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Ison JM, Jackson JD, Hemley H, Willis A, Siddiqi B, Macklin EA, Ulysse C, Fitts MS, Pham TTH, Afshari M, Agarwal P, Aminoff M, Bissonnette S, Fullard M, Khan TS, Larson DN, Wielinski C, Sanchez AV. Fostering Inclusivity in Research Engagement for Underrepresented Populations in Parkinson's Disease: The FIRE-UP PD study. Contemp Clin Trials 2024; 144:107619. [PMID: 38971301 DOI: 10.1016/j.cct.2024.107619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Members of vulnerable populations are underrepresented in Parkinson's disease (PD) research. A complex web of research barriers perpetuates this gap. Community-based research methods are one approach to addressing this issue. The present PD study was designed to examine the effectiveness of community-based interventions to overcome barriers and increase research participation among underrepresented groups (URGs). METHODS Eight study sites across the US were selected and paired based on proposed interventions with specific URGs. Surveys assessed knowledge and attitudes toward PD research. Finally, researchers examined whether the present study affected recruitment to Fox Insight, an online PD research study also recruiting at each site. RESULTS In total, 474 participants were recruited. At post-intervention for the FIRE-UP PD Study, recruitment increased significantly in intervention compared to control sites among Black and African American non-Hispanic/Latino populations (p = 0.003), White Hispanic/Latino (p = 0.003) populations, and Not Listed Hispanic/Latino populations (p < 0.001) as well as those with an educational attainment of a high school diploma/General Education Diploma (GED) (p = 0.009), and an income <$20,000 (p = 0.005) or between $20,000-$34,999 (p < 0.001). Study surveys measuring changes in awareness and attitudes toward PD research had mixed results. In Fox Insight, 181 participants were passively recruited with a shift toward more diverse participant demographics. CONCLUSION Research participation demographics reflective of the general population are critical to PD investigation and treatment. The FIRE-UP PD Study showed the effectiveness of localized community engagement strategies in increasing URG recruitment to PD research. Therefore, further PD research employing community-based methods to improve diverse participant recruitment is needed.
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Affiliation(s)
- Juliana M Ison
- University of California, Gevirtz Graduate School of Education, Isla Vista, Santa Barbara, CA 93106, USA
| | - Jonathan D Jackson
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Helen Hemley
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Allison Willis
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Bernadette Siddiqi
- The Michael J. Fox Foundation, 111 W. 33rd St, New York City, NY 10120, USA
| | - Eric A Macklin
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Christine Ulysse
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Michael S Fitts
- University of Alabama at Birmingham (UAB Libraries), 1700 University Blvd, Birmingham, AL 35233, USA
| | - Tiffany T-H Pham
- Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA
| | - Mitra Afshari
- Rush University Medical Center, 1620 W Harrison St, Chicago, IL 60612, USA
| | - Pinky Agarwal
- Evergreen Health Care, 12040 NE 128th St, Kirkland, WA 98034, USA
| | - Michael Aminoff
- University of California San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, USA
| | - Stephanie Bissonnette
- Virginia Commonwealth University School of Medicine, 1201 E Marshall St #4-100, Richmond, VA 23298, USA
| | - Michelle Fullard
- University of Colorado Denver, 1201 Larimer St, Denver, CO 80204, USA
| | - Tarannum S Khan
- Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA
| | | | - Catherine Wielinski
- Park Nicollet Struthers Parkinson's Center, 6701 Country Club Dr, Minneapolis, MN 55427, USA
| | - Angie V Sanchez
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; University of Louisiana at Lafayette, 104 E University Ave, Lafayette, LA 70504, USA.
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2
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Green E, Marcelin JR. Robust Performance Metrics for Assessing Equitable Clinical Trial Participant Enrollment: Can We Get There? Clin Infect Dis 2024; 79:148-150. [PMID: 38305650 DOI: 10.1093/cid/ciae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Evangeline Green
- Internal Medicine Residency, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jasmine R Marcelin
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Abernethy NF, McCloskey K, Trahey M, Rinn L, Broder GB, Andrasik M, Laborde R, McGhan D, Spendolini S, Marimuthu S, Kanzmeier A, Hanes J, Kublin J. Rapid Development of a Registry to Accelerate COVID-19 Vaccine Clinical Trials. RESEARCH SQUARE 2024:rs.3.rs-4397271. [PMID: 38947011 PMCID: PMC11213164 DOI: 10.21203/rs.3.rs-4397271/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background The unprecedented scientific response to the SARS-Cov-2 pandemic in 2020 required the rapid development and activation of extensive clinical trial networks to study vaccines and therapeutics. The COVID-19 Prevention Network (CoVPN) coordinated hundreds of sites conducting phase 2 and 3 clinical trials of vaccines and antibody therapeutics. To facilitate these clinical trials, the CoVPN Volunteer Screening Registry (VSR) was created to collect volunteer information at scale, identify volunteers at risk of COVID-19 who met enrollment criteria, distribute candidates across clinical trial sites, and enable monitoring of volunteering and enrollment progress. Methods We developed a secure database to support three primary web-based interfaces: a national volunteer questionnaire intake form, a clinical trial site portal, and an Administrative Portal. The Site Portal supported filters based on volunteer attributes, visual analytics, enrollment status tracking, geographic search, and clinical risk prediction. The Administrative Portal supported oversight and development with pre-specified reports aggregated by geography, trial, and trial site; charts of volunteer rates over time; volunteer risk score calculation; and dynamic, user-defined reports. Findings Over 650,000 volunteers joined the VSR, and 1094 users were trained to utilize the system. The VSR played a key role in recruitment for the Moderna, Oxford-AstraZeneca, Janssen, and Novavax vaccine clinical trials, provided support to the Pfizer and Sanofi vaccine and prophylactic antibody clinical trials, and enhanced the diversity of trial participants. Clinical trial sites selected 166,729 volunteer records for follow-up screening, and of these 47·7% represented groups prioritized for increased enrollment. Despite the unprecedented urgency of its development, the system maintained 99·99% uptime. Interpretation The success of the VSR demonstrates that information tools can be rapidly yet safely developed through a public-private partnership and integrated into a distributed and accelerated clinical trial setting. We further summarize the requirements, design, and development of the system, and discuss lessons learned for future pandemic preparedness.
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Affiliation(s)
- Neil F. Abernethy
- Biomedical Informatics and Medical Education, University of Washington, 850 Republican St., Seattle, WA 98109
| | - Kylie McCloskey
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Meg Trahey
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Laurie Rinn
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, Fred Hutch Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Gail B. Broder
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Michele Andrasik
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | | | - Daniel McGhan
- Oracle Corporation, 2300 Oracle Way, Austin, TX 78741
| | | | | | | | - Jayson Hanes
- Oracle Corporation, 2300 Oracle Way, Austin, TX 78741
| | - James Kublin
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
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4
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Nippak P, Begum H, Ahmed W, Santhikumar D. Barriers and Concerns that Contribute to Vaccine Hesitancy in Black, Indigenous, and People of Colour (BIPOC) Individuals in Ontario, Canada. Cureus 2024; 16:e63033. [PMID: 39050314 PMCID: PMC11268265 DOI: 10.7759/cureus.63033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Despite research demonstrating the effectiveness of COVID-19 vaccines, hesitancy is extremely common in minority communities. The purpose of this study was to identify key barriers and concerns that contribute to vaccine hesitancy in Black, Indigenous, and People of Colour (BIPOC) individuals and provide recommendations to address these barriers and concerns. METHODS The study was an online cross-sectional survey conducted among 1491 BIPOC and Caucasian adults, recruited using social media networks in August-September 2021. The questionnaire consisted of five sections that probed concerns and attitudes contributing to COVID-19 vaccine hesitancy. RESULTS Respondents were mostly Caucasian males (75.7%) and the average age was 29.1 years. A higher proportion of BIPOC respondents received both doses (50.6%) than Caucasian respondents (36.4%). Out of the unvaccinated, a higher percentage of BIPOC respondents did not plan on getting vaccinated (17.1%) compared to Caucasian respondents (4.2%). BIPOC respondents preferred the Pfizer-BioNTech (34.1%) vaccine whereas Caucasian respondents preferred AstraZeneca (29.3%). The biggest concern BIPOC and Caucasian respondents had with COVID-19 vaccines were side effects (56.6% vs 54.4%, respectively). BIPOC respondents identified dependability as the next biggest concern after side effects. A higher percentage of BIPOC respondents were against getting vaccinated against COVID-19 (16% vs 1.2%) compared to Caucasian respondents. CONCLUSION Among unvaccinated respondents, COVID-19 vaccine hesitancy was most evident in the BIPOC respondents compared to Caucasian respondents. Side effects, trustworthiness, and lack of information were identified as the three most common concerns surrounding vaccines in general. Increased accessibility to reliable and accurate vaccine information in various languages/dialects can raise awareness about COVID-19 vaccinations in BIPOC communities.
