Diversifying Research Staff Is Linked to Increase in Racially Diverse Clinical Trial Participants
The Bottom Line
In ophthalmological clinical studies, if research staff were of a different race or ethnicity than a patient, 39.9% of patients consented to participation in a clinical trial, as compared to 65.1% who consented when their provider was of the same race or ethnicity. Though this study was performed within the confines of ophthalmology, it stands to reason that its findings are applicable in clinical trials across the board.
There are several ophthalmological diseases — cataract, glaucoma, and diabetic retinopathy in particular — that are more likely to affect Black people. But most clinical trials do not include people of color. One of the most deep-rooted sources of this racial gap is the long-standing mistrust between communities of color and the medical industry. Building a racially diverse clinical team is an oft-proposed method to increase trust and improve engagement among potential study participants. A racially and ethnically diverse clinical trial cohort can result in better outcomes for all patients.
To determine how racial and ethnic identity of researchers affected potential patient participation in ophthalmological clinical trials.
Researchers from Boston Medical Center (BMC) examined screening logs from 10 prospective clinical studies between 2015 and 2021 involving 1,380 patients who were approached for their consent to engage in a clinical trial from the eye clinic at BMC. During recruitment for the clinical studies, screening logs were used to document patients who were approached by research staff for study participation. The log recorded, among others, each patient’s decision to participate or decline, basic demographic information, and the research staff member who approached the patient.
Of the 1,380 prospective patients, 566 were Black; 327 were Hispanic or Latino/a; 373 were white; 36 were another race/ethnicity; and 78 declined to answer. Black patients and Hispanic or Latino/a patients were less likely to consent to participate when compared with white patients. Patients with lower socioeconomic status were less likely to consent than patients with higher socioeconomic status. Concordance between patient and research staff race and ethnicity was associated with increased odds of affirmative consent.
"Our hope is that this study will provide…principal investigators with some strategies to help improve representation of those typically underrepresented in clinical studies," said Manju Subramanian, MD, an ophthalmologist at BMC and co-author of this study in a recent press release, "Further work is needed to investigate the effects of reducing other barriers to study participation, such as decreasing the burden of travel time and cost, promoting community support, and enhancing outreach efforts to improve equity in patient recruitment."
Bains A, Osathanugrah P, Sanjiv N, et al (2023). “Diverse Research Teams and Underrepresented Groups in Clinical Studies.” JAMA Ophthalmology.