November 28th, 2018

Increasing African-American Enrollment in Clinical Trials through Holistic Recruitment

african american patients

African-Americans are underrepresented in many clinical trials. Here are three steps CROs and sponsors can take to improve recruitment of minority patients.

While nearly 40% of Americans now belong to a racial or ethnic minority, clinical trials have often struggled to recruit diverse patients. In fact, some studies testing new drugs are composed of 80-90% white patients.

African-Americans are particularly underrepresented in clinical trials, which means that physicians and pharmaceutical companies may lack comprehensive data on how to accurately treat them. In tests for 24 of the 31 cancer drugs approved by the FDA since 2015, for example, less than 5% of patients were of African descent. This is especially concerning considering that the death rate from cancer is 24% higher in African-American men and 14% higher in African-American women than in their Caucasian counterparts.

Fortunately, clinical trials can be proactive in recruiting African-American patients by relying on digital marketing and local recruitment efforts. Telehealth and remote monitoring can also remove barriers for diverse patients looking to participate in research. By incorporating the following three practices, CROs and sponsors have the potential to expand their patient pools and bring valuable treatment opportunities to underrepresented populations.

1. Build trust through transparent consent

Due to a history of questionable healthcare practices, minority patients tend to distrust medical professionals and fear exploitation. In fact, 50% of African-Americans continue to cite lack of trust as a barrier to clinical trial participation.

To combat this negative perception, CROs and sponsors should focus on building trust through clear and informative consent policies and transparent onboarding processes. Electronic Informed Consent (eConsent) is an especially useful tool in that it allows patients to complete the consent process in their own time, often from their own home.

With a disproportionately high percentage of African-American enrolled in clinical trials that do not require consent – such as emergency medical procedures where patients are unable to respond – the issue of informed consent is especially relevant. By taking the steps to clearly and consistently educate patients on what a study entails, clinical trials can maintain trust and reduce patient dropouts.

2. Reduce barriers to clinical trial participation

African-American underrepresentation in clinical trials may also be due to the fact that many minorities lack access to the specialty centers that tend to recruit patients for research. In addition, African-Americans may not have the time or financial resources to participate in what is often perceived as a burdensome process.

To recruit and retain minority patients, trials can make use of technology like remote monitoring, which allows patients to measure their health from home. Many trials are also partnering with companies like Uber and Lyft to bring patients to and from study locations. As reliable transportation is an obstacle for many patients, CROs and sponsors may want to invest in ridesharing services that make participation more feasible.

3. Use digital marketing to reach new patients

Finally, many African-Americans simply are not aware of the many research opportunities that could improve their quality of life. That’s why it’s important for CROs and sponsors to expand their recruitment efforts with digital marketing.

Digital marketing helps generate diverse patient leads, as well as target specific communities and demographics. Mobile advertising is an especially effective way to reach potential African-American patients, as studies show that members of the African-American and Latinx communities are more likely to use their phones to research health information.

Facebook ads have the ability to target for age, gender, interests, and other factors, which can help clinical trials build out a comprehensive patient pool. To further narrow their audience, CROs and sponsors can use localized advertising. This means that ads show in only a particular region, which can boost recruitment for specific investigator sites.

As a lack of African-American representation in clinical trials means that researchers won’t be able to gather accurate data for how a device or treatment affects the entire population, it’s important for CROs and sponsors to be proactive. Fortunately, efforts to make clinical trials visible and accessible to African-Americans can help build a more representative patient pool.