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Affiliation(s)
- Pria Nippak
- Health Services Management, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, CAN
| | - Housne Begum
- Health Services Management, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, CAN
| | - Wajiha Ahmed
- Health Services Management, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, CAN
| | - Devi Santhikumar
- Health Services Management, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, CAN
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Cabrera C, Fernández-Llaneza D, Ghazoui Z, D'Abrantes S, Esparza-Franco MA, Sopp C, Maj B, Chiou VL, Valastro B, Pangalos MN, Galbraith S, Ghiorghiu S, Massacesi C. Diversity of US participants in AstraZeneca-sponsored clinical trials. Contemp Clin Trials 2024; 140:107496. [PMID: 38467274 DOI: 10.1016/j.cct.2024.107496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/08/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND To develop medicines that are safe and efficacious to all patients, clinical trials must enroll appropriate target populations, but imbalances related to race, ethnicity and sex have been reported. A comprehensive analysis and improvement in understanding representativeness of patient enrollment in industry-sponsored trials are key public health needs. METHODS We assessed race/ethnicity and sex representation in AstraZeneca (AZ)-sponsored clinical trials in the United States (US) from 2010 to 2022, compared with the 2019 US Census. RESULTS In total, 246 trials representing 95,372 patients with complete race/ethnicity and sex records were analyzed. The proportions of different race/ethnicity subgroups in AZ-sponsored clinical trials and the US Census were similar (White: 69.5% vs 60.1%, Black or African American: 13.3% vs 12.5%, Asian: 1.8% vs 5.8%, Hispanic: 14.4% vs 18.5%). We also observed parity in the proportions of males and females between AZ clinical trials and US Census (males: 52.4% vs 49.2%, females: 47.6% vs 50.8%). Comparisons of four distinct therapy areas within AZ (Respiratory and Immunology [R&I]; Cardiovascular, Renal, and Metabolism [CVRM]; Solid Tumors; and Hematological Malignancies), including by trial phases, revealed greater variability, with proportions observed above and below US Census levels. CONCLUSION This analysis provides the first detailed insights into the representativeness of AZ trials. Overall, the proportions of different race/ethnicity and sex subgroups in AZ-sponsored clinical trials were broadly aligned with the US Census. We outline some of AZ's planned health equity initiatives that are intended to continue to improve equitable patient enrollment.
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Affiliation(s)
- Claudia Cabrera
- Real World Science and Analytics, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden.
| | | | - Zara Ghazoui
- Data Science and Artificial Intelligence, BioPharmaceuticals Research and Development, AstraZeneca, Cambridge, UK
| | - Sofia D'Abrantes
- Data Science and Artificial Intelligence, BioPharmaceuticals Research and Development, AstraZeneca, Cambridge, UK
| | - M Alejandro Esparza-Franco
- Data Science and Artificial Intelligence, BioPharmaceuticals Research and Development, AstraZeneca, Cambridge, UK
| | - Charles Sopp
- Real World Science and Analytics, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
| | - Beata Maj
- Chief Medical Office, AstraZeneca, Gothenburg, Sweden
| | - Victoria L Chiou
- Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - Barbara Valastro
- Research and Development Patient Science, Chief Medical Office, AstraZeneca, Gothenburg, Sweden
| | | | - Susan Galbraith
- Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - Serban Ghiorghiu
- Chief Medical Office and Oncology Research and Development, AstraZeneca, Cambridge, UK
| | - Cristian Massacesi
- Chief Medical Office and Oncology Research and Development, Research and Development, AstraZeneca, Gaithersburg, MD, USA
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6
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van Wamelen DJ, Rota S, Hartmann M, Martin NH, Alam AM, Thomas RH, Dodd KC, Jenkins T, Smith CJ, Zandi MS, Easton A, Carr G, Benjamin LA, Lilleker JB, Saucer D, Coles AJ, Wood N, Ray Chaudhuri K, Breen G, Michael BD. Addressing ethnic disparities in neurological research in the United Kingdom: An example from the prospective multicentre COVID-19 Clinical Neuroscience Study. Clin Med (Lond) 2024; 24:100209. [PMID: 38642613 PMCID: PMC11091497 DOI: 10.1016/j.clinme.2024.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Minority ethnic groups have often been underrepresented in research, posing a problem in relation to external validity and extrapolation of findings. Here, we aimed to assess recruitment and retainment strategies in a large observational study assessing neurological complications following SARS-CoV-2 infection. METHODS Participants were recruited following confirmed infection with SARS-CoV-2 and hospitalisation. Self-reported ethnicity was recorded alongside other demographic data to identify potential barriers to recruitment. RESULTS 807 participants were recruited to COVID-CNS, and ethnicity data were available for 93.2%. We identified a proportionate representation of self-reported ethnicity categories, and distribution of broad ethnicity categories mirrored individual centres' catchment areas. White ethnicity within individual centres ranged between 44.5% and 89.1%, with highest percentage of participants with non-White ethnicity in London-based centres. Examples are provided how to reach potentially underrepresented minority ethnic groups. CONCLUSIONS Recruitment barriers in relation to potentially underrepresented ethnic groups may be overcome with strategies identified here.
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Affiliation(s)
- Daniel J van Wamelen
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London, London, United Kingdom; Parkinson Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust, and King's College London, United Kingdom; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology; Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands; Institute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, Division of Neuroscience; King's College London, London, United Kingdom.
| | - Silvia Rota
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London, London, United Kingdom; Parkinson Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust, and King's College London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, Division of Neuroscience; King's College London, London, United Kingdom
| | - Monika Hartmann
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London, London, United Kingdom
| | - Naomi H Martin
- Institute of Psychiatry, Psychology & Neuroscience; Department of Neuroimaging; King's College London, London, United Kingdom
| | - Ali M Alam
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, United Kingdom
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, United Kingdom
| | - Katherine C Dodd
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Manchester Centre for Clinical Neurosciences, Salford Royal Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom
| | - Thomas Jenkins
- Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, United Kingdom; Midland St John of God Hospital and Curtin University, Perth, Western Australia, Australia
| | - Craig J Smith
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Manchester Centre for Clinical Neurosciences, Salford Royal Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom; Division of Cardiovascular Sciences, School of Medical Sciences, The University of Manchester, Geoffrey Jefferson Brain Research Centre, Manchester, United Kingdom
| | - Michael S Zandi
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Ava Easton
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, United Kingdom; Encephalitis Society, Malton, United Kingdom
| | - Georgina Carr
- Neurological Alliance, London WD17 1EU, United Kingdom
| | - Laura A Benjamin
- National Hospital for Neurology and Neurosurgery, London, United Kingdom; Stroke Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - James B Lilleker
- Manchester Centre for Clinical Neurosciences, Salford Royal Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom; Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - David Saucer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Alasdair J Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas Wood
- Department of Clinical and Movement Neurosciences, University College London, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - K Ray Chaudhuri
- Parkinson Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust, and King's College London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, Division of Neuroscience; King's College London, London, United Kingdom
| | - Gerome Breen
- Institute of Psychiatry, Psychology & Neuroscience; Social, Genetic & Developmental Psychiatry Centre; King's College London, London, United Kingdom
| | - Benedict Daniel Michael
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Department of Neurology, Liverpool, United Kingdom
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7
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Michaels TI, Simon-Pearson L, Kane JM, Cornblatt B. Racial Disparities Among Clinical High-Risk and First-Episode Psychosis Multisite Research Participants: A Systematic Review. Psychiatr Serv 2024; 75:451-460. [PMID: 38204372 DOI: 10.1176/appi.ps.20230120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE The NIH has mandated equal representation of Black, Indigenous, and people of color (BIPOC) individuals in clinical research, but it is unclear whether such inclusion has been achieved in multisite research studies of individuals at clinical high risk for psychosis or with first-episode psychosis (FEP). An assessment of inclusion rates is important for understanding the social determinants of psychosis and psychosis risk that specifically affect BIPOC individuals. METHODS The authors conducted a systematic review of the literature published between 1993 and 2022 of multisite research studies of clinical high risk for psychosis and FEP in North America to determine ethnoracial inclusion rates. Using an online systematic review tool, the authors checked 2,278 studies for eligibility. Twelve studies met all inclusion criteria. Data were extracted, and demographic characteristics, socioeconomic status, study design, and recruitment strategies used by each study were analyzed. RESULTS Most (62%) of the participants in studies of clinical high risk for psychosis were White. Compared with national data, the demographic characteristics of individuals with clinical high risk were representative across most ethnoracial groups. Black participants (43%) made up the largest ethnoracial group in FEP studies and were overrepresented compared with their representation in the U.S. population. FEP studies were more likely to recruit participants from community mental health centers than were the studies of clinical high risk. CONCLUSIONS Although these results suggest high representation of BIPOC individuals in psychosis research, opportunities exist for an improved focus on ethnoracial representation. The authors offer recommendations for practices that may increase ethnoracial diversity in future psychosis study samples.
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Affiliation(s)
- Timothy I Michaels
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Laura Simon-Pearson
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - John M Kane
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Barbara Cornblatt
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
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8
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Chappell E, Arbour L, Laksman Z. The Inclusion of Underrepresented Populations in Cardiovascular Genetics and Epidemiology. J Cardiovasc Dev Dis 2024; 11:56. [PMID: 38392270 PMCID: PMC10888590 DOI: 10.3390/jcdd11020056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Novel genetic risk markers have helped us to advance the field of cardiovascular epidemiology and refine our current understanding and risk stratification paradigms. The discovery and analysis of variants can help us to tailor prognostication and management. However, populations underrepresented in cardiovascular epidemiology and cardiogenetics research may experience inequities in care if prediction tools are not applicable to them clinically. Therefore, the purpose of this article is to outline the barriers that underrepresented populations can face in participating in genetics research, to describe the current efforts to diversify cardiogenetics research, and to outline strategies that researchers in cardiovascular epidemiology can implement to include underrepresented populations. Mistrust, a lack of diverse research teams, the improper use of sensitive biodata, and the constraints of genetic analyses are all barriers for including diverse populations in genetics studies. The current work is beginning to address the paucity of ethnically diverse genetics research and has already begun to shed light on the potential benefits of including underrepresented and diverse populations. Reducing barriers for individuals, utilizing community-driven research processes, adopting novel recruitment strategies, and pushing for organizational support for diverse genetics research are key steps that clinicians and researchers can take to develop equitable risk stratification tools and improve patient care.
