"Bridging the Gap: Increasing Participation of Underrepresented Populations in Allergy and Immunology Research"

Despite decades of national initiatives, racial, ethnic, socioeconomic, and historically underrepresented populations remain inadequately represented in allergy and immunology research. This limits the generalizability of findings, impedes identification of differences in treatment response and safety, and contributes to persistent disparities among populations disproportionately affected by allergic and immunologic diseases. Underrepresentation reflects patient-, provider-, investigator-, institutional-, and regulatory-level barriers: mistrust of research, financial and logistical burdens, restrictive eligibility criteria, language and health literacy challenges, limited community engagement, and inequitable recruitment practices. We summarize current evidence of barriers to participation in allergy and immunology clinical research and highlight practical, evidence-based strategies to improve equitable recruitment and retention. Key approaches include culturally and linguistically appropriate recruitment materials, community advisory boards and trusted community partners, collaboration with clinicians serving underserved populations, decentralized and hybrid designs that reduce participant burden, broader eligibility criteria when scientifically appropriate, improved investigator and staff training, and participant-centered retention strategies. Sustained partnerships and dissemination of findings to participating communities foster long-term trust. Increasing diversity requires a coordinated, systems-level approach that embeds equity throughout study design, recruitment, implementation, retention, and dissemination. Doing so strengthens the validity and generalizability of the evidence base and ensures that future advances benefit all populations equitably.