The role of functional, social, and mobility dynamics in facilitating older African Americans participation in clinical research

Eve T Shapiro,1,2 Jay T Schamel,2 Kimberly A Parker,3 Laura A Randall,1,2 Paula M Frew1,2,4 1Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, 2Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, 3Department of Health Studies, Texas Women’s University, Denton, TX, 4Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA Purpose: Older African Americans experience disproportionately higher incidence of morbidity and mortality related to chronic and infectious diseases, yet are significantly underrepresented in clinical research compared to other racial and ethnic groups. This study aimed to understand the extent to which social support, transportation access, and physical impediments function as barriers or facilitators to clinical trial recruitment of older African Americans.Methods: Participants (N=221) were recruited from six African American churches in Atlanta and surveyed on various influences on clinical trial participation.Results: Logistic regression models demonstrated that greater transportation mobility (odds ratio [OR]=2.10; p=0.007) and social ability (OR=1.77; p=0.02) were associated with increased intentions of joining a clinical trial, as was greater basic daily living ability (OR=3.25; p=0.03), though only among single participants. Among adults age ≥65 years, those with lower levels of support during personal crises were more likely to join clinical trials (OR=0.57; p=0.04).Conclusion: To facilitate clinical trial entry, recruitment efforts need to consider the physical limitations of their potential participants, particularly basic physical abilities and disabilities. Crisis support measures may be acting as a proxy for personal health issues among those aged >65 years, who would then be more likely to seek clinical trials for the personal health benefits. Outreach to assisted living homes, hospitals, and other communities is a promising avenue for improved clinical trial recruitment of older African Americans. Keywords: clinical trials, aging, minority populations, African Americans, physical disabilitie