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Affiliation(s)
- Elias Chappell
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada
| | - Zachary Laksman
- Department of Medicine and the School of Biomedical Engineering, Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Ilias MR, Zhang X, Stinson N, Carrington K, Huff E, Freeman N, Wilson-Frederick S, Ampey B, Rajapakse N, Johnson LE, Mensah GA. Establishing a Community Engagement Consultative Resource: A CEAL Initiative. Am J Public Health 2024; 114:S22-S24. [PMID: 37733995 PMCID: PMC10785170 DOI: 10.2105/ajph.2023.307385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Maliha R Ilias
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Xinzhi Zhang
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Nathaniel Stinson
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Kelli Carrington
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Erynn Huff
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Naomi Freeman
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Shondelle Wilson-Frederick
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Bryan Ampey
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Nishadi Rajapakse
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - Lenora E Johnson
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
| | - George A Mensah
- Maliha R. Ilias and Xinzhi Zhang are with the Health Inequities and Global Health Branch, Center for Translation Research and Implementation Sciences (CTRIS), National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Nathaniel Stinson and Kelli Carrington are with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, NIH. Erynn Huff is with the Other Transaction Authority Office, Office of Management, NHLBI. Naomi Freeman is with the National Center for Advancing Translational Sciences, NIH. Bryan Ampey is with the Immediate Office of the Director, NHLBI. Nishadi Rajapakse is with the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Shondelle Wilson-Frederick and Lenora E. Johnson are with the Office of Science Policy, Engagement, Education, and Communication, NHLBI. George A. Mensah is with CTRIS
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Mensah GA, Johnson LE, Zhang X, Stinson N, Carrington K, Malla G, Land SR, Huff E, Freeman N, Stoney C, Ampey B, Paltoo D, Clark D, Rajapakse N, Ilias MR, Haase KP, Punturieri A, Kurilla MG, Archer H, Bolek M, Santos M, Wilson-Frederick S, Devaney S, Marshall V, Farhat T, Hooper MW, Wilson DR, Perez-Stable EJ, Gibbons GH. Community Engagement Alliance (CEAL): A National Institutes of Health Program to Advance Health Equity. Am J Public Health 2024; 114:S12-S17. [PMID: 37944098 PMCID: PMC10785165 DOI: 10.2105/ajph.2023.307476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 11/12/2023]
Affiliation(s)
- George A Mensah
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Lenora E Johnson
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Xinzhi Zhang
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Nathan Stinson
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Kelli Carrington
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Gargya Malla
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Stephanie R Land
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Erynn Huff
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Naomi Freeman
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Catherine Stoney
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Bryan Ampey
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Dina Paltoo
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Dave Clark
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Nishadi Rajapakse
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Maliha R Ilias
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Karen Plevock Haase
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Antonello Punturieri
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Michael G Kurilla
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Hillary Archer
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Michelle Bolek
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Melanie Santos
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Shondelle Wilson-Frederick
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Stephanie Devaney
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Vanessa Marshall
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Tilda Farhat
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Monica Webb Hooper
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - David R Wilson
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Eliseo J Perez-Stable
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Gary H Gibbons
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
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11
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Goddard-Eckrich D, Gatanaga OS, Thomas BV, Liu Y, Downey DL, Dsouza N, Medley B, Hunt T, Wu E, Johnson K, Black C, Brown M, Hall J, El-Bassel N, Gilbert L. Characteristics of drug-involved black women under community supervision; implications for retention in HIV clinical trials and healthcare. SOCIAL WORK IN HEALTH CARE 2024; 63:35-52. [PMID: 37965711 PMCID: PMC10842763 DOI: 10.1080/00981389.2023.2278781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023]
Abstract
This study examined retention and its relationship to mental health, substance use, and social determinants of health in a randomized clinical trial of a behavioral HIV/sexually transmitted infection prevention intervention with drug-involved Black women (N = 348) under community supervision programs in New York City. Using secondary analysis, we used logistic models to test the association between factors related to mental health, substance use, and social determinants of health and follow-up assessment completion (three, six, and 12 months). Participants who were diagnosed with schizophrenia had lower odds of retention. Participants who misused prescription opiates during their lifetime or food insecure in the past 90 days had higher odds of retention throughout the intervention.
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Affiliation(s)
| | | | | | - Yang Liu
- The Social Intervention Group, Columbia University, New York, New York
| | - Dget Lynn Downey
- The Social Intervention Group, Columbia University, New York, New York
| | - Nishita Dsouza
- The Social Intervention Group, Columbia University, New York, New York
| | - Bethany Medley
- The Social Intervention Group, Columbia University, New York, New York
| | - Timothy Hunt
- The Social Intervention Group, Columbia University, New York, New York
| | - Elwin Wu
- The Social Intervention Group, Columbia University, New York, New York
| | - Karen Johnson
- University of Alabama School of Social Work, Tuscaloosa, AL
| | - Chermaine Black
- The Social Intervention Group, Columbia University, New York, New York
| | - Mary Brown
- The Social Intervention Group, Columbia University, New York, New York
| | - Jennifer Hall
- The Social Intervention Group, Columbia University, New York, New York
| | - Nabila El-Bassel
- The Social Intervention Group, Columbia University, New York, New York
| | - Louisa Gilbert
- The Social Intervention Group, Columbia University, New York, New York
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12
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Zhang X, Kaholokula JK, Kahn-John M, Walters K, Ma G, Thao C, Lepule JT, Stinson N. Elevating Voice and Visibility: Health Research for American Indian and Alaska Native, Asian American, and Native Hawaiian and Pacific Islander Populations in the United States. Am J Public Health 2024; 114:S25-S28. [PMID: 38207264 PMCID: PMC10785185 DOI: 10.2105/ajph.2023.307494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Xinzhi Zhang
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Joseph Keaweʻaimoku Kaholokula
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Michelle Kahn-John
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Karina Walters
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Grace Ma
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Chia Thao
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Jonathon Tana Lepule
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Nathan Stinson
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
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13
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Craig LS, Sarpong DF, Peacock EM, Roberts S, Theall KP, Williams L, Al-Dahir S, Davis TC, Arnold CL, Williams A, Fields T, Wilson M, Krousel-Wood M. Using Community Feedback to Inform Strategies for Inclusive Participation in Research: Lessons Learned From the Louisiana Community Engagement Alliance (LA-CEAL). Am J Public Health 2024; 114:S29-S32. [PMID: 37944099 PMCID: PMC10785181 DOI: 10.2105/ajph.2023.307457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Leslie S Craig
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Daniel F Sarpong
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Erin M Peacock
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Shearon Roberts
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Katherine P Theall
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - LaKeisha Williams
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Sara Al-Dahir
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Terry C Davis
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Connie L Arnold
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Allie Williams
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Tynesia Fields
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Michelle Wilson
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
| | - Marie Krousel-Wood
- Leslie S. Craig, Erin M. Peacock, Michelle Wilson, and Marie Krousel-Wood are with Tulane University, School of Medicine, Department of Medicine, Center for Health Outcomes, Implementation and Community-Engaged Science, New Orleans, LA. Daniel F. Sarpong, LaKeisha Williams, Sara Al-Dahir, and Tynesia Fields are with Xavier University of Louisiana, College of Pharmacy, New Orleans. Shearon Roberts is with Xavier University of Louisiana, Department of Mass Communication, New Orleans. Katherine P. Theall and Allie Williams are with Tulane University, School of Public Health and Tropical Medicine, New Orleans. Terry C. Davis and Connie L. Arnold are with Louisiana State University Health Sciences Center‒Shreveport, Shreveport, LA
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14
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Carter-Edwards L, Hidalgo B, Lewis-Hall F, Nguyen T, Rutter J. Diversity, equity, inclusion, and access are necessary for clinical trial site readiness. J Clin Transl Sci 2023; 7:e268. [PMID: 38380391 PMCID: PMC10877510 DOI: 10.1017/cts.2023.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/19/2023] [Accepted: 10/18/2023] [Indexed: 02/22/2024] Open
Affiliation(s)
- Lori Carter-Edwards
- Kaiser Permanente Bernard J Tyson School of Medicine,
Pasadena, CA, USA
- The University of North Carolina at Chapel Hill Gillings School of Global
Public Health, Chapel Hill, NC,
USA
| | - Bertha Hidalgo
- The University of Alabama at Birmingham, Birmingham,
AL, USA
| | | | - Tung Nguyen
- University of California San Francisco, San
Francisco, CA, USA
| | - Joni Rutter
- National Center for Advancing Translational Sciences,
Bethesda, MD, USA
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15
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Geffen SR, Poteat T, Dean LT, Malone J, Greene N, Adams MA. Engaging Black sexual minority women in breast cancer research: Lessons in community partnerships. Cancer 2023; 129:3439-3447. [PMID: 37489804 PMCID: PMC10592156 DOI: 10.1002/cncr.34960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Black sexual minority women (BSMW) face significant breast cancer health inequities and are underrepresented in health research because of historical and present-day exclusion. However, there exists no peer-reviewed literature on best practices for the inclusion of BSMW in cancer research. "Our Breast Health: The Access Project" was a national primary data collection study in June 2018 through October 2019 that aimed to identify facilitators and barriers to breast cancer care among BSMW, and that successfully recruited the highest number of BSMW for any national breast cancer screening study at the time of its publication. METHODS The present analysis highlights best practices for reaching BSMW by examining by how effective various recruitment sources were at recruiting BSMW. Recruitment partners were grouped into several categories: (1) cancer focused, (2) Black women or sexual minority women focused, (3) BSMW focused, (4) social media, and (5) other. Then logistic regression was used to estimate the odds that a particular recruitment source category could recruit BSMW compared with other categories. RESULTS Partnerships with community-based organizations led by and intended for BSMW were the most successful at recruiting BSMW, demonstrating the importance of an intersectional approach to recruitment. Community-based organizations focused on BSMW specifically were 26 times more successful in recruiting BSMW to the study compared with recruiting Black women who were not sexual minorities (odds ratio, 26.43 [95% CI, 7.50-93.10]). CONCLUSIONS Successful recruitment enables breast cancer research grounded in the perspectives of BSMW, which can generate key findings that have the potential to remedy longstanding health inequities for this population.
