Barriers to Medical Research Participation as Perceived by Clinical Trial Investigators: Communicating with Rural and African American Communities

TLDR

Clinical trials advance public health, yet participation remains low among rural and African American populations in medically underserved areas. The study aimed to assess investigators’ perceived barriers to recruiting participants in South Carolina’s five major academic medical centers. An online survey of 119 investigators was conducted to identify these barriers across the general population, rural, and African American communities. Survey results showed that recruiting from rural areas was most difficult, rural residents were underrepresented, communication and awareness barriers were greatest for the general public and rural communities, psychological barriers were most prevalent in African American communities, and the findings offer insights to improve outreach strategies.

Abstract

Clinical trials help advance public health and medical research on prevention, diagnosis, screening, treatment, and quality of life. Despite the need for access to quality care in medically underserved areas, clinical trial participation remains low among individuals in rural and African American communities. This study assessed clinical trial research in South Carolina's five main academic medical centers, focusing specifically on clinical trial investigators' perceived barriers to recruitment in the general population and in rural and African American communities. Online survey responses (N = 119) revealed that it was most difficult for investigators to recruit from rural areas and that rural residents were least likely to be represented in medical research, behind both the general public and African Americans. Barriers focusing on communication or awareness proved to be the biggest hurdles to finding potential participants in both the general public and rural communities. Psychological barriers to recruitment were perceived to be most prevalent in African American communities. Study findings provide important insights from the perspective of the clinical trial investigator that will aid in the development of effective communication and education strategies for reaching rural and African American residents with information about clinical trials.