Abstract
Historically marginalized communities are disproportionately affected by cardiometabolic diseases yet are underrepresented in clinical trials that investigate needed interventions. This review investigates the barriers to equitable inclusion in clinical trials, identifying opportunities for improvement at the institutional, trial, community, and individual level. It proposes a social determinants-based approach that serves as a toolkit to target these barriers using structural, economic, community, healthcare access, and technology solutions, supporting constructive improvement in the clinical trial recruitment process.
Keywords:
clinical trials; recruitment; social determinants; underrepresentation.
Copyright: © 2024 The Author(s).
MeSH terms
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Clinical Trials as Topic*
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Health Services Accessibility
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Health Status Disparities
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Healthcare Disparities
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Humans
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Minority Groups
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Patient Selection*
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Research Subjects
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Social Determinants of Health*
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Vulnerable Populations
Grants and funding
Dr. Fatima Rodriguez reports equity from Carta Healthcare and HealthPals and is a consultant for HealthPals, Novartis, NovoNordisk, Esperion Therapeutics, Movano Health, Kento Health, Inclusive Health, Edwards, Arrowhead Pharmaceuticals, HeartFlow, iRhythm, Amgen, and Cleerly Health outside the submitted work; she receives grant funding from the NIH National Heart, Lung, and Blood Institute (1K01HL144607; R01HL168188), the American Heart Association/Harold Amos Medical Faculty Development program, and the Doris Duke Foundation (Grant #2022051).