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Affiliation(s)
- Sophia R Geffen
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- CHOP, Philadelphia, Pennsylvania, USA
| | - Tonia Poteat
- University of North Carolina at Chapel Hill School of Medicine, Department of Social Medicine, Chapel Hill, North Carolina, USA
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | - Lorraine T Dean
- Johns Hopkins University Bloomberg School of Public Health, Epidemiology, Baltimore, Maryland, USA
| | - Jowanna Malone
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | - Naomi Greene
- Johns Hopkins University Bloomberg School of Public Health, Health, Behavior and Society, Baltimore, Maryland, USA
| | - Mary Anne Adams
- ZAMI NOBLA: National Organization of Black Lesbians on Aging, Atlanta, Georgia, USA
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16
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Shatnawi E, Steiner-Lim GZ, Karamacoska D. Cultural inclusivity and diversity in dementia friendly communities: An integrative review. DEMENTIA 2023; 22:2024-2046. [PMID: 37871120 PMCID: PMC10644696 DOI: 10.1177/14713012231206292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation.
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Affiliation(s)
- Eman Shatnawi
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Genevieve Z Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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17
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Craig LS, Sarpong DF, Peacock EM, Theall KP, Williams L, Al-Dahir S, Davis TC, Arnold CL, Williams A, Fields T, Wilson M, Krousel-Wood M. Clinical trial participation among underserved communities: Insights from the Louisiana Community Engagement Alliance. Am J Med Sci 2023; 366:254-262. [PMID: 37517691 PMCID: PMC10962264 DOI: 10.1016/j.amjms.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Diverse, equitable and inclusive participation in clinical research is needed to ensure evidence-based clinical practice and lessen disparities in health outcomes. Yet, clinical trial participation remains critically low in minoritized communities, particularly among Blacks. The Louisiana Community Engagement Alliance against COVID-19 Disparities (LA-CEAL) was launched in response to the disproportionate impact of COVID-19 on Black Louisianans to understand community barriers and preferences and increase inclusive participation in research. This study aims to understand perceptions regarding COVID-19 trial participation among underrepresented Louisianans. METHODS A rapid assessment integrating cross-sectional, surveys among federally qualified health center (FQHC) patients and community residents, and focus group discussions (FGDs) from community representatives was conducted in 2020-2021. Factors and perceptions underlying trial participation were identified using logistic regression models and thematic analyses, respectively. RESULTS Quantitative findings (FQHC: N=908, mean age=46.6 years, 66.4% Black; community: N=504, mean age=54.2 years, 93.7% Black) indicated that 0.9% and 3.6%, respectively, ever participated in a COVID-19 trial. Doctors/Healthcare providers were most trusted (FQHC=55.1%; community=59.3%) sources of information about trials. Advancing age was associated with increased odds of being very willing to participate (ORFQHC=1.03, 95% CI 1.02-1.05; ORCommunity=1.02, 95% CI 1.00-1.04). Qualitative data (6 FGDs, 29 attendees) revealed limited awareness, experimentation/exploitation-based fears, and minimal racial/ethnic representation among trialists as barriers to participation. CONCLUSION COVID-19 trial participation rates were low in our sample. Altruism was a key facilitator to participation; fear, mistrust, and low awareness were predominant barriers. Community-centered approaches, engaging informed providers and trusted community members, may facilitate inclusive trial participation.
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Affiliation(s)
- Leslie S Craig
- Tulane University, School of Medicine, New Orleans, LA, USA
| | - Daniel F Sarpong
- Xavier University of Louisiana, College of Pharmacy, New Orleans, LA, USA; Yale School of Medicine, General Internal Medicine, Office of Health Equity Research
| | - Erin M Peacock
- Tulane University, School of Medicine, New Orleans, LA, USA
| | - Katherine P Theall
- Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - LaKeisha Williams
- Xavier University of Louisiana, College of Pharmacy, New Orleans, LA, USA
| | - Sara Al-Dahir
- Xavier University of Louisiana, College of Pharmacy, New Orleans, LA, USA
| | - Terry C Davis
- Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Connie L Arnold
- Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Allie Williams
- Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Tynesia Fields
- Xavier University of Louisiana, College of Pharmacy, New Orleans, LA, USA
| | | | - Marie Krousel-Wood
- Tulane University, School of Medicine, New Orleans, LA, USA; Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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18
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St Pierre M, Daniels S, Sanchez TA, Holtzman S, Russo EB, Walsh Z. The Naturalistic Cannabis Administration Protocol (NCAP): A Proof-of-Concept Study. J Psychoactive Drugs 2023; 55:389-401. [PMID: 36130915 DOI: 10.1080/02791072.2022.2125466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 10/14/2022]
Abstract
Lab-based studies examining the effects of cannabis administration on human behavior compromise ecological validity due to the influence of set and setting. Contextual factors of clinical settings have long been recognized as producing measurable changes in physiology, emotionality, and cognition. Among people who use drugs, these settings may be associated with higher levels of perceived stigma and stereotype threat which may meaningfully confound the effects of cannabis on outcomes of interest. Recent liberalization of cannabis regulation may allow novel and more ecologically valid approaches to assessing the acute effects of cannabis. The Naturalistic Cannabis Administration Protocol (NCAP) is a novel paradigm for the study of acute cannabis effects in an ecologically valid manner. Two independent studies demonstrated the safety and feasibility of the NCAP. Participants (N= 79; Mage = 25.44, SD = 5.67) self-administered the cannabis of their choice in their home and then (Study 1; n= 47) engaged in a leisure activity or (Study 2; n= 32) underwent cognitive assessment remotely via videoconference following cannabis administration. The NCAP was well tolerated across samples with no reported adverse events. These findings provide a rationale for the adoption of the NCAP to reduce research barriers and develop our research capabilities to fit the landscape of cannabis use today.
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Affiliation(s)
- Michelle St Pierre
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Sarah Daniels
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Tatiana A Sanchez
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Susan Holtzman
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | | | - Zach Walsh
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
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19
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Echeverria SL, Shultz G, Navarro O, Li E, Sifuentes J, Lavani R, Takhsh E, Mena Lora AJ. Impact of a culturally sensitive multilingual community outreach model on coronavirus disease 2019 (COVID-19) vaccinations at an urban safety-net community hospital. Infect Control Hosp Epidemiol 2023; 44:1526-1528. [PMID: 36727170 DOI: 10.1017/ice.2023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We assessed the efficacy of a culturally competent outreach model with promotoras in raising the coronavirus disease 2019 (COVID-19) first-dose vaccination rates in Chicago's at-risk ZIP codes from February through May 2021. Utilizing community members from within target communities may reduce barriers, increase vaccination rates, and enhance COVID-19 prevention.
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Affiliation(s)
| | | | | | - Ella Li
- Saint Anthony Hospital, Chicago, Illinois
| | | | | | | | - Alfredo J Mena Lora
- Saint Anthony Hospital, Chicago, Illinois
- University of Illinois at Chicago, Chicago, Illinois
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20
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Mayers SA, Cook SK, Rantala C, Israel T, Helmer T, Schorr M, Campos G, Hahn D, Pimentel P, Wynn M, Edwards TL, Stroud M, Harris PA, Wilkins CH. The RIC Recruitment & Retention Materials Toolkit - a resource for developing community-informed study materials. J Clin Transl Sci 2023; 7:e182. [PMID: 37706001 PMCID: PMC10495822 DOI: 10.1017/cts.2023.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 09/15/2023] Open
Abstract
Clinical trials face many challenges with meeting projected enrollment and retention goals. A study's recruitment materials and messaging convey necessary key information and therefore serve as a critical first impression with potential participants. Yet study teams often lack the resources and skills needed to develop engaging, culturally tailored, and professional-looking recruitment materials. To address this gap, the Recruitment Innovation Center recently developed a Recruitment & Retention Materials Content and Design Toolkit, which offers research teams guidance, actionable tips, resources, and customizable templates for creating trial-specific study materials. This paper seeks to describe the creation and contents of this new toolkit.
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Affiliation(s)
- Stephanie A. Mayers
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah K. Cook
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Caitlin Rantala
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tiffany Israel
- Center for Emergency Care Research & Innovation, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tara Helmer
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matt Schorr
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - David Hahn
- Intracell Research Group, Wake Forest, NC, USA
| | - Pamela Pimentel
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, USA
- Institute for Clinical & Translational Science, University of California, Irvine, CA, USA
| | - Mysha Wynn
- Project Momentum, Incorporated, Rocky Mount, NC, USA
| | - Terri L. Edwards
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mary Stroud
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul A. Harris
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Consuelo H. Wilkins
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
- Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
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21
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Marrie RA, Chataway J, Bierer BE, Finlayson M, Martinez-Lapiscina EH, Panagoulias J, Sormani MP, Williams MJ, Amezcua L. Enhancing diversity of clinical trial populations in multiple sclerosis. Mult Scler 2023; 29:1174-1185. [PMID: 37555490 PMCID: PMC10413791 DOI: 10.1177/13524585231189677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/02/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Demographic characteristics, social determinants of health (SDoH), health inequities, and health disparities substantially influence the general and disease-specific health outcomes of people with multiple sclerosis (MS). Participants in clinical trials do not represent all people with MS treated in practice. OBJECTIVE To provide recommendations for enhancing diversity and inclusion in clinical trials in MS. METHODS We held an international workshop under the Auspices of the International Advisory Committee on Clinical Trials in MS (the "Committee") to develop recommendations regarding diversity and inclusivity of participants of clinical trials in MS. Workshop attendees included members of the Committee as well as external participants. External participants were selected based on expertise in trials, SDoH, health equity and regulatory science, and diversity with respect to gender, race, ethnicity, and geography. RESULTS Recommendations include use of diversity plans, community engagement and education, cultural competency training, biologically justified rather than templated eligibility criteria, adaptive designs that allow broadening of eligibility criteria over the course of a trial, and logistical and practical adjustments to reduce study participant burden. Investigators should report demographic and SDoH characteristics of participants. CONCLUSION These recommendations provide sponsors and investigators with methods of improving diversity and inclusivity of clinical trial populations in MS.
