Survey: 4 Barriers Keeping Blacks Out of Clinical Trials

Clinical trials play a major role in developing new medicines and advancing medical knowledge, yet access barriers can hinder participation, particularly among marginalized communities. Understanding the challenges faced by Black Americans in accessing clinical trials is crucial for health care workers to improve inclusivity and ensure equitable health care outcomes. (BDO) conducted a survey in February 2024 to assess the issues facing Black individuals revealing the obstacles encountered by Black individuals and shedding light on areas where health care professionals can intervene to promote accessibility and participation.

While almost 43 percent of respondents reported no challenges with accessing or participating in clinical trials, health care workers should remain vigilant and recognize that access barriers may vary based on individual circumstances. 

Requesting Time off from Work

Taking time off from work was the most prominent concern among those surveyed, with 17.99 percent of respondents expressing difficulties in balancing work commitments with participation in clinical trials. Many Black Americans face socioeconomic disparities, including limited access to paid leave or flexible work arrangements, making it challenging to prioritize health care needs over employment. 

Health care workers can support potential participants by advocating for flexible appointment scheduling to include evening or weekend hours to accommodate work schedules. Additionally, providing information about the importance of clinical research and its potential benefits may help individuals navigate discussions with employers about time off for trial participation.

Transportation Challenges

Among the issues identified in the survey, transportation to the clinical trial site emerged as a significant barrier, with 15.55 percent of respondents citing this concern. Where the average clinical trial participant has to travel 67 miles to get to their trial site. Accessing reliable transportation can be particularly challenging for individuals living in underserved communities without a car. 

Health care workers can address this issue by partnering with community organizations or local transportation services to provide shuttle services or, at the minimum, reimbursement for travel expenses. By offering transportation assistance, health care providers can eliminate a major obstacle to participation and ensure that Black individuals have equitable access to clinical trials.

Financial Barriers

The costs associated with participation were highlighted by 10.67 percent of respondents, indicating that financial constraints remain a significant barrier to clinical trial access. While participation in clinical trials is typically free, individuals may incur indirect expenses such as transportation, childcare, or time away from work. 

Health care workers can address this issue by providing comprehensive information about available financial assistance programs, including reimbursement for out-of-pocket expenses and support for ancillary costs. By addressing financial barriers, health care providers can ensure that cost does not prevent Black Americans from participating in potentially life-saving research.

Study Duration and Participant Engagement

Concerns about the length of the study and potential loss of interest were expressed by 12.80 percent of respondents. Clinical trials often require a significant time commitment, which may deter individuals from participating. 

Health care workers can mitigate this barrier by providing ongoing support and communication throughout the trial process. Regular check-ins, personalized interactions, and opportunities for feedback can help maintain participant engagement and motivation. Additionally, offering incentives or rewards for continued participation can incentivize adherence to the trial protocol and enhance retention rates among Black participants.

The survey results underscore the importance of addressing access barriers to clinical trials to promote diversity and inclusivity in medical research. Health care workers play a vital role in advocating for equitable access and supporting Black Americans in overcoming the challenges they may face. By implementing targeted interventions, such as transportation assistance, flexible scheduling, and financial support, healthcare providers can ensure that all individuals have the opportunity to participate in clinical trials and contribute to advancements in health care. Together, we can work towards a future where health care research reflects the diversity of the population it serves, leading to improved health outcomes for all.

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