barriers that limit participation of older adults in surgical trials. We aimed to identify barriers and facilitators to participation in surgical randomized trials among adults aged 65+.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and Setting<\/jats:title>\n                    <jats:p>Patients aged 65+ years having hernia surgery at two high\u2010volume Veterans' Affairs hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted semi\u2010structured interviews to identify barriers and facilitators to participation in clinical trials. Interviews were analyzed with directed content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We interviewed 40 Veterans aged 65+ years. The most frequently cited barriers to participation were logistical (e.g., needing to visit the hospital more frequently) and emotional (e.g., medical mistrust, fear of hospitals, and fear of bodily harm). COVID\u201019 pandemic\u2010related misinformation was commonly cited by these participants as a justification for medical mistrust. The most frequently cited motivators to participate in trials were altruism, access to novel treatments, increased time with clinicians, and advancing scientific knowledge. Patients uncertain about participation were potentially persuadable by referencing the impact of the trial on their friends and family, or by increasing transparency around trial purpose and design. Notably, using virtual visits to minimize travel to the hospital was not regarded as a viable way to address logistical barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increasing the participation of older adults in surgical clinical trials will require a multi\u2010factorial strategy that emphasizes communication of benefits to more than just the patient and includes deliberate planning to combat misperceptions and misinformation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70218","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T13:29:11Z","timestamp":1764163751000},"page":"161-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying Barriers and Motivators to Increase Surgical Clinical Trial Participation for Older Veterans"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2035-5496","authenticated-orcid":false,"given":"Benjamin A. Y.","family":"Cher","sequence":"first","affiliation":[{"name":"Wisconsin Surgical Outcomes Research Group, Department of Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Lunardi","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Veterans Affairs North Texas Health Care System  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9638-4266","authenticated-orcid":false,"given":"Melissa","family":"Thornton","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Veterans Affairs North Texas Health Care System  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ava","family":"Hitzeman","sequence":"additional","affiliation":[{"name":"Qualitative Health Research Consultants  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Baker","sequence":"additional","affiliation":[{"name":"Qualitative Health Research Consultants  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Qualitative Health Research Consultants  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celette Sugg","family":"Skinner","sequence":"additional","affiliation":[{"name":"Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1629-5507","authenticated-orcid":false,"given":"Cynthia J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Louisiana State University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Don","family":"Mai","sequence":"additional","affiliation":[{"name":"Wisconsin Surgical Outcomes Research Group, Department of Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"William S. Middleton Memorial VA Hospital  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa L.","family":"Marten","sequence":"additional","affiliation":[{"name":"Wisconsin Surgical Outcomes Research Group, Department of Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"William S. Middleton Memorial VA Hospital  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Makris","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey Veterans Medical Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luisa Machado","family":"Heredia","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey Veterans Medical Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miles","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Stanford Medicine  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Munro","family":"Cullum","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Neurology University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Neurological Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6345-1237","authenticated-orcid":false,"given":"Simon C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Population Health University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thai H.","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Veterans Affairs North Texas Health Care System  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney J.","family":"Balentine","sequence":"additional","affiliation":[{"name":"Wisconsin Surgical Outcomes Research Group, Department of Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"William S. Middleton Memorial VA Hospital  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(04)17670\u20108"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.08.010"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16875"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102407\u20106\u201034"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.04.003"},{"key":"e_1_2_11_7_1","unstructured":"Bureau UC \u201cNational Population Projections Tables: Main Series \u201d2023Census.gov (2023) https:\/\/www.census.gov\/data\/tables\/2023\/demo\/popproj\/2023\u2010summary\u2010tables.html."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.0284"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2022.04.008"},{"key":"e_1_2_11_10_1","unstructured":"National Institute on Aging \u201cAging in Place: Growing Older at Home \u201d(2023) https:\/\/www.nia.nih.gov\/health\/aging\u2010place\/aging\u2010place\u2010growing\u2010older\u2010home."},{"key":"e_1_2_11_11_1","unstructured":"\u201cCurrent and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs \u201dhttps:\/\/www.rand.org\/pubs\/periodicals\/health\u2010quarterly\/issues\/v5\/n4\/13.html."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291722000617"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13725"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0528"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_11_16_1","unstructured":"\u201cNVivo: Leading Qualitative Data Analysis Software|Lumivero \u201daccessed March 24 2025 https:\/\/lumivero.com\/products\/nvivo\/?utm_source=google&utm_medium=search_paid&utm_campaign=nv_NA_go_acq_ecomm_perfmax&gad_source=1&gclid=Cj0KCQjwhYS_BhD2ARIsAJTMMQZxRvdZEEpJyEr10GpQQsSDALNReHLCw02gOOArIlbf5na9E\u2010h83\u2010MaAgeQEALw_wcB."},{"key":"e_1_2_11_17_1","unstructured":"Bureau UC \u201cThe U.S. Joins Other Countries With Large Aging Populations \u201daccessed January 13 2025 Census.gov https:\/\/www.census.gov\/library\/stories\/2018\/03\/graying\u2010america.html."},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12806"},{"issue":"9","key":"e_1_2_11_19_1","first-page":"1423","article-title":"Effective Physician\u2010Patient Communication and Health Outcomes: A Review","volume":"152","author":"Stewart M. A.","year":"1995","journal-title":"CMAJ: Canadian Medical Association Journal"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2008.03.012"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002512\u2010200724030\u201000002"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2024.515"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1525\/jer.2011.6.3.31"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.974782"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1740774512456455"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040324"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.29104"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70218","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T18:23:17Z","timestamp":1767723797000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/jgs.70218"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70218","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"type":"print","value":"0002-8614"},{"type":"electronic","value":"1532-5415"}],"subject":[],"published":{"date-parts":[[2025,11,26]]},"assertion":[{"value":"2025-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}