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Affiliation(s)
- Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jeremy Chataway
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK/National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK/Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Barbara E Bierer
- The Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard, Cambridge, MA, USA/Harvard Medical School, Boston, MA, USA
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Elena H Martinez-Lapiscina
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Office of Therapies for Neurological and Psychiatric Disorders, Human Medicines Division, European Medicines Agency, Amsterdam, The Netherlands
| | | | | | | | - Lilyana Amezcua
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Hesse-Biber S, Seven M, Shea H, Heaney M, Dwyer AA. Racial and Ethnic Disparities in Genomic Healthcare Utilization, Patient Activation, and Intrafamilial Communication of Risk among Females Tested for BRCA Variants: A Mixed Methods Study. Genes (Basel) 2023; 14:1450. [PMID: 37510354 PMCID: PMC10378850 DOI: 10.3390/genes14071450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to gain a deeper understanding of genomic healthcare utilization, patient activation, and intrafamilial risk communication among racially and ethnically diverse individuals tested for BRCA variants. We employed an explanatory, sequential, mixed-methods study guided by the Theory of Planned Behavior. Participants completed an online survey, including sociodemographic, medical history, and several validated instruments. A subset of participants participated in in-depth, semi-structured interviews. A total of 242 women were included in the quantitative analyses. The majority of survey participants identified as non-Hispanic white (NHW) (n = 197, 81.4%) while 45/242 (18.5%) identified as black, Indigenous, and people of color (BIPOC). The NHW participants were more likely to communicate genetic test results with healthcare providers, family, and friends than BIPOC participants (p < 0.05). BIPOC participants had lower satisfaction with testing decisions and significantly higher ratings of personal discrimination, fatalism, resilience, uncertainty, and lower patient activation scores (p < 0.05). Participants with higher education, greater satisfaction with testing decisions, and lower resilience are more likely to communicate BRCA test results with family members through the mediating effect of patient activation. Bridging disparities to ensure that genomic healthcare benefits all people may demand theory-driven, multi-level interventions targeting the individual, interpersonal, and healthcare system levels.
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Affiliation(s)
- Sharlene Hesse-Biber
- Department of Sociology, Boston College, Chestnut Hill, MA 02467, USA; (S.H.-B.); (H.S.); (M.H.)
| | - Memnun Seven
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Hannah Shea
- Department of Sociology, Boston College, Chestnut Hill, MA 02467, USA; (S.H.-B.); (H.S.); (M.H.)
| | - Madeline Heaney
- Department of Sociology, Boston College, Chestnut Hill, MA 02467, USA; (S.H.-B.); (H.S.); (M.H.)
| | - Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA;
- Harvard Center for Reproductive Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
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23
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Purcell RA, Theisen RM, Arnold KB, Chung AW, Selva KJ. Polyfunctional antibodies: a path towards precision vaccines for vulnerable populations. Front Immunol 2023; 14:1183727. [PMID: 37600816 PMCID: PMC10433199 DOI: 10.3389/fimmu.2023.1183727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/30/2023] [Indexed: 08/22/2023] Open
Abstract
Vaccine efficacy determined within the controlled environment of a clinical trial is usually substantially greater than real-world vaccine effectiveness. Typically, this results from reduced protection of immunologically vulnerable populations, such as children, elderly individuals and people with chronic comorbidities. Consequently, these high-risk groups are frequently recommended tailored immunisation schedules to boost responses. In addition, diverse groups of healthy adults may also be variably protected by the same vaccine regimen. Current population-based vaccination strategies that consider basic clinical parameters offer a glimpse into what may be achievable if more nuanced aspects of the immune response are considered in vaccine design. To date, vaccine development has been largely empirical. However, next-generation approaches require more rational strategies. We foresee a generation of precision vaccines that consider the mechanistic basis of vaccine response variations associated with both immunogenetic and baseline health differences. Recent efforts have highlighted the importance of balanced and diverse extra-neutralising antibody functions for vaccine-induced protection. However, in immunologically vulnerable populations, significant modulation of polyfunctional antibody responses that mediate both neutralisation and effector functions has been observed. Here, we review the current understanding of key genetic and inflammatory modulators of antibody polyfunctionality that affect vaccination outcomes and consider how this knowledge may be harnessed to tailor vaccine design for improved public health.
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Affiliation(s)
- Ruth A. Purcell
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Robert M. Theisen
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Kelly B. Arnold
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Amy W. Chung
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Kevin J. Selva
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
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24
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Dubé K, Peterson B, Jones NL, Onorato A, Carter WB, Dannaway C, Johnson S, Hayes R, Hill M, Maddox R, Riley JL, Shull J, Metzger D, Montaner LJ. Community engagement group model in basic and biomedical research: lessons learned from the BEAT-HIV Delaney Collaboratory towards an HIV-1 cure. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:39. [PMID: 37291622 PMCID: PMC10248979 DOI: 10.1186/s40900-023-00449-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/16/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Achieving effective community engagement has been an objective of U.S. National Institutes of Health-funded HIV research efforts, including participation of persons with HIV. Community Advisory Boards (CABs) have remained the predominant model for community engagement since their creation in 1989. As HIV cure-directed research efforts have grown into larger academic-industry partnerships directing resources toward both basic and clinical research under the Martin Delaney Collaboratories (MDC), community input models have also evolved. The BEAT-HIV MDC Collaboratory, based at The Wistar Institute in Philadelphia, United States, implemented a three-part model for community engagement that has shown success in providing greater impact for community engagement across basic, biomedical, and social sciences research efforts. DISCUSSION In this paper, we review the case study of the formation of the BEAT-HIV Community Engagement Group (CEG) model, starting with the historical partnership between The Wistar Institute as a basic research center and Philadelphia FIGHT as a not-for-profit community-based organization (CBO), and culminating with the growth of community engagement under the BEAT-HIV MDC. Second, we present the impact of a cooperative structure including a Community Advisory Board (CAB), CBO, and researchers through the BEAT-HIV CEG model, and highlight collaborative projects that demonstrate the potential strengths, challenges, and opportunities of this model. We also describe challenges and future opportunities for the use of the CEG model. CONCLUSIONS Our CEG model integrating a CBO, CAB and scientists could help move us towards the goal of effective, equitable and ethical engagement in HIV cure-directed research. In sharing our lessons learned, challenges and growing pains, we contribute to the science of community engagement into biomedical research efforts with an emphasis on HIV cure-directed research. Our documented experience with implementing the CEG supports greater discussion and independent implementation efforts for this model to engage communities into working teams in a way we find a meaningful, ethical, and sustainable model in support of basic, clinical/biomedical, social sciences and ethics research.
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Affiliation(s)
- Karine Dubé
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
- Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Beth Peterson
- Wistar Institute, 3601 Spruce Street, Room 480, Philadelphia, PA, 19104, USA
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Nora L Jones
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Amy Onorato
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - William B Carter
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Christine Dannaway
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Steven Johnson
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Roy Hayes
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Marcus Hill
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - Rease Maddox
- BEAT-HIV Delaney Collaboratory Community Advisory Board (CAB), Philadelphia, PA, USA
| | - James L Riley
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jane Shull
- Philadelphia FIGHT Community Health Centers, Philadelphia, PA, USA
| | - David Metzger
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Luis J Montaner
- Wistar Institute, 3601 Spruce Street, Room 480, Philadelphia, PA, 19104, USA.
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25
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Gazaway S, Bakitas M, Underwood F, Ekelem C, Duffie M, McCormick S, Heard V, Colvin A, Elk R. Community Informed Recruitment: A Promising Method to Enhance Clinical Trial Participation. J Pain Symptom Manage 2023; 65:e757-e764. [PMID: 36871774 PMCID: PMC10192118 DOI: 10.1016/j.jpainsymman.2023.02.319] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/07/2023]
Abstract
CONTEXT Low recruitment rates in palliative care clinical trials amongst Black and rural individuals have been attributed to lack of trust and procedural barriers. Community engagement strategies have increased clinical trial participation of under-represented populations. OBJECTIVE Describe a successful community-engaged recruitment strategy in an ongoing multi-site randomized clinical trial (RCT). STUDY DESIGN AND METHODS Using community-based participatory research principles and input from a prior pilot study's community advisory group (CAG), we designed a novel recruitment strategy for Community Tele-Pal, a three-site, culturally based palliative care tele-consult RCT for Black and White seriously ill inpatients and their family caregivers. Local site CAGs helped design and implement a recruitment strategy in which a CAG member accompanied the study coordinators to introduce the study to eligible patients. Initially, CAG members could not accompany study coordinators in person due to pandemic restrictions. Hence, they created videos of themselves introducing the study, just as they would have done in person. We examined outcomes to date by the three recruitment methods and race. RESULTS Of the 2879 patients screened, 228 were eligible and approached. Overall, the proportions of patients who consented 102 (44.7%) vs. not consented 126 (55.3%) were similar by race- White (consented= 75 [44.1%]) vs; Black (consented = 27 [46.6%]). Proportionally, consent rates favored CAG-involved methods: coordinator only- 47 approached and 13 (12.7%) consented vs. coordinator/CAG video-105 approached and 60 (58.8%) consented. CONCLUSION A novel community-enhanced recruitment strategy demonstrated the potential to increase clinical trial participation from historically under-represented populations.
