The Most Simple Way to Diversify Clinical Trials Begins in The Heart of The Community

Today’s clinical trials struggle to include diverse patient populations due to limited, centralized trial sites that are not easily accessible for many. However, community-based research sites bring a host of diversity benefits to the clinical research ecosystem.

Laurel Uballez
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Today’s clinical trials struggle to include diverse patient populations due to limited, centralized trial sites that are not easily accessible for many. Even when sites are accessible, underserved and minority populations have a heightened lack of trust in healthcare providers and systems due to historical biases exhibited by care teams. In their recent Achieving Health Equity report, the Milken Institute says:

“Research shows that Black patients are systematically undertreated for pain relative to White patients … there is implicit bias in the system, and it’s led to earned distrust.”

Additionally, many patients in these more diverse populations experience financial, logistical, and physical barriers to participate. These major clinical site operations unfortunately lack patient familiarity, trust, and flexibility to accommodate, making these major roadblocks to including underserved populations in research.

“These [large academic] sites and investigators generally do not provide care to underserved populations and are often not easily accessible to diverse communities.” (2021, Woodcock et al.)

Because many diverse patients are unable to access today’s trials, the common trial makeup often inaccurately represent the true populations in the world. This 2017 Journal of Oncology Practice article on the Representation of Minorities and Women in Oncology Clinical Trials demonstrates how Hispanic people, for example, only make up 2.6% of clinical cancer research participants while they make up 18% of the total U.S. population.

This means we have room to grow in developing treatments that are more effective for everyone, and we all can play a role in how we get there.

Starting in The Community

Community-based research sites bring a host of diversity benefits to the clinical research ecosystem. Conveniently located where patients live and work, local research physicians and care teams have already established strong connections and trust with their unique communities. Many are more than qualified with the right skills, experience, and capabilities to participate in global trials, but are overlooked and unfamiliar to sponsors.

Community sites bring:

  • Access to diverse patient populations within their community and increase patient access to the care facilities conveniently located where they live and work.
  • Care teams who mirror the community’s diversity, promoting higher cultural competence and patient comfort.
  • Flexibility to creatively reduce financial, logistical, and physical barriers for patients.
  • Relationships with local patients and strong community ties brings deeper levels of trust, comfort, and confidence.

As an industry, we have a powerful opportunity to maximize the impact of these strong, already diverse, and trusted community sites. Enabling them to participate in more clinical trials would unlock their community’s access to trials and sponsor access to more diverse patients. So how do we enable them? By creating an opportunity for visibility, connection, and trust with sponsors. When we stop focusing solely on diversifying patient enrollment and start working to diversify trial sites, the expanded patient populations will follow.

Inato does exactly this. Our platform connects top sponsors with community sites. We help sites find and match with the right trials, spotlight their diversity strengths, and get in front of sponsors. And we help sponsors get visibility and access to more reliable, diverse sites to make their trials more inclusive.

In a current COPD trial with a top-20 sponsor, the Hispanic population represented 42% of Inato-sourced site patient screenings compared to only 15% Hispanic representation for non-Inato sites. Many Inato site partners are reporting far above average engagement of underrepresented patient populations. For instance, one Florida site recently reported their 40% Black patient population (compared to their city’s 16.5% Black population). And another in Indiana reported a 70% Hispanic population compared to the state’s 7.7% Hispanic population. This kind of access to reliable, diverse sites is the result of Inato’s thorough validation process that top sponsors have come to trust. Together, we’re able to move the needle toward more inclusive research for everyone.

“Inato is enlarging our investigators network, reaching sites with less competition, potentially less number of patients but patients who will not be captured for our studies without them. These different site profiles are enriching our trial patient populations.” – Top-20 Industry Sponsor

Learn more about Inato and how we’re already enabling 2.4k+ community researchers globally to connect with more sponsors and trials at inato.com.

References

Achieving Health Equity. Yasmeen Long and Esther Krofah. 2021

Integrating Research into Community Practice — Toward Increased Diversity in Clinical Trials . Janet Woodcock, M.D., et al. 2021. The New England Journal of Medicine.

Representation of Minorities and Women in Oncology Clinical Trials: Review of the Past 14 Years. Narjust Duma, et al. 2017. American Society of Clinical Oncology. JCO Oncology Practice Journal.

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