One of the best ways the clinical research enterprise can address issues of trust in communities of color is to encourage research sites to sprout from within those communities, thought leaders on topics tied to patient diversity challenges in clinical trials say.
“Without trust, we do not have access to communities of color,” says Awawu Igbinadolor, MD, principal investigator with Monroe Biomedical Research in North Carolina and coauthor of a peer-reviewed article on addressing the diversity gap in clinical research that is forthcoming in the February issue of ACRP’s Clinical Researcher journal. “Without access, we cannot foster trust through education. Medical doctors within these communities can educate patients about research with a baseline of trust, which in turn fosters confidence in clinical trial participation.”
However, saying that minority groups will only trust medical professionals who look like them risks oversimplifying the matter, Igbinadolor notes. “The conundrum of trust is much more nuanced,” she says. “Considering the historic deficits and inequities suffered by ethnic minorities, patients of color require reassurances that they will not be treated differently due to their race. They will place their confidence in a medical team which will value their health and wellbeing irrespective of their identity. If a patient observes a study team comprised of many different backgrounds cooperating and valuing one another, then the patient will anticipate the same treatment in turn. Therefore, diversity in patient enrollment begins with a diverse study team.”
Diversity in clinical research is both a scientific and ethical issue, explains LaQuinta Jernigan, executive vice president for The Americas with mdgroup, who wrote about raising awareness of clinical trials in diverse communities in the December 2021 issue of Clinical Researcher. “Of key importance from a scientific standpoint is the fact that study data are incomplete if diverse communities are left out,” she says. “Ethically, it is our duty as an industry to work to remove disparities in healthcare, making it accessible for all. We must make sure nobody is left out. We cannot allow ourselves to be overwhelmed by everything that needs to be done. We need to start wherever we can.”
The fact that such discussions are now happening on an industry level is a sign of progress, Jernigan says.
“One of the first things that needs to happen is the inclusion of people of color in the research process—not only as participants but as administrators and facilitators,” Rashaad Galloway, a cofounder of CliniSpan Health, is quoted as saying in Jernigan’s article. “We need more black doctors because black people trust black doctors—people of color trust the people who look like them.”
Considering that many diseases disproportionately impact the African American community, researchers must frame the diversity deficit as nothing less than a scientific crisis, Igbinadolor adds. “As our industry continues its fight against the pandemic, we must recognize that only through diverse clinical trial participation will the next generation of therapeutics benefit all Americans,” she says.
Edited by Gary Cramer