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Affiliation(s)
- Shena Gazaway
- School of Nursing, University of Alabama at Birmingham (S.G., M.B.,), Birmingham, AL, USA; Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA.
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham (S.G., M.B.,), Birmingham, AL, USA; Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Division of Geriatrics, School of Medicine, University of Alabama at Birmingham (M.B., F.U., C.E., R.E.), Birmingham, AL, USA
| | - Felicia Underwood
- Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Division of Geriatrics, School of Medicine, University of Alabama at Birmingham (M.B., F.U., C.E., R.E.), Birmingham, AL, USA
| | - Christiana Ekelem
- Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Division of Geriatrics, School of Medicine, University of Alabama at Birmingham (M.B., F.U., C.E., R.E.), Birmingham, AL, USA
| | - Marlee Duffie
- Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Russell Medical Center (M.D., V.H.), Alexander City, AL, USA
| | - Sheila McCormick
- Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Aiken Regional Medical Center (S.M.), Aiken, SC, USA
| | - Vantrice Heard
- Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Russell Medical Center (M.D., V.H.), Alexander City, AL, USA
| | | | - Ronit Elk
- Center for Palliative and Supportive Care, University of Alabama at Birmingham (S.G., M.B., F.U., C.E., M.D., S.M., V.H., R.E.), Birmingham, AL, USA; Division of Geriatrics, School of Medicine, University of Alabama at Birmingham (M.B., F.U., C.E., R.E.), Birmingham, AL, USA
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26
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Roy E, Chino F, King B, Madu C, Mattes M, Morrell R, Pollard-Larkin J, Siker M, Takita C, Ludwig M. Increasing Diversity of Patients in Radiation Oncology Clinical Trials. Int J Radiat Oncol Biol Phys 2023; 116:103-114. [PMID: 36526234 PMCID: PMC10414211 DOI: 10.1016/j.ijrobp.2022.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/21/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
Radiation oncology clinical trials lack full representation of the ethnic and racial diversity present in the general United States and in the cancer patient population. There are low rates of both recruitment and enrollment of individuals from underrepresented ethnic and racial backgrounds, especially Black and Hispanic patients, people with disabilities, and patients from underrepresented sexual and gender groups. Even if approached for enrollment, barriers such as mistrust in medical research stemming from historical abuse and contemporary biased systems, low socioeconomic status, and lack of awareness prohibit historically marginalized populations from participating in clinical trials. In this review, we reflect on these specific barriers and detail approaches to increase diversity of the patient population in radiation oncology clinical trials to better reflect the communities we serve. We hope that implementation of these approaches will increase the diversity of clinical trials patient populations in not only radiation oncology but also other medical specialties.
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Affiliation(s)
- Emily Roy
- Baylor College of Medicine, Houston, Texas
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Benjamin King
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Chika Madu
- Department of Radiation Oncology, Staten Island University Hospital, Staten Island, New York
| | - Malcolm Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Rosalyn Morrell
- Advanced Radiation Center of Beverly Hills, Beverly Hills, California
| | | | - Malika Siker
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Christiane Takita
- Department of Radiation Oncology, Miami University School of Medicine, Miami, Florida
| | - Michelle Ludwig
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas.
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27
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Syder NC, Elbuluk N. Racial and Ethnic Disparities in Research and Clinical Trials. Dermatol Clin 2023; 41:351-358. [PMID: 36933925 DOI: 10.1016/j.det.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Clinical trials are an essential component of research for determining the safety and efficacy of treatments for medical diseases. In order for the results of clinical trials to be generalizable to diverse populations, they must include participants at ratios that are reflective of national and global populations. A significant number of dermatology studies not only lack racial/ethnic diversity but also fail to report data on minority recruitment and enrollment. Reasons for this are multifold and are discussed in this review. Although steps have been implemented to improve this issue, greater efforts are needed for sustained and meaningful change.
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Affiliation(s)
- Nicole C Syder
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 South Flower Street, Ste 100, Los Angeles, CA 90017, USA
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 South Flower Street, Ste 100, Los Angeles, CA 90017, USA.
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Dietrich JJ, Munoz J, Tshabalala G, Makhale LM, Hornschuh S, Rentas F, Mulaudzi M, Laher F, Andrasik MP. A qualitative study of stakeholder and researcher perspectives of community engagement practices for HIV vaccine clinical trials in South Africa. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:998-1015. [PMID: 36342974 PMCID: PMC10613584 DOI: 10.1002/jcop.22951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/10/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Community engagement increases community trust of research and improves trial participation. However, there is limited documented appraisal of community engagement practices. Several HIV vaccine efficacy trials have been conducted in South Africa, the country most affected by HIV, predominantly in collaboration with the HIV Vaccine Trials Network (HVTN). We explored stakeholder and researcher perspectives of the HVTN community engagement practices used in the Gauteng province of South Africa. In 2017, we conducted a qualitative study. Using semi-structured interview guides, we facilitated two group discussions with Community Advisory Board (CAB) members (n = 13), and 14 in-depth interviews with HVTN-affiliated employees (n = 8 in South Africa and n = 6 in the USA). Group discussions and in-depth interviews were audio-recorded, transcribed verbatim, translated into English, and coded using NVIVO 12 Plus software for thematic data analysis. Overall, median age of study participants was 22 (interquartile range 32-54) years, and 74% (n = 20) were female. Three main themes about community engagement emerged: (i) community engagement as an ongoing iterative relationship between researchers and community; (ii) methods of community engagement, encompassing community education by linking with external stakeholders and through awareness campaigns by pamphlet distribution and mass events, working with communities to develop recruitment messages, and working with CAB as a link to communities; and (iii) strategies to improve community engagement, for example, using simple language, linking with religious leaders and traditional healers, and communicating via conventional (newspapers, television, and radio) and social (videos and listicles) media. Our data indicate ways for researchers to improve relationships with community by understanding local needs, strengthening collaborations, and tailoring communication strategies. In this regard, CABs signify critical linkages between researchers and communities. CABs can relay relevant health research needs, advise on the creation of suitable materials, and link researchers more effectively with community leaders and media.
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Affiliation(s)
- Janan J. Dietrich
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Health Systems Research UnitSouth African Medical Research CouncilCape TownSouth Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), Division of the Wits Health ConsortiumUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Jessica Munoz
- Ohio State University College of MedicineColumbusOhioUSA
- Department of Emergency MedicineLoma Linda University Medical CenterLoma LindaCaliforniaUSA
| | - Gugulethu Tshabalala
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Lerato M. Makhale
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Stefanie Hornschuh
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Francisco Rentas
- Vaccine and Infectious Disease DivisionFred Hutchinson Cancer CenterSeattleWashingtonUSA
| | - Mamakiri Mulaudzi
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Fatima Laher
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Michele P. Andrasik
- Vaccine and Infectious Disease DivisionFred Hutchinson Cancer CenterSeattleWashingtonUSA
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Versavel S, Subasinghe A, Johnson K, Golonski N, Muhlhausen J, Perry P, Sanchez R. Diversity, equity, and inclusion in clinical trials: A practical guide from the perspective of a trial sponsor. Contemp Clin Trials 2023; 126:107092. [PMID: 36702295 DOI: 10.1016/j.cct.2023.107092] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/15/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Considering diversity, equity, and inclusion (DEI) in clinical trials ensures that data collected for investigational treatments reflect the populations most likely to benefit from those therapies. Resources and recommendations regarding DEI were assembled by the trial sponsor to assist clinical trial development. METHODS A cross-disciplinary team from the sponsoring organization was assembled to inform trial planning and collate resources that promote DEI throughout the clinical trial life cycle. RESULTS Representatives from clinical operations, health economic outcomes research, medical affairs, patient advocacy, procurement, and research and development functional groups united together to implement DEI strategies in clinical trials. Planning strategies focus on eligibility, participant/patient engagement, feedback through patient advocacy organizations, and community interactions. Informed site, investigator, and vendor selection at trial startup supports efforts to recruit diverse target trial populations and engage underrepresented businesses; establishing relationships and demographic target-goal tracking should be maintained throughout trial management. Continued communication during trial closeout consolidates learnings and enhances partnerships with trial participants and patient advocacy organizations. The sponsoring organization continuously updates an internal library of resources to facilitate implementation of outlined strategies. CONCLUSIONS This first iteration of guidance intends to improve the representation of target populations who will ultimately benefit from investigational therapies; to assist sponsor clinical trial teams in developing recruitment and retention plans; and to ensure compliance with federal granting agencies. The sponsoring organization anticipates data from future clinical trials will help characterize the impact of these initiatives to ensure evidence-based practices are used in future clinical trials to enhance DEI.
