Inclusion of People of Color in Randomized Controlled Trials for the Unified Protocol: A Systematic Review

Area of Science:

• Clinical Psychology
• Health Services Research
• Evidence-Based Practice

Background:

• Clinical research, particularly randomized controlled trials (RCTs), often lacks diversity, predominantly featuring non-Latinx white participants.
• This limits the generalizability of findings for evidence-based treatments across diverse ethnic and racial groups.
• The effectiveness of transdiagnostic treatments, like the Unified Protocol, in minority populations remains largely unknown due to underrepresentation.

Purpose of the Study:

• To systematically review existing literature on the Unified Protocol (UP).
• To assess the inclusion rates of ethnic and racial minoritized communities in RCTs of the UP.
• To identify key recommendations for enhancing the representation of underrepresented groups in clinical outcome research.

Main Methods:

• A systematic review of published RCTs was conducted using PsycInfo, EMBASE, PubMed, and Medline.
• Studies focused on the Unified Protocol and included ethnic or racial minoritized communities.
• Data extracted included demographics, recruitment strategies, diagnoses, treatment parameters, and outcomes.

Main Results:

• The review included 19 articles from an initial search of 457.
• Ethnic and racial minoritized communities were found to be underrepresented in RCTs evaluating the Unified Protocol.
• Data summarized demographics, recruitment, diagnoses, treatment, and outcomes for adolescent and adult populations.

Conclusions:

• Significant underrepresentation of ethnic and racial minority groups in Unified Protocol RCTs was identified.
• There is a critical need to improve the inclusion of diverse populations in clinical research.
• Recommendations are proposed to guide clinical scientists in conducting more inclusive research and mitigating health inequities.