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Peer-reviewedCC BY-NC-NDPreventive medicine reports

Strategies for recruitment and retention of underrepresented populations in randomized clinical trials in the United States: A mixed-methods study.

  • Josiah Drakes1,2,3
  • Medha Romee Maitra2,3,4
  • Jasmine A Silvestri2,3
  • Emma Britez Ferrante2,3
  • Dorothy Sheu2,3
  • Sebastian Castro2,3,5
  • Adina Lieberman2,3
  • Scott Halpern2,3,6,7
  • Meghan Lane-Fall8
  • Rachel Kohn2,3,6,7
  • Tamar Klaiman2,3,9,10
  • BETTER Center
10 affiliations
  1. 1Xavier University of Louisiana, New Orleans, Louisiana, United States.
  2. 2Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, United States.
  3. 3Behavioral Economics to Transform Trial Enrollment Representativeness (BETTER) Center, American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials, United States.
  4. 4The University of Georgia, Athens, GA, United States.
  5. 5Princeton University, Princeton, NJ, United States.
  6. 6Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
  7. 7Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
  8. 8Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, NY, New York, United States.
  9. 9Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania, Philadelphia, PA, United States.
  10. 10Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
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Abstract

Objective

We explored facilitators influencing participation in randomized clinical trials (RCTs) among underrepresented groups in the United States, including Black and Hispanic/Latinx individuals, women, and rural populations.Methods

We recruited a convenience sample of adults from these underrepresented groups to complete an online survey of multiple-choice and open-ended questions about preferences and motivations for RCT participation. Recruitment occurred May through September 2023.Results

Facilitators included regular communication, minimizing participant burden, building trust, fair compensation, and emphasizing the purpose and value of research.Conclusion

To improve inclusivity and generalizability, addressing the barriers to RCT participation for underrepresented groups is crucial. Our results point to the importance of designing RCTs that prioritize transparency, clearly define the research objectives, reduce participant burden, and cultivate trust, while ensuring that compensation and logistical support are equitable and reflect participants' time and effort.

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Cite

BibTeXRIS
BibTeX
@article{drakes2026strategies,
  title = {{Strategies for recruitment and retention of underrepresented populations in randomized clinical trials in the United States: A mixed-methods study.}},
  author = {Josiah Drakes and Medha Romee Maitra and Jasmine A Silvestri and Emma Britez Ferrante and Dorothy Sheu and Sebastian Castro and Adina Lieberman and Scott Halpern and Meghan Lane-Fall and Rachel Kohn and Tamar Klaiman and BETTER Center},
  journal = {Preventive medicine reports},
  year = {2026},
  month = oct,
  doi = {10.1016/j.pmedr.2026.103653},
  url = {https://europepmc.org/article/MED/42894875},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Strategies for recruitment and retention of underrepresented populations in randomized clinical trials in the United States: A mixed-methods study.
AU  - Josiah Drakes
AU  - Medha Romee Maitra
AU  - Jasmine A Silvestri
AU  - Emma Britez Ferrante
AU  - Dorothy Sheu
AU  - Sebastian Castro
AU  - Adina Lieberman
AU  - Scott Halpern
AU  - Meghan Lane-Fall
AU  - Rachel Kohn
AU  - Tamar Klaiman
AU  - BETTER Center
PY  - 2026
DA  - 2026/10/08
JO  - Preventive medicine reports
DO  - 10.1016/j.pmedr.2026.103653
UR  - https://europepmc.org/article/MED/42894875
AB  - Objective  We explored facilitators influencing participation in randomized clinical trials (RCTs) among underrepresented groups in the United States, including Black and Hispanic/Latinx individuals, women, and rural populations.Methods  We recruited a convenience sample of adults from these underrepresented groups to complete an online survey of multiple-choice and open-ended questions about preferences and motivations for RCT participation. Recruitment occurred May through September 2023.Results  Facilitators included regular communication, minimizing participant burden, building trust, fair compensation, and emphasizing the purpose and value of research.Conclusion  To improve inclusivity and generalizability, addressing the barriers to RCT participation for underrepresented groups is crucial. Our results point to the importance of designing RCTs that prioritize transparency, clearly define the research objectives, reduce participant burden, and cultivate trust, while ensuring that compensation and logistical support are equitable and reflect participants' time and effort.
SN  - 2211-3355
ER  -