As the issues surrounding clinical trial participant diversity become better understood globally, more eyes are turning to the next frontier in drug development diversity, equity, and inclusion: the clinical research workforce.
In the forthcoming August 2022 issue of Clinical Researcher from ACRP, the authors of an expanded and updated study of principal investigators, nurses, and other allied health professionals focus on understanding the motivations of these professionals for joining the healthcare industry, as well as the barriers they perceive to involvement in it. Among other observations, the authors note that addressing the lack of mentorship for non-white professionals is an important step to providing opportunities for candidates from all backgrounds to contribute their expertise to the clinical research workforce.
Led by researchers from the Tufts Center for the Study of Drug Development (CSDD) at Tufts University and described in a peer-reviewed article for Clinical Researcher with coauthors from Merck, Genentech, and CSL Behring, the new study follows up on work from 2008 which found that significant racial and ethnic disparities exist among clinical investigators despite a comparable interest in clinical research involvement. The authors of that work also proposed that physician race or ethnicity may influence the race or ethnicity of clinical trial volunteers.
For the new work, a survey was distributed to a global audience between April and July 2021. In all, 611 respondents consented to participate in the online survey, with 54% of respondents from North America (U.S. or Canada) and 46% from outside North America. This survey was open to both healthcare professionals with and without clinical research experience. Overall, white and non-white respondents reported similar levels of clinical research experience.
Given the options of “extremely interested,” “somewhat interested,” and “not at all interested” in clinical research work, non-white respondents—both overall and within a subgroup of those holding MDs or PhDs—selected “extremely interested” in higher proportions. In North America, non-white MDs/PhDs were significantly more likely to be “extremely interested.”
Respondents with no work experience in clinical research were asked to rate a variety of barriers to clinical research involvement as “very important,” “somewhat important,” or “not at all important.” A higher proportion of non-white MDs/PhDs indicated that a variety of barriers were “very important” to their decision not to participate than did white MDs/PhDs. Overall, non-white respondents also reported most barriers as “very important” to their decision not to become involved in clinical research in higher proportion than white respondents, except for “time constraints,” which was the highest reported barrier overall. Statistically significant differences were seen between white and non-white respondents in “lack of access to clinical trials,” “infrastructural needs,” “lack of patient interest,” “study complexity,” and “lack of potential personal benefit.”
This report of higher barriers—particularly in access—among both global and North American non-white respondents was consistent with a lower proportion of this subgroup reporting having a mentor or peer ask them to join their first trial compared to white respondents. This element is important to address, the authors write, as mentorship has been found to be a more effective tool in diverse recruitment than other diversity, equity, and inclusion initiatives such as mandatory diversity training, job tests, and grievance systems. Survey respondents reported overwhelmingly that having a mentor had a positive impact on their clinical research experience, as well as increased their likelihood to refer patients and to continue working in clinical research after their first trial.
The full article by Emily Botto, BA (Tufts CSDD); Maria Florez, MA (Tufts CSDD); Adrelia Allen, PharmD (Merck); Ruma Bhagat, MD, MPH (Genentech); Ellyn Getz, MPH (CSL Behring); and Kenneth Getz, MBA (Tufts CSDD) will be published online next week as part of the August 2022 issue on the Clinical Researcher website.
Edited by Gary Cramer