Attracting a diverse population of patients for a clinical trial is critical for patient health and long-term community wellness. And clinical trial diversity goals aren’t just a “nice to have;” the National Institutes of Health Revitalization Act of 1993 requires all federally funded clinical research to prioritize efforts to include women, as well as underserved racial and ethnic groups. The Food and Drug Administration also encourages greater diversity; its efforts include a website engineered to draw in trial patients from underrepresented genders, races and age groups.
Increasing the diversity of clinical trial patient populations is a formidable challenge, but one that’s imperative for national health advancements. Meeting goals will require contributions from across the medical community.
6 Ways to achieve a Greater level of diversity in your trial candidate group
Bringing in patients from different backgrounds requires a certain degree of effort and awareness on the part of clinical trial managers. Here are a few areas where your team should focus to achieve a greater level of diversity in trials:
- Build trust
- Leverage technology that increases engagement
- Partner with physicians
- Talk to advocates
- Help clear economic obstacles
- Expand recruitment
Unfortunately, mistrust of doctors exists among many minority communities. The likelihood of mistrust can increase if they encounter medical staff that don’t look like them and have little or no awareness of the culture they come from.
One powerful way to increase trust with a community is to recruit a staff of clinical trial investigators that reflect the diversity of the community you work with. Patients that come from a certain racial or cultural background tend to feel more at ease with people from similar backgrounds. When that need is met, they are more likely to give open, honest and accurate responses to your questions. Their increased comfort level also may mean they are less likely to leave the clinical trial.
Leveraging technology to increase engagement
Given the advances in machine learning, clinical sites are turning to AI to help ensure diverse populations are a key component in their studies. AI techniques extracts symptoms, diagnoses, treatments, genomics, lifestyle, demographics and thousands of other data points from medical files and sorts the fragments into patient profiles, all while protecting private identifying information. AI effectively identifies a diverse mix of patients eligible for a specific study and allows sites to show sponsors that their databases align with study needs. The result is a larger and more diverse pool of potential volunteers that better represent communities.
Once enrolled, there are also clinical trial solutions that help keep diverse populations Engaged. Digital solutions such as eConsent can help fully engage patients on a one-to-one level, especially critical for patient populations who might not have a positive view of trials. Clinical trial managers can build patient-specific engagement by using color, images, audio, video, and other digital elements to elevate the experience from static to dynamic and from general to personal. Digitizing the process can increase the chances of a positive experience and boost patient retention
Partnering with Physicians
Reaching underrepresented communities to increase awareness and understanding of clinical trials can prove to be a significant obstacle.Physicians that serve communities you are working to increase participation from can help with outreach. They can explain what a clinical trial is, outline the benefits, and increase their comfort with the process. Take the time to explain your trials to these doctors and nurses, how your efforts ultimately may promote better health among the people they serve, and how their patients can participate. The connection potentially offers mutual benefits—you provide the medical offices with culturally appropriate healthcare information, and they help steer potential patients to your site. Armed with that knowledge, patients will have increased comfort and understanding of clinical trials and be more inclined to join.
Working with Advocates
Talk to advocates. Groups that work with and for specific minority populations have a unique relationship with those people. Representatives of these organizations can help you build a connection with such people, and inform you of their needs. Because its stated mission is working with and advocating for a specific population, an advocacy group that addresses the needs of that population can offer you unique insight. They likely can share useful information on cultural challenges, obstacles to care, diseases more common to people of that racial background and more. Such data can be extremely beneficial when recruiting, engineering trial access, designing trials and improving recruitment and retention.
Help clear economic obstacles
Taking part in a trial can require a patient to incur expenses—transportation, childcare, missed work and more. Finding solutions that help alleviate the economic burden can increase chances of participation. Offering patients assistance in acquiring transportation to and from your trial site might help recruitment and retention. Reimbursing or paying for bus, train or other public transit is one possibility. Rideshare company Uber offers Uber Health, a non-emergency health transport system that enables doctors, clinical trial administrators and other such personnel to arrange for rides to and from their site, even if the patient doesn’t own a smartphone.
Another potential consideration: participation in the trial may require additional tests or treatment that your sponsor or the patient’s insurance does not cover. It is your obligation to inform potential patients if such expenses exist, but you can improve the likelihood they will enroll if you connect them with resources to help pay for them. Patient advocacy groups and government agencies might be able to help cover such costs.
Casting a wider net
Expanding recruitment efforts is a crucial step to increasing diversity. Your current marketing and outreach work may not be getting in front of a diverse enough area of recruits. Consider expanding your messaging to different geographic areas, or using different advertising avenues. Digital recruitment and participation tools also can amplify your recruitment messaging. Social media ads and app messages can help. Also, if you can tell patients at least part of the trial can be conducted remotely via computer or smartphone responses, that might increase the appeal for minority populations. Remote trial participation reduces the burden of travel, cuts down the time they will be required to be away from work and family, and generally increases convenience.
Increasing the diversity of clinical trial patient populations is a formidable challenge, but one that’s imperative for national health advancements. Meeting goals will require contributions from across the medical community. Learn how Trial Suite can support your efforts.