Enrollment Patterns and Site-Level Predictors of Black Participant Recruitment to a Multisite Randomized Cancer...

Area of Science:

• Clinical Trials
• Health Equity
• Oncology Research

Background:

• Clinical trial diversity is crucial for generalizability and equitable access.
• Patient-level factors are often the focus of research on trial accrual barriers.
• Site-level factors influencing trial diversity remain underexplored.

Purpose of the Study:

• To identify site-level characteristics associated with the accrual of Black and younger participants in a multicenter clinical trial.
• To address the lack of race and age diversity in clinical trials.

Main Methods:

• Analysis of Alliance 191901 (GETSET) trial data, which oversamples Black women and those under 50.
• Examined associations between site characteristics (region, neighborhood racial composition, site type, accrual volume) and participant race/age.
• Assessed accrual trajectories over time for different demographic subgroups.

Main Results:

• Southern sites and those in neighborhoods with higher Black composition recruited a greater proportion of Black participants.
• Site type and historical accrual volume were not associated with Black participant recruitment.
• Recruitment of Black participants lagged behind targets, while non-Black participant recruitment exceeded targets.

Conclusions:

• Neighborhood composition and geographic region are significant predictors of Black participant accrual.
• Site type and historical accrual volume do not predict Black participant recruitment.
• Targeted site selection based on neighborhood demographics and geography can enhance clinical trial diversity.