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. 2023 Jan-Feb;21(1):54-56.
doi: 10.1370/afm.2901.

Recruiting Indigenous Patients Into Clinical Trials: A Circle of Trust

Arch G Mainous 3rd  1   2 , Allison Kelliher  3 , Donald Warne  4
Affiliations

Recruiting Indigenous Patients Into Clinical Trials: A Circle of Trust

Arch G Mainous 3rd et al. Ann Fam Med. 2023 Jan-Feb.

Abstract

The Circle of Trust is a new conceptual model that can help investigators and the American Indian/Alaska Natives (AI/AN) community work together to promote inclusion of AI/AN populations in clinical trials to improve health outcomes. Racial/ethnic minority groups remain underrepresented in clinical trials and this creates the need and opportunity for novel approaches. Indigenous populations are particularly underrepresented in clinical trials. Studies show that AI/AN have the lowest representation of race/ethnic groups in the United States. American Indian/Alaska Natives suffer from significant health disparities with higher rates of morbidity and mortality and lower rates for preventative measures and access to health services. A variety of barriers to recruitment of minority patients exist at several levels including the system/institutional, interpersonal, and the individual. The authors, experts in AI/AN health and recruitment of minorities into research, collaborated to modify the currently existing and published "trust triangle" model that focuses on minority recruitment to include participants, researcher, and trusted entity. We advocate for expanding the trust triangle into a circle of trust inclusive of community. The "circle of trust" is a new conceptual model that can help investigators and the AI/AN community work together to promote inclusion of AI/AN populations in clinical trials to improve health outcomes.

Keywords: Alaska Natives; American Indians; barriers to recruitment; circle of trust; patient recruitment for clinical trials; triangle of trust; trust.

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Figures

Figure 1.
Figure 1.
The trust triangle.
Figure 2.
Figure 2.
The circle of trust.
See this image and copyright information in PMC

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