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

The inclusion of ethnic and racial minoritized communities in clinical research is crucial in order to determine the generalizability of findings that support evidence-based and empirically supported treatments. To date, many randomized controlled trials assessing evidence-based treatments have predominantly non-Latinx white samples. Therefore, it is unknown whether treatment findings are applicable across diverse groups. Though transdiagnostic treatments have shown promise among ethnic and racial groups, little is known about the Unified Protocol and its effectiveness across diverse groups. This systematic review aims to provide an overview of existing work and highlight inclusion rates of ethnic and racial minoritized communities in randomized controlled trials assessing the Unified Protocol. A systematic review of published literature focusing on randomized controlled trials utilizing the Unified Protocol with ethnic and racial minoritized communities was conducted using PsycInfo, EMBASE, PubMed, and Medline databases. The review included 19 articles (reduced from 457). This manuscript summarizes these results in terms of race and ethnicity demographics, recruitment methods, diagnoses, treatment format, treatment duration, and outcomes for adolescent and adult populations. We found that ethnic and racial minoritized communities have mostly been underrepresented in randomized controlled trials on the Unified Protocol. Finally, building from the existing literature, we provide key recommendations for clinical scientists conducting clinical outcome research with ethnic and racial minoritized communities, which can enhance the representation of underrepresented groups in research and reduce health inequities.