Non-Hispanic Black Patients Are Less Likely to Participate in Clinical Trials

A new study showed that there may be differences in invitation to and participation in clinical trials by person-level demographics and clinical characteristics.

In an analysis of the 3,689 participants in the Health Information National Trends Survey, non-Hispanic Black adults had a high likelihood of being invited to participate in a clinical trial, but a lower likelihood of actually participating.

Of the included participants, 59% were non-Hispanic White, 10% non-Hispanic Black, and 14% Hispanic. Only about one-tenth (9%) of survey respondents had been invited to participate in any clinical trial.

Non-Hispanic Black patients had increased odds of invitation to participate compared with non-Hispanic White patients (adjusted odds ratio [aOR]=1.85, 95% confidence interval [CI] 1.13-3.02).

“These results contrast with prior literature proposing trial design- and researcher-level explanations for racial and ethnic disparities in clinical trial representation, such as restrictive eligibility criteria and researcher bias, that may hinder equitable invitation,” the researchers wrote. “Our results may reflect researcher-level uptake of initiatives to increase the diversity of clinical trial participants.”

Highly likelihood of invitation was also seen for those with a high school education compared with less than a high school education (aOR=4.84, 95% CI 1.89-12.39), who were single compared with married or living as married (aOR=1.68, 95% CI 1.04-2.73), and who had at least one medical condition compared to none (aOR=2.25, 95% CI 1.32-3.82).

Interestingly, respondents living in a rural area had a 77% decreased likelihood of invitation to participate in a clinical trial compared with those living in an urban area.

In contrast to invitation to participate, non-Hispanic Black patients had 72% reduced odds of participating in a clinical trial compared with non-Hispanic White patients (aOR=0.28, 95% CI 0.09-0.87).

“Multilevel institutional efforts addressing eligibility, access, and systemic racism are needed to decrease racial and ethnic health inequities in clinical trial participation, such as diversifying the health care workforce, increasing community engagement, enhancing transparency of research practices, and training health care professionals in structural competency, defined as identifying and clinically addressing structural drivers of health inequity,” the researchers concluded.