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. Author manuscript; available in PMC: 2017 Jul 25.
Published in final edited form as: Stroke. 2015 Jul 16;46(8):2232–2237. doi: 10.1161/STROKEAHA.114.008564

Table 2.

Investigator identified best practices and recommendations.

Barrier Theme Illustrative Quote(s) Best Practice, Recommendation(s)
Structural and Institutional NIH Inclusion Policy Clarification If the African American community makes up 12% of the population and you have 12% of your study patients who are African American, is that adequate? Will you be able to anything with that analysis?

  • Guidance on criteria for optimal inclusion rates;

  • A priori minority recruitment and retention budget parameter.
Trial design and site selection What is the prevalence of the disease? Are you mimicking the prevalence or the racial breakdown of wherever you are conducting the trial?

  • Best practices on clinical trial design/analysis.
Value of community engagement and partnerships You have to go to the community to develop those relationships. That’s the only way you’re going to get those participants.

  • Tips/tools on fostering and maintaining equitable community partnerships.
[An academic institution] is two miles from the clinic, and the patients are there, the diversity is there but the patients are not traveling to [the institution] and vice versa. I think that is one of the biggest challenges…bridg[ing] trials to communities.
Physician relationships If the physician believes it’s a good choice for [the patient then] he/she are usually more onboard.

  • Primary Physician toolkit with active trial information.
Recruitment Communication Effective training I would support training to recruit minorities or recruit anyone, recruitment is training people about what are these peoples’ concerns, how do I establish trust, what are the patients’ needs.

  • Communication education;

  • Cultural Competency training;

  • Motivational Interviewing.
Recruitment is not based on the recruiter but it is really the psychologies, motivational interviewing, the ‘human factor.’
Unique challenges Clinical environment and patient population Because neurologic injury occurs, a proxy now has to make a decision about a loved one to enroll in a clinical trial… It’s not your own risk; it’s the risk for a loved one.

  • Navigating acute clinical trials;

  • Guidance on patient denial/stigma.