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Clinical Trials Aren鈥檛 Diverse Enough. Here鈥檚 Why.

MSM's Dr. Priscilla Pemu shared insights on barriers to participation and strategies to make clinical trials more inclusive, particularly for communities of color and rural areas.

By Taylyn Harmon, BlackDoctor.org

Clinical trials are essential for developing new medical treatments, but historically they have lacked diverse representation.

In a recent BlackDoctor.org discussion on Facebook Live, 无码人妻 School of Medicine

Associate Dean of Clinical Research Dr. Priscilla Pemu; the Cobb Institute鈥檚 Dr. Christina

Stephens; and Tesheia Harris, chief strategy officer at Yale Center for Clinical Investigation at Yale School of Medicine, shared insights on barriers to participation and strategies to make clinical trials more inclusive, particularly for communities of color and rural areas.

Why Diversity in Clinical Trials Matters

Dr. Pemu, who also serves as a professor of Clinical Medicine at MSM, emphasized that diversity in clinical trials is crucial because 鈥渢he only way to really figure out if [a treatment] works is to do a clinical trial.鈥�

She noted that different populations may respond differently to treatments, so it鈥檚 important to have representation from all groups likely to use a medication or device.

Harris added that diversity impacts trust and uptake of new treatments. 鈥淥ne of the primary questions post [COVID] vaccine approval was, 'Were there people like me in that clinical trial?' Having representation allows researchers to say, 'There were people like me who participated.'鈥�

Key Barriers to Participation

The experts outlined several barriers preventing diverse participation. Social determinants of health play a significant role, as Harris noted, 鈥淚f someone is worried about whether they鈥檙e going to lose their house or they don鈥檛 have food, then clinical trials participation will be at the top of the list.鈥�

Logistical challenges also pose obstacles, with Harris explaining that participation often requires "time off from work, or they might need even someone to go with them because they鈥檙e so ill.鈥� Lack of awareness is another major issue, with Harris stating, 鈥淥ne of the largest barriers to participation is simply just not being asked.鈥� Mistrust based on historical experiences and anxiety about the clinical trial process were also identified as significant barriers.

Strategies to Increase Diverse Participation

To address these challenges, the speakers highlighted several strategies. Community partnerships with churches and local organizations can help build trust and reach diverse populations. Dr. Pemu emphasized the importance of person-centered care, focusing on 鈥渃ommunication that takes into consideration the needs, the culture, the aspirations of the individual.鈥� Ensuring diverse research teams and tailoring outreach efforts to different age groups and communities were also recommended. While cautioning that 鈥渢echnology is not a silver bullet,鈥� Harris noted that it can play a role in improving access and engagement. Dr. Pemu also suggested educating people about career opportunities in clinical research to build a more diverse workforce.

The Role of EQBMED

The speakers discussed the Equitable Breakthroughs in Medicine Development (EQBMED) initiative, which aims to increase diverse participation in clinical trials. Dr. Pemu explained that EQBMED provides tailored support for practices based on their specific needs. The project involves partnerships with faith-based organizations and community leaders, with a focus on sustainability.

Harris emphasized the importance of 鈥渉aving the conversations with our funder, Pharma, about how important sustainability would be.鈥� EQBMED also works to connect pharmaceutical sponsors with diverse research sites.

Practical Steps for Potential Black Clinical Trial Participants

For those interested in participating in clinical trials, Dr. Pemu offered practical advice. She recommended searching for relevant studies in one鈥檚 area and reaching out to study sites directly with questions. She encouraged discussing logistical concerns like transportation with study staff and exploring decentralized trials that may come to participants. Contacting advocacy organizations for support was also suggested.

The speakers emphasized the critical importance of diverse participation in clinical trials. As Dr. Pemu concluded, 鈥淪tanding on the side and not participating, I think, guarantees that we continue to see the health inequities that we鈥檙e so concerned about.鈥� By addressing barriers and implementing inclusive strategies, the medical community can work towards more equitable and effective health care for all.