A roadmap for improving representation in clinical trials

Abstract

Clinical trials continue to struggle with recruiting diverse participants that include historically underrepresented and minoritized patients, who are typically patients in non-white racial and ethnic groups and have low income (Medicaid). Enrolling diverse participants will benefit the health sciences by providing more generalizable findings. The Cancer Financial Experience project (CAFÉ) study sought to improve financial distress by providing financial navigation for newly diagnosed cancer patients, and intentionally recruited diverse participants. All diverse participants consented at slightly higher rates than non-diverse participants (21.3 % vs. 20.1 %). Spanish-speaking patients consented at a much higher rate than non-Spanish speakers (36.4 % vs. 20.2 % respectively). Here we discuss how we increased our recruitment of diverse participants. Obtaining diverse participation is achievable and will provide more meaningful findings.

Fig. 1

Consented Diverse Participants. Note: Percentages are based on the number of individuals who consented to participate in the CAFÉ trial among those who were approached to participate, stratified by whether it was they were from the under represented or general recruitment population. P-value = 0.54 based on chi-square test.

Fig. 2

Consented Primary Spanish Speaking Participants Note: Percentages are based on the number of individuals who consented to participate in the CAFÉ trial among those who were approached to participate, stratified by whether it was they were in the Spanish- or English-speaking population. P-value-0.01 based on chi-square test.