BACKGROUND:There are analogies between the development of therapeutic drugs for cancer and the development of interventions for reducing cancer health disparities. In both cases, it can take between 12 and 15 years for the benefits to become apparent. METHODS:The initial preclinical phase of drug development is analogous to the development of community partnerships and helping the community learn about cancer. The preclinical phase of in vitro and in vivo testing is analogous to identifying the disparities in the community. Then clinical testing begins with phase 1, toxicity, and dose-establishing studies. Analogously, community-based participatory research is used to develop disparities-reducing interventions (DRIs) within the community. RESULTS:The phase 2 clinical studies to determine whether the drug has activity are analogous to the DRI being implemented in the community to determine whether it can cause behavioral changes that will reduce cancer health disparities. If a drug passes phase 1 and 2 studies, phase 3 clinical trials are initiated. These are controlled studies to examine the efficacy of the drug. The similar activity for disparities research is to determine whether the DRI is better than the current standard/usual practice in controlled trials. If the drug is beneficial, the final phase is the dissemination and adoption of the drug. Analogously in disparities, if the DRI is beneficial, it is disseminated and is culturally adapted to other racial/ethnic groups and finally adopted as standard practice. CONCLUSIONS:The process of creating an effective DRI can be envisioned to have 4 stages, which can be used to aid in measuring the progress being made in reducing cancer health disparities.

译文

背景:癌症治疗药物的开发与减少癌症健康差异的干预措施的开发之间存在类比。在这两种情况下,收益的显现都可能需要12到15年。
方法:药物开发的临床前阶段类似于社区伙伴关系的发展,并帮助社区了解癌症。体外和体内测试的临床前阶段类似于确定社区中的差异。然后,临床测试从阶段1,毒性和剂量确定研究开始。类似地,基于社区的参与性研究被用于在社区内开发减少差异的干预措施(DRI)。
结果:确定该药物是否具有活性的2期临床研究类似于在社区实施的DRI,以确定其是否会引起行为改变,从而减少癌症健康差异。如果药物通过了第1和第2阶段的研究,则将启动第3阶段的临床试验。这些是检查药物疗效的对照研究。差异研究的类似活动是确定DRI是否比对照试验中的当前标准/常规更好。如果药物是有益的,那么最后阶段就是药物的传播和采用。类似地,如果DRI是有益的,则将DRI传播并在文化上适应其他种族/族裔群体,并最终用作标准做法。
结论:可以将创建有效DRI的过程分为四个阶段,这些阶段可用于帮助衡量减少癌症健康差异方面取得的进展。

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