Contemp Clin Trials. 2019 Mar;78:1-10. doi: 10.1016/j.cct.2019.01.004. Epub 2019 Jan 8.
People from ethnic minorities are reported to have higher rates of physical illness (diabetes and ischemic heart disease) and mental disorders. Disparities relate not just to diagnosis, but also to care pathways and treatment outcomes. Despite this, they are underrepresented in clinical research. This reduces the generalisability of research findings across multi ethnic populations and hinders the development of accessible services. Researchers often face difficulties in recruiting ethnic minority participants to clinical research due to low levels of cultural competence and limited resources. There are few published trials focusing on ethnic minorities in the UK and we need to understand what recruitment strategies have already been implemented and recommended when recruiting ethnic participants. This will help researchers in applying these lessons to future clinical trials.
To identify strategies for recruiting ethnic minorities to clinical trials in the UK a systematic review of published randomised controlled trials (RCT) exclusively targeting ethnic minorities was conducted. Multiple databases were searched by combining the terms "ethnic minorities", "randomised controlled trials" and "United Kingdom". Data was extracted on recruitment strategies described by each RCT and then themes were created.
Twenty-one included RCT's identified various strategies to recruit ethnic communities to clinical trials. These have been described under three overarching themes; adaptation of screening and outcome measures, culturally specific recruitment training and recruitment processes.
The review highlighted that researchers employed limited strategies to enhance the recruitment level. The full extent of the use of strategies was not described well in the publications. There is a need for wider training and support for the trialist to enhance and build up recruitment skills to facilitate the recruitment of ethnic minorities to clinical trials.
据报道,少数民族人群的身体疾病(糖尿病和缺血性心脏病)和精神障碍发病率较高。这种差异不仅与诊断有关,还与护理途径和治疗结果有关。尽管如此,他们在临床研究中的代表性仍然不足。这降低了跨多种族人群的研究结果的普遍性,并阻碍了可及性服务的发展。由于文化能力水平低和资源有限,研究人员在招募少数民族参与者参与临床研究时经常面临困难。在英国,很少有专门针对少数民族的临床试验发表,我们需要了解在招募少数民族参与者时已经实施和推荐了哪些招募策略。这将有助于研究人员将这些经验教训应用于未来的临床试验。
为了确定在英国招募少数民族参与临床试验的策略,对专门针对少数民族的已发表的随机对照试验(RCT)进行了系统综述。通过将“少数民族”、“随机对照试验”和“英国”这几个术语结合起来,在多个数据库中进行了搜索。提取了每个 RCT 中描述的招募策略的数据,然后创建了主题。
21 项纳入的 RCT 确定了各种策略,以招募少数民族社区参与临床试验。这些策略被描述为三个总体主题:筛查和结果测量的适应性、特定于文化的招募培训和招募过程。
综述强调,研究人员仅采用了有限的策略来提高招募水平。这些策略的使用程度在出版物中没有得到很好的描述。需要为试验人员提供更广泛的培训和支持,以增强和建立招募技能,从而促进少数民族参与临床试验。