TABLE 1.

Overview of articles examined.

Author and year	Article title	Type of source	Study design	Findings
Alzheimer's Association, 2002	African American's and Alzheimer's disease: a silent epidemic	Report	NA	Black Americans are underrepresented in AD clinical trials and community outreach efforts must be redesigned for inclusion.
Alzheimer's Association, 2008	Serving African American families: home and community‐based services for people with dementia and their caregivers.	Toolkit	NA	Recommended ways to support Black populations impacted by AD include providing culturally sensitive educational materials on dementia and caregiving, increasing awareness of AD through community outreach, facilitate connections to resources and services, develop dementia‐competent services to provide support to caregivers.
Alzheimer's Association, 2021	2021 Alzheimer's disease facts and figures, special report: race, ethnicity and Alzheimer's in America	Annual report	NA	Differences in lived experience and clinical trial design explain how Black populations are underrepresented in AD clinical trials.
Babulal et al., 2020	Perspectives on ethnic and racial disparities in Alzheimer's disease and related dementias: Update and areas of immediate need	Qualitative research	Review	Recommendations to increase inclusion of Black Americans = in AD clinical trials include developing trainings for practitioners and researchers to improve cultural competence, creating educational materials for communities, and incorporating the impact of social determinants of health into AD trial design.
Ballard et al., 2013	Challenges and opportunities: recruitment and retention of African Americans for Alzheimer disease research: lessons learned.	Qualitative research	Community research participation model	The transparency, accountability, and behavior of the trial researchers is critical in determining Black American participation in AD clinical trials.
Baquet et al., 2008	Clinical trials: the art of enrollment	Qualitative research	Literature review	Key barriers to participation include SES, distance to trial site, awareness, trust, fear, cultural competency, and costs. Strategy to improve diversity in clinical trials must include increasing research on barriers to participation in each community context, developing diverse teams, developing educational materials, creating sustainable trial infrastructure in community settings.
Clark et al., 2019	Increasing diversity in clinical trials: overcoming critical barriers	Qualitative research	Literature review	Solutions for increasing diversity in clinical trials include building trust, increasing communication, and developing a common understanding of goals, growing awareness of clinical trials, revisioning the role of the study coordinator, ensuring proper resources. A multi‐stakeholder approach is critical.
Coakley et al., 2011	Dialogues on diversifying clinical trials: successful strategies for engaging women and minorities in clinical trials	Report	NA	Increasing diversity in clinical trials requires strategy related to the inclusion of more female and minority physicians, improved transparency, greater cultural sensitivity in outreach, increased education and outreach, intentional community engagement, and an increased use of technology.
Cocroft et al., 2020	Racially diverse participant registries to facilitate the recruitment of African Americans into presymptomatic Alzheimer's disease studies	Qualitative research	Systematic review	Five key lessons regarding the creation of diverse registries include “(1) cultural sensitivity (2) building trust relationships (3) inclusive access to research (4) ongoing connection with research participants (5) allocating resources to meet the costs.”
Denny et al., 2018	Perspective on the “African American participation in Alzheimer disease research: Effective strategies”	Qualitative research	Workshop and systematic review	Key learnings and recommendations to increase Black American participation in AD research include building awareness, increasing evidence‐based recruitment strategies, practicing transparency, building diverse teams, training on cultural competency, developing long‐term community relationships and partnerships, offering incentives.
Esiaka et al., 2022	A Mini‐Review of Strategies for Recruiting Older African Americans to Alzheimer's Disease	Qualitative research	Mini‐review	Strategies to advance participation of Black American populations in AD clinical trials include community outreach, education, at home access, and partnership with local organizations.
Gilmore‐Bykovskyi et al., 2019	Recruitment and retention of underrepresented populations in Alzheimer's disease research: A systematic review.	Qualitative research	Systematic review	Attitudes, barriers/facilitators, education, trust, and religiosity are key factors influencing Black American participation in AD clinical trials.
Graham et al., 2018	Best strategies to recruit and enroll elderly Blacks into clinical and biomedical research	Quantitative and qualitative research	Retrospective study and community outreach	Health fairs, educational materials and advertisements tailored to communities’ unique health interests and needs, and personal referrals were the most successful means of recruiting Black populations to AD clinical trials.
