Public Health

Latinos enroll in Alzheimer's disease (AD) clinical trials at lower rates, yet it remains unclear whether their willingness differs from their non-Hispanic White (NHW) counterparts. This study examined differences in trial willingness, along with barriers and motivators, among Latino and NHW adults in a nationally representative sample.

A structured web panel survey was administered to 1,800 adults aged 50 and older with no self-reported neurological disorders, including 600 NHW and 1,200 Latino participants across the U.S. Participants received a primer on AD and clinical trials before responding. Willingness to participate was assessed using Likert-scale items on general and AD-specific trial participation. Multinomial logistic regression examined willingness differences, adjusting for age, sex, education, income, and AD family history. Secondary analyses explored motivators and barriers.

Among Latinos, 34.6% identified as Puerto Rican, 26.9% as Mexican, 14.4% as Central or South American, 8.5% as Cuban, 3.7% as Dominican, and 11.9% as other/mixed heritage. While overall trial willingness did not differ between NHW and Latinos, a trend in heritage-specific differences emerged. Cuban (OR=2.30; 95% CI: 0.73-7.28) and Central American (OR=1.89; 95%CI: 0.45-7.93) participants showed a pattern of greater willingness compared to NHW, while Dominican (OR=0.60; 95% CI: 0.14-2.47) and Mexican participants (OR=0.78; 95%CI: 0.33-1.82) showed a trend toward lower willingness. Motivators also varied by heritage: Cubans prioritized health benefits (76.5%), research contributions (55.1%), and monetary incentives (40.9%), while Central Americans valued health benefits (68.2%), monetary incentives (50.6%), and physician recommendations (34.7%). Barriers also differed: Dominicans cited safety concerns (48.2%), visit burden (27.8%), and transportation (24.2%), while Mexicans noted visit burden (31.3%), safety concerns (29.3%), and time constraints (20.8%). More Latinos reported they would be "more willing" to participate in AD-focused trials than NHW (42.6% vs. 36%, p = 0.0069).

Willingness is not universally a barrier for Latinos, but heritage-specific trends underscore the need for culturally tailored recruitment strategies. Addressing logistical barriers, safety concerns, and emphasizing trust and societal benefits is key to improving Latino participation in AD trials.