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30
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Walker DM, Swoboda CM, Shiu-Yee K, Tarver WL, Nolan TS, Joseph JJ. Diversity of Participation in Clinical Trials and Influencing Factors: Findings from the Health Information National Trends Survey 2020. J Gen Intern Med 2023; 38:961-969. [PMID: 36138277 PMCID: PMC10039144 DOI: 10.1007/s11606-022-07780-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/30/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Clinical trial diversity is critical to advance health and health equity. Research addressing the discrepancy between goals of achieving clinical trial diversity and realities of study enrollment remains underdeveloped. OBJECTIVE This study aims to examine the association between race/ethnicity and clinical trial invitation, participation, knowledge, and sources of influence on clinical trial participation. DESIGN AND PARTICIPANTS A cross-sectional, observational study using nationally representative data from 3689 US adults (≥ 18 years of age) who responded to the Health Information National Trends Survey fielded from February 24 to June 15, 2020. MAIN MEASURES Primary outcomes included clinical trial invitation, participation, knowledge, and sources of influence on participation. The independent variable of interest is self-reported race/ethnicity. KEY RESULTS Respondents identifying as non-Hispanic Black (relative to non-Hispanic White) had higher odds of being invited into a clinical trial (adjusted odds ratio: 2.0, 95% confidence interval (CI): 1.1, 3.7), but no differences in odds of participation were observed by race/ethnicity. Respondents from all races/ethnicities reported that personal healthcare providers were the most trusted source of clinical trial information. Hispanic (marginal effect (ME): - 0.09; 95% CI: - 0.16, - 0.03), non-Hispanic Black (ME: - 0.11; 95% CI: - 0.18, - 0.04), and non-Hispanic other (ME: - 0.11; 95% CI: - 0.19, - 0.02) respondents had lower odds than non-Hispanic White respondents of saying they would be influenced "a lot" by their doctor encouraging participation. Non-Hispanic Black respondents had significantly lower odds (relative to non-Hispanic White) of indicating family encouragement would influence their clinical trial participation decision "a lot" (ME: - 0.09; 95%: CI: - 0.14, - 0.03). CONCLUSION While personal healthcare providers were trusted sources of information, racial/ethnic minority populations noted lower odds of clinical trial participation influence from providers and family. Thus, it is imperative for the healthcare, government, and industry organizations to build trust in medicine and science.
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Affiliation(s)
- Daniel M Walker
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Ave, Suite 4000, Columbus, OH, 43202, USA.
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Christine M Swoboda
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Karen Shiu-Yee
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Willi L Tarver
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, Ohio State Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Timiya S Nolan
- College of Nursing, The Ohio State University, Columbus, OH, USA
- The James Nursing Research Department, Ohio State Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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Examining participant representation by sex, race, ethnicity and age in United States blood donation and blood transfusion clinical trials. Transfus Apher Sci 2023:103653. [PMID: 36781328 DOI: 10.1016/j.transci.2023.103653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Significant inequities based on sex, race, ethnicity, and age exist among participants in clinical trials dedicated to investigating medical disease states. While general demographic data regarding blood donors and blood transfusion recipients have been studied extensively, the demographics of participants involved in blood donation and blood transfusion clinical trials are unknown. We performed a cross-sectional analysis of United States (U.S.) -based interventional blood donation and blood transfusion clinical trials registered with Clinicaltrials.gov to ascertain the composition of participants' sex, race, ethnicity, and age, as well as diagnostic conditions and geographic trial locations.Eligible trials were undertaken between July 2003 and August 2020. Thirty-eight of the one hundred and fifty-two blood donation and blood transfusion clinical trials met inclusion criteria (seven blood donation and thirty-one blood transfusion trials). While the participant dataset from trial reports were incomplete, 100 % of blood donation trials reported sex and age, 71.4 % reported race, and 42.3 % reported ethnicity. 96.8 % of blood transfusion trials reported sex, 51.6 % reported race, 38.7 % reported ethnicity, and 100 % reported age. Among 2720 participants enrolled in the seven blood donation trials, females were underrepresented (28.5 %) compared to U.S. Census data. Conversely, female (50.8 %) and male participants (49.2 %) were equally represented in blood transfusion trials (9255 participants). White participants were overrepresented in blood donation trials (73.4 %), while Hispanic or Latinos were underrepresented in both blood donation (7.7 %) and blood transfusion (8.2 %) trials compared to 2019 U.S.Census data. Only 8.3 % of blood transfusion clinical trials open to adults reported including older adults (i.e., ≥ 65yo). Despite mandatory reporting requirements and an already established framework, researchers frequently failed to report complete demographics of blood donation and blood transfusion clinical trial participants. Furthermore, various demographic groups were underrepresented in blood donation and/or blood transfusion clinical trials, including females, Hispanic or Latino individuals, and older adults. These findings demonstrate the need for implementation of strategies to ensure equitable representation of individuals in blood donation and transfusion clinical trials.
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Collins F, Adam S, Colvis C, Desrosiers E, Draghia-Akli R, Fauci A, Freire M, Gibbons G, Hall M, Hughes E, Jansen K, Kurilla M, Lane HC, Lowy D, Marks P, Menetski J, Pao W, Pérez-Stable E, Purcell L, Read S, Rutter J, Santos M, Schwetz T, Shuren J, Stenzel T, Stoffels P, Tabak L, Tountas K, Tromberg B, Wholley D, Woodcock J, Young J. The NIH-led research response to COVID-19. Science 2023; 379:441-444. [PMID: 36730407 DOI: 10.1126/science.adf5167] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Investment, collaboration, and coordination have been key.
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Affiliation(s)
| | - Stacey Adam
- The Foundation for the National Institutes of Health, North Bethesda, MD, USA
| | - Christine Colvis
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | | | | | - Anthony Fauci
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Maria Freire
- The Foundation for the National Institutes of Health, North Bethesda, MD, USA
| | - Gary Gibbons
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Matthew Hall
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | | | | | - Michael Kurilla
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - H Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | | | - Peter Marks
- US Food and Drug Administration, Silver Spring, MD, USA
| | - Joseph Menetski
- The Foundation for the National Institutes of Health, North Bethesda, MD, USA
| | | | - Eliseo Pérez-Stable
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | | | - Sarah Read
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Joni Rutter
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - Michael Santos
- The Foundation for the National Institutes of Health, North Bethesda, MD, USA
| | - Tara Schwetz
- Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Lawrence Tabak
- Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Karen Tountas
- The Foundation for the National Institutes of Health, North Bethesda, MD, USA
| | - Bruce Tromberg
- National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - David Wholley
- The Foundation for the National Institutes of Health, North Bethesda, MD, USA
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Waanders A, Brown A, Caron NR, Plisiewicz A, McHugh ST, Nguyen TQ, Lehmann K, Stevens J, Storm PJ, Resnick A, Davidson TB, Mueller S, Kline C. Indigenous peoples and inclusion in clinical and genomic research: Understanding the history and navigating contemporary engagement. Neoplasia 2023; 37:100879. [PMID: 36738585 PMCID: PMC9918407 DOI: 10.1016/j.neo.2023.100879] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 02/05/2023]
Abstract
Despite significant improvements in pediatric cancer survival outcomes, there remain glaring disparities in under-represented racial and ethnic groups that warrant mitigation by the scientific and clinical community. To address and work towards eliminating such disparities, the Pacific Pediatric Neuro-Oncology Consortium (PNOC) and Children's Brain Tumor Network (CBTN) established a Diversity, Equity, and Inclusion (DEI) working group in 2020. The DEI working group is dedicated to improving access to care for all pediatric patients with central nervous system (CNS) tumors, broadening diversity within the research community, and providing sustainable data-driven solutions. To this end, the DEI working group aims to coordinate regular educational sessions centered on critical DEI topics in pediatric research and clinical care of pediatric patients, with a focus on pediatric neuro-oncology. In April 2022, the group led a moderated panel of experts on Indigenous Peoples' rights and participation in clinical research activities. The following paper serves to provide the scientific community a perspective on how to prioritize the inclusion of Indigenous Peoples in research with cultural sensitivity and with the intent of improving not only representation, but patient outcomes regardless of patient race, ethnicity, or socioeconomic background.
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Affiliation(s)
- Angela Waanders
- Department of Hematology, Oncology, and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA,Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alex Brown
- Australian National University and Telethon Kids Institute, Adelaide, SA, Australia
| | - Nadine R. Caron
- University of Northern British Columbia, Prince George, BC, Canada
| | - Alexa Plisiewicz
- Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Sean T. McHugh
- Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Thinh Q. Nguyen
- Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kaitlin Lehmann
- Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jeffrey Stevens
- Division of Pediatric Hematology/Oncology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle Children's Research Institute, Seattle, WA, USA
| | - Phillip J. Storm
- Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Adam Resnick
- Center for Data-Driven Discovery in Biomedicine, Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Tom Belle Davidson
- Division of Hematology-Oncology, Cancer and Blood Disease Institute and Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Sabine Mueller
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA,Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA,Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA,University Children's Hospital Zurich, Zurich, Switzerland
| | - Cassie Kline
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Cunningham-Erves J, Joosten Y, Kusnoor SV, Mayers SA, Ichimura J, Dunkel L, Israel TL, Ray D, Stroud M, Harris PA, Wilkins CH. A community-informed recruitment plan template to increase recruitment of racial and ethnic groups historically excluded and underrepresented in clinical research. Contemp Clin Trials 2023; 125:107064. [PMID: 36572240 PMCID: PMC9926351 DOI: 10.1016/j.cct.2022.107064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Engaging communities in research planning and implementation can enhance recruitment and retention (R&R) of racial and ethnic groups historically excluded and underrepresented in clinical research; however, most studies do not use community-informed approaches. This paper describes the formative research process used to design a Community-Informed Recruitment Plan Template for racial and ethnic groups historically excluded and underrepresented in clinical research. METHODS Using an existing R&R template as a starting point, we iteratively developed and refined the community-informed template through a 3-phase process to achieve cultural-appropriateness. Phase 1 included a literature review, 34 community engagement (CE) studios to review recommendations, community advisory board (CAB) review, and survey data from minority recruitment experts. Phase 2 involved integration of content into existing R&R template. Phase 3 was a final review and revision using input of the CAB and researchers' panel. Survey data collected in Phase 1 were analyzed using descriptives (i.e., frequencies and percentages). Open-ended survey responses were analyzed using inductive, qualitative thematic analysis. RESULTS The final 8-section template can help develop effective grant or proposal language where study R&R plans are requested. They include: 1) Recruitment Strategy; 2) A Stakeholder Communication Plan; 3) Evidence of Recruitment Feasibility; 4) Recruitment and Retention Team; 5) Recruitment and Retention Methods; 6) Recruitment and Retention Timeline; 7) Evaluation; and 8) Budget. CONCLUSIONS Incorporating multiple perspectives into this formative research process enhances the cultural appropriateness of this community-informed R&R template to help research teams achieve R&R goals for individuals historically excluded and underrepresented in clinical research.
