Health Care Professional Research Highlights Barriers to Clinical Trial Diversity

Improving communication, education, and collaboration were all recommendations to alleviate biases and overcome obstacles to Black patient participation in clinical trials.

Identifying and addressing the perceptions and experiences of health care professionals may assist in overcoming several of the problems associated with clinical trials due to the complex social environments they occur in, according to the PAACT (Participatory Action for Access to Clinical Trials) community-based participatory research project presented at the 2025 American Association for Cancer Research Annual Meeting.

The recommendations were as follows:

• Improve education in the health care system relating to implicit bias and clinical trial communication that will increase understanding of the impact of systemic racism on Black/African American health.
• Interdisciplinary peer collaborations that would increase patient referrals, aid with inter-department communication, and increase knowledge regarding clinical trials.
• Management and leaders need to recognize how much time and resources are required to enroll in a clinical trial.
• Accessible and targeted clinical information for patients that addresses concerns across diverse groups, as well as the financial, social, and psychosocial burdens from clinical trials.

Regarding disparities and distrust, the 3 most prominent themes were community and patient distrust of trials, health care professional biases, and the importance of diversity in clinical trials.

The poster displayed quotes regarding each topic:

“I would say even if it's not African American specific, we are not geared as a health care system to take care of vulnerable populations in general,” one professional said, on distrust.

“If a physician comes in and the individual or the family that he’s speaking to may be poor, maybe the physician will not offer [the CT],” one professional said, on the biases of health care professionals.

“[The study population] needs to be represented by different ethnic [and] different racial groups. That’s why I tell the patients we cannot do a study using one race because it’ll apply only to that race,” said one professional, on the importance of diversity.

Regarding systemic challenges, the most prominent themes were time commitment for clinical trials and recognition, patient personal challenges related to participation, and emotional challenges related to diagnosis and clinical trials.

“At the same time, taking care and offering somebody a clinical trial takes more time, more effort, and that’s not necessarily reflected in clinical productivity,” said one professional, on the time commitment for clinical trials.

“The treatment is only 15 minutes or, depending on what kind of treatment…45 minutes. Then you’re trying to work in a questionnaire or some blood work...and they got to get back home, because this person is depending on them to be babysitting the grandkids...” said a professional, on the personal challenges of a patient that may affect clinical trial participation.

“....[patients] are overwhelmed, when they have a cancer diagnosis, they have cancer treatment...Adding an additional layer or 2 or 3 on top of that can be burdensome for someone,” said a professional, on the emotional distress a cancer diagnosis can cause.

Regarding clinical trial screening, prominent themes were the need for supportive services and the importance of communication between doctors and clinical trial staff.

“Having people that not only support the trial, but also support the patient and their questions, concerns, and their needs is important...like supportive oncology services and psychosocial support and financial support and those things,” a health care professional said on the need for additional services.

“Even if a provider will reach out to us sometimes, we’ll ask, ‘Does the patient know that we’re looking at this first?’ Because sometimes they want to know, before they even present it to the patient. They want to say, ‘Hey, is this looking good? Does this patient, just at first glance, look good?’” said a professional, on the importance of communication.

The project’s data were collected from health care professionals at Henry Ford Cancer Institute in Detroit, MI, who worked in cancer care or cancer clinical trials.

In-person and virtual interviews were conducted using qualitative guides developed via a comprehensive literature review. All responders were also asked to recommend changes to the procedure that may support the access of Black/African American patients to cancer clinical trials.

After initial data analysis, 2 community forums were organized such that patients and community members were able to review and interpret the outcomes and recommendations that the survey came to. A total of 83 patients were included in the community forums.

PAACT 2.0 is currently piloting the recommendations from this study.

References

Kaljee LM, Antwi S, Dankerlui D, et al. Black/African American participation in cancer clinical trials: healthcare professionals perspectives. Presented at the 2025 American Association for Cancer Research Annual Meeting; April 25-30, 2025; Chicago, IL. Abstract 3996.