Strategies for recruitment and retention of underrepresented populations in randomized clinical trials in the United States: A mixed-methods study

Objective We explored facilitators influencing participation in randomized clinical trials (RCTs) among underrepresented groups in the United States, including Black and Hispanic/Latinx individuals, women, and rural populations. Methods We recruited a convenience sample of adults from these underrepresented groups to complete an online survey of multiple-choice and open-ended questions about preferences and motivations for RCT participation. Recruitment occurred May through September 2023. Results Facilitators included regular communication, minimizing participant burden, building trust, fair compensation, and emphasizing the purpose and value of research. Conclusion To improve inclusivity and generalizability, addressing the barriers to RCT participation for underrepresented groups is crucial. Our results point to the importance of designing RCTs that prioritize transparency, clearly define the research objectives, reduce participant burden, and cultivate trust, while ensuring that compensation and logistical support are equitable and reflect participants' time and effort.