Herremans K. Trials and tribulations: diversity and inclusion in pancreatic ductal adenocarcinoma clinical trials. Abstract 901. Digestive Disease Week 2021; May 21–24, 2021.
, 5HealioUnfortunately, many in academia, community-serving organisations, government, and the biopharmaceutical industry struggle to establish meaningful partnerships and are therefore unable to move beyond contemplation and into action. We recommend starting by convening key stakeholders and prioritising reciprocity, accountability, sustainability, and awareness of partners' needs and resources. Using this approach, we developed academic–community–government partnerships to advance public health during the COVID-19 pandemic and distributed 46 000 facemasks, 10 000 bottles of hand soap, 18 000 hand sanitisers, and 12 000 dental hygiene items within five target zip codes of communities with the most people susceptible to infection in Columbus, OH. The Ohio Governor subsequently scaled this strategy to more than 60 of Ohio's 88 counties.
We have since adapted this community engagement model to academic–community–government–industry partnerships, to address the lack of diversity in clinical trials. The biopharmaceutical industry in particular, as manufacturers of novel therapeutics and clinical trial sponsors, is well positioned to promote clinical trial diversity. The FDA recently highlighted the important role of the industry in advancing clinical trial diversity through modifications to protocol design, eligibility criteria, and study enrolment practices, which is concordant with many recent industry efforts.
We recently partnered with a pharmaceutical company and with a community organisation, the National African American Male Wellness Agency, on a live, interactive, and community-facing webinar series focused on improving health equity through diversity. The central theme of the inaugural webinar was increasing representation of racial and minority ethnic groups in clinical trials. The programme engaged over 250 global attendees and featured panellists from under-represented minority groups, including a US Congresswoman, a biotechnology industry representative, a clinician scientist, a local community member, and a local news anchor who participated in a clinical trial. Each discussed the importance of clinical trials and their lived experience with, or advocacy for, engagement in clinical trials.
Community members, scientists, clinicians, governmental officials, and biopharmaceutical industry leaders worked together to identify foci for potential solutions. Participants recommended that education on clinical trials included acknowledgment of historical trauma from unethical trial practices in the USA. They ascribed value to engaging grassroots and faith-based organisations in advocacy for clinical trial participation. They endorsed formal training for clinical trial staff on cultural humility, implicit bias mitigation, and recruitment strategies to facilitate accrual of under-represented minorities. They proposed developing culturally sensitive educational materials such as images and statements from under-represented minorities, and leveraging multimedia platforms to disseminate these materials. They advocated for resources that both minimise financial costs for clinical trial participants and that connect academia–community–government–industry partners in sharing best practices to improve diversity in clinical trials. They emphasised the importance of improving the diversity of the staff, scientists, and health-care providers doing clinical trials. Furthermore, they all stressed the fierce urgency of acting promptly to leverage these opportunities to advance inclusive research.
We thank Gerren Wilson, Senior Director of Inclusion & Health Equity at Genentech. DMG reports a consultant relationship with Genentech in 2018–19, unrelated to the contents of this Comment. All other authors declare no competing interests.
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