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Diverse Recruitment for Clinical Trials Using Three Diversity-Enhancing Interventions: Qualitative Study
Erin Rose Cruz1, Tenzin Yeshi Wangdak Yuthok1, Anekwe Onwuanyi2
1School of Medicine, Stanford Medicine, 453 Quarry Rd, Palo Alto, CA, 94304, United States, 1 650-723-2300.
JMIR Formative Research
|August 7, 2026
Summary
Diverse clinical trial recruitment strategies show promise but face significant barriers. Sustained support and rapid feedback are crucial for improving enrollment and research equity.
Area of Science:
- Clinical Trials
- Health Equity
- Research Methodology
Background:
- Lack of diversity in clinical trials compromises the generalizability and equity of treatment efficacy findings across demographic groups.
- Ensuring diverse participant populations is essential for relevant, high-quality, and equitable research outcomes.
Purpose of the Study:
- To evaluate the implementation and impact of four distinct recruitment strategies on clinical trial enrollment.
- To assess the effectiveness of community ambassador, social media, and registry/patient engagement platforms compared to usual recruitment methods.
- To identify barriers and facilitators to implementing diverse recruitment strategies within the Trial of Sites to Increase Diversity in Clinical Trials (TOTAL) project.
Main Methods:
- Randomized trial design comparing three intervention recruitment strategies against a control (usual recruitment) arm.
- Utilized the Stanford Lightning Report, a rapid qualitative approach, involving interviews with principal investigators and trial staff at multiple time points.
- Gathered insights on the user-friendliness, impact, and challenges associated with each recruitment strategy.
Main Results:
- Recruitment platforms were generally user-friendly, and external support was valued for accessing broader participant pools.
- Community ambassadors facilitated community connections, while registry/engagement platforms streamlined outreach; social media ads improved screening efficiency.
- Common barriers included limited resources (time, staff, funding), restrictive eligibility, lack of language access, transportation issues, and operational delays (IRB, contracts).
Conclusions:
- Enhancing diversity in clinical trials necessitates robust financial, human, and institutional backing alongside effective recruitment strategies.
- Rapid qualitative feedback mechanisms are vital for early identification of implementation challenges and enabling real-time strategic adjustments.
- Sustained commitment and adaptive strategies are key to overcoming barriers and achieving equitable clinical trial participation.
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