Hughson et al., 2016	A review of approaches to improve participation of culturally and linguistically diverse populations in clinical trials	Qualitative research	Systematic review	Significant barriers to participation in clinical trials for diverse populations include mistrust, communication and language, culture, SES, time, and transportation. Suggested strategies to address these barriers include community outreach and relationship building, improved communication tactics, greater cultural sensitivity, improving physical access to trials, and educating companies on common barriers and pitfalls to inclusion.
Indorewalla et al., 2021	Modifiable barriers for recruitment and retention of older adults participants from underrepresented minorities in Alzheimer's disease research	Qualitative research	Narrative review	Barriers to participation in AD clinical trials for Black populations include mistrust, lack of awareness, the need for a study partner, and participant burden.
Langbaum et al., 2022	Recommendations to address key recruitment challenges of Alzheimer's disease clinical trials	Qualitative research	Advisory panel	The panel identified 27 solutions to improve current AD clinical trial processes, including community outreach, virtual clinical trials, and educational campaigns.
Lincoln et al., 2018	Fundamental causes of barriers to participation in Alzheimer's clinical research among African Americans	Qualitative research	Focus group analysis	Factors that influence beliefs and participation in clinical trials among Black American populations include (1) lived experience and discrimination, (2) cultural trauma, (3) cultural norms, (4) a lack of cultural competency in recruitment methods. Recommended ways to increase diversity in clinical trials include transparency, culturally appropriate community outreach and education, and addressing mistrust of research processes.
Lines et al., 2014	Racial and ethnic disparities among individuals with Alzheimer's disease in the United States: a literature review	Qualitative research	Literature review	Potential contributors to racial disparities in AD include genetics, comorbidities, poverty, education level, culture, discrimination. Highlight importance of equal provision of health services to advance equity.
National Institute for Aging, 2020	NIA: strategic directions for research 2020‐2025	Report	NA	Causes of health disparities are multidimensional, and therefore require multifaceted solutions to effectively address them. Including diverse populations in research will require new strategy such as the implementation of community based participatory research methods.
Robinson et al., 2020	Framework for creating storytelling materials to promote African American/Black adult enrollment in research on Alzheimer's disease and related disorders	Quantitative and qualitative research	Semi‐structured interviews	Culturally relevant communication and educational materials are critical in the recruitment of Black populations to AD clinical trials.
Shaw et al., 2020	Recruitment of older African Americans in Alzheimer's disease clinical trials using a community education approach	Qualitative research	Community engaged research approach	Community based recruitment methods increase AD knowledge, clinical trial interest, as well as recruitment into “observational and lifestyle” AD clinical trials.
Shin et al., 2016	Underrepresentation of African Americans in Alzheimer's Trials: A Call for Affirmative Action	Article	NA	Recommendations for increasing inclusion of African American populations in AD clinical trials include developing relationships with community‐based organizations and dedicating budget specifically to the recruitment of minority populations.
U.S. Food and Drug Administration, 2022	Diversity plans to improve enrollment of participants from underrepresented racial and ethnic populations in clinical trials: draft guidance for industry	Guidance document	NA	To increase diversity in clinical trials companies must design strategy in a way that accounts for factors such as site location and access, community engagement, and ways to streamline processes to ease the burden of participation for patients.
Weiner et al., 2007	Alzheimer's disease demonstration grants to states program: cross‐state report on initiatives targeting limited English‐speaking populations and African American communities	Report	NA	There are several areas critical to better engaging diverse populations in AD research: (1) Building trust in communities by investing in relationships and partnering with community organizations, (2) building greater awareness and understanding of AD, (3) using culturally appropriate language and strategies, and (4) understanding the role of family in different contexts.
Woods‐Burnham et al., 2021	The role of diverse populations in us clinical trials	Commentary	NA	Increasing diversity in clinical trials requires more diversity among physician teams, community partnerships, greater education and awareness, cultural competency and diversity trainings for clinical trial staff, and greater consideration around cost and transportation.
Zhou et al., 2017	African Americans are less likely to enroll in preclinical Alzheimer's disease clinical trials.	Quantitative and qualitative research	Secondary analysis of interviews (a mixed‐methods experimental design)	Black American populations called attention to the importance of factors such as study risks, the requirement of a study partner, study procedures, and study location as strong influences on participation.

Abbreviations: AD, Alzheimer's disease; NA, not applicable; SES, socioeconomic status.