Addressing Gaps in Clinical Trial Access for African Americans

Background: Clinical trials are essential for generating evidence on the safety and efficacy of new treatments. However, Black Americans remain underrepresented in clinical research, particularly for conditions that disproportionately affect them. This underrepresentation compromises the generalizability of findings and perpetuates health disparities. This study aimed to identify barriers and facilitators to African American participation in clinical trials and to inform culturally sensitive strategies to improve enrollment of diverse populations. Methods: We developed a 38-question web-based survey, divided into three domains: (1) cultural affinity, (2) trust, and (3) background information. The survey was administered using Jotform, a HIPAA-compliant platform. Participants—Black adults residing in the Southern U.S.—were recruited via community outreach, social media, and radio advertisements. Results: A total of 260 Black adults completed the survey. Key barriers to participation included historical mistreatment of African Americans in medical research, concerns about side effects of experimental treatments, and the lack of Black clinicians in research roles. Facilitators included increased representation of African Americans in medical research, physician recommendation, diverse IRBs, clear explanations of study details, and community relevance of the research. Notably, only 27.6% of respondents were influenced by free transportation, and 37.5% by financial compensation. Conclusion: While Black Americans are willing to engage in clinical research, trust and safety remain critical concerns. Addressing historical injustices, promoting diversity in research leadership, and enhancing community engagement are essential for fostering trust. Use of plain language, cultural competence, and inclusive recruitment practices are key strategies to increase African American participation in clinical trials.