Association between e-health usage and consideration for clinical trial participation: An exploratory study on the mediating role of cancer-related self-efficacy and patient-centered communication.

Background: The journey of any new treatment begins in the lab and through a clinical trial. Clinical trials have become an important means to promote public health causes. In digital age, e-health usage (EHU) might be a key factor to promote clinical trials. However, how consideration for clinical trial participation is impacted by EHU remains unclear. Method: Secondary analyses were conducted on data from the Health Information National Trends Survey 2020 (HINTS 5, Cycle 4). This study proposed and tested a serial mediation model linking EHU to consideration for clinical trial participation, mediated by patient-centered communication (PCC) and cancer-related self-efficacy (CS). Analysis was performed using a sample survey targeted at individuals with chronic disease and/or family cancer history, conducted in 2020 in the United States ( Result: This study found that EHU exerted positive effects on clinical trial participation directly. Furthermore, their relationship can be mediated by PCC and CS. Only when PCC serves as the first mediator did CS exert the serial meditation effect. Annual household income significantly moderates the path from CS to consideration for clinical trial participation. For low-income groups, an increase in CS significantly expends their consideration for clinical trial participation. Conclusion: EHU can improve PCC and CS. This can be considered as motivators for increasing participation to clinical trials. Based on the finding, information related clinical trials should be promoted through e-health channels and the information should gain better patients' understanding. Those findings throw out suggestions on building trust, addressing concerns and alleviating fears to clinical trial participation.