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Affiliation(s)
| | - Yvonne Joosten
- Vanderbilt Institute for Medicine and Public Health, Nashville, TN, USA
| | - Sheila V Kusnoor
- Center for Knowledge Management, Strategy and Innovation, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Stephanie A Mayers
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jabari Ichimura
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leah Dunkel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tiffany L Israel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Devan Ray
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mary Stroud
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul A Harris
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Consuelo H Wilkins
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
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Mena Lora AJ, Long JE, Huang Y, Baden LR, El Sahly HM, Follmann D, Goepfert P, Gray G, Grinsztejn B, Kotloff K, Rouphael N, Sobieszczyk M, Walsh SR, Andriesen J, Shah KA, Zhang Y, Gilbert P, Janes H, Gay CL, Falsey AR, Tripp RL, Gorman RL, Tong T, Marovich M, Neuzil K, Corey L, Kublin JG. Rapid Development of an Integrated Network Infrastructure to Conduct Phase 3 COVID-19 Vaccine Trials. JAMA Netw Open 2023; 6:e2251974. [PMID: 36689221 PMCID: PMC10546713 DOI: 10.1001/jamanetworkopen.2022.51974] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Importance The COVID-19 pandemic has caused millions of infections and deaths and resulted in unprecedented international public health social and economic crises. As SARS-CoV-2 spread across the globe and its impact became evident, the development of safe and effective vaccines became a priority. Outlining the processes used to establish and support the conduct of the phase 3 randomized clinical trials that led to the rapid emergency use authorization and approval of several COVID-19 vaccines is of major significance for current and future pandemic response efforts. Observations To support the rapid development of vaccines for the US population and the rest of the world, the National Institute of Allergy and Infectious Diseases established the COVID-19 Prevention Network (CoVPN) to assist in the coordination and implementation of phase 3 efficacy trials for COVID-19 vaccine candidates and monoclonal antibodies. By bringing together multiple networks, CoVPN was able to draw on existing clinical and laboratory infrastructure, community partnerships, and research expertise to quickly pivot clinical trial sites to conduct COVID-19 vaccine trials as soon as the investigational products were ready for phase 3 testing. The mission of CoVPN was to operationalize phase 3 vaccine trials using harmonized protocols, laboratory assays, and a single data and safety monitoring board to oversee the various studies. These trials, while staggered in time of initiation, overlapped in time and course of conduct and ultimately led to the successful completion of multiple studies and US Food and Drug Administration-licensed or -authorized vaccines, the first of which was available to the public less than 1 year from the discovery of the virus. Conclusions and Relevance This Special Communication describes the design, geographic distribution, and underlying principles of conduct of these efficacy trials and summarizes data from 136 382 prospectively followed-up participants, including more than 2500 with documented COVID-19. These successful efforts can be replicated for other important research initiatives and point to the importance of investments in clinical trial infrastructure integral to pandemic preparedness.
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Affiliation(s)
- Alfredo J Mena Lora
- Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago
| | - Jessica E Long
- Department of Medicine, University of Washington, Seattle
| | - Yunda Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts
| | - Hana M El Sahly
- Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Dean Follmann
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Paul Goepfert
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham
| | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Beatriz Grinsztejn
- HIV/STI Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Karen Kotloff
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Nadine Rouphael
- Hope Clinic of the Emory Vaccine Center, Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Decatur, Georgia
| | - Magdelena Sobieszczyk
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Stephen R Walsh
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jessica Andriesen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Karan A Shah
- Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Yuanyuan Zhang
- Statistical Center for HIV/AIDS Research & Prevention, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Peter Gilbert
- Department of Biostatistics, University of Washington, Seattle
| | - Holly Janes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Bioinformatics and Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Cynthia L Gay
- Division of Infectious Diseases, Department of Medicine, UNC HIV Cure Center, University of North Carolina at Chapel Hill School of Medicine
| | - Ann R Falsey
- Infectious Disease Division, Department of Medicine, University of Rochester, Rochester, New York
| | - Rebecca L Tripp
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Richard L Gorman
- Division of Clinical Development, Biomedical Advanced Research & Development Authority, Washington, DC
| | - Tina Tong
- Vaccine Research Program, Division of AIDS, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland
| | - Mary Marovich
- Vaccine Research Program, Division of AIDS, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland
| | | | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - James G Kublin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Global Health, University of Washington, Seattle
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Arneson LC, Taber KA, Williams JN, Ulysse SN, Erickson DL, Chmiel JS, Milaeger H, Freeman E, Canessa P, Song J, Chung AH, Feldman CH, Ramsey-Goldman R. Use of Popular Opinion Leader Models to Disseminate Information About Clinical Trials to Black Individuals With Lupus in Two US Cities. Arthritis Care Res (Hoboken) 2023; 75:44-52. [PMID: 35381123 PMCID: PMC10087388 DOI: 10.1002/acr.24889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/11/2022] [Accepted: 03/31/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Clinical trials for systemic lupus erythematosus ("lupus") under enroll Black individuals despite higher disease prevalence, morbidity, and mortality among Black compared to White individuals. To begin to address this disparity, we leveraged community-academic partnerships in 2 US cities (Boston and Chicago) to train popular opinion leaders (POLs) to disseminate information about clinical trials in predominantly Black communities. METHODS The team of community and academic partners collaboratively developed a 5-module curriculum about clinical trials, barriers, facilitators, and structural racism in research. We enrolled POLs in Boston and Chicago to participate virtually in the curriculum and assessed knowledge gained by comparing pre- and post-test scores. We described the POLs' ability to disseminate information about clinical trials through their communities. RESULTS We enrolled 19 POLs in Boston and 16 in Chicago; overall, 71% reported a lupus diagnosis, 94% were female, and 80% self-identified as Black or African American. The program was adapted to virtual formats due to the COVID-19 pandemic. POLs demonstrated significant improvement comparing pre/post scores for the conduct of clinical trials and history of racism in clinical research. Fifteen POLs (43%) reported their dissemination of information about clinical trials. Information reached 425 community members in Boston (90% virtually) and 1,887 in Chicago (95% virtually). CONCLUSION By leveraging community-academic partnerships, we developed and implemented a curriculum to promote familiarity with clinical trials, leading to information dissemination by POLs in predominantly Black communities that are underrepresented in lupus clinical trials. The program successfully transitioned to a virtual model during the COVID-19 pandemic.
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Affiliation(s)
- Laura C Arneson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kreager A Taber
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Sciaska N Ulysse
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Daniel L Erickson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joan S Chmiel
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Holly Milaeger
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elmer Freeman
- Center for Community Health Education Research and Service, Boston, Massachusetts
| | | | - Jing Song
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anh H Chung
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Candace H Feldman
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Racial disparities in pancreatic cancer clinical trials: Defining the problem and identifying solutions. Adv Cancer Res 2023. [DOI: 10.1016/bs.acr.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
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LILLEY CULLENM, DELILLE MINERVE, MIRZA KAMRANM, PARILLA MEGAN. Toward a More Just System of Care in Molecular Pathology. Milbank Q 2022; 100:1192-1242. [PMID: 36454130 PMCID: PMC9836258 DOI: 10.1111/1468-0009.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/09/2022] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
Policy Points American health care policy must be critically assessed to establish the role it plays in sustaining and alleviating the health disparities that currently exist in molecular genetic testing. It is critical to understand the economic and sociocultural influences that drive patients to undergo or forgo molecular testing, especially in marginalized patient populations. A multipronged solution with actions necessary from multiple stakeholders is required to reduce the cost of health care, rebalance regional disparities, encourage physician engagement, reduce data bias, and earn patients' trust. CONTEXT The health status of a population is greatly influenced by both biological processes and external factors. For years, minority and low socioeconomic patient populations have faced worse outcomes and poorer health in the United States. Experts have worked extensively to understand the issues and find solutions to alleviate this disproportionate burden of disease. As a result, there have been some improvements and successes, but wide gaps still exist. Diagnostic molecular genetic testing and so-called personalized medicine are just now being integrated into the current American health care system. The way in which these tests are integrated can either exacerbate or reduce health disparities. METHODS We provide case scenarios-loosely based on real-life patients-so that nonexperts can see the impacts of complex policy decisions and unintentional biases in technology without needing to understand all the intricacies. We use data to explain these findings from an extensive literature search examining both peer-reviewed and gray literature. FINDINGS Access to diagnostic molecular genetic testing is not equitable or sufficient, owing to at least five major factors: (1) cost to the patient, (2) location, (3) lack of provider buy-in, (4) data-set bias, and (5) lack of public trust. CONCLUSIONS Molecular genetic pathology can be made more equitable with the concerted efforts of multiple stakeholders. Confronting the five major factors identified here may help us usher in a new era of precision medicine without its discriminatory counterpart.
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Affiliation(s)
| | | | - KAMRAN M. MIRZA
- Loyola University Chicago, Strich School of Medicine
- Loyola Medical Center
| | - MEGAN PARILLA
- Loyola University Chicago, Strich School of Medicine
- Loyola Medical Center
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Read SW, Kim P, Marovich M, Dieffenbach CW, Fauci AS. Forty years of investment in HIV research: progress towards ending the HIV pandemic and preparation for future pandemics. J Int AIDS Soc 2022; 25:e26039. [PMID: 36448551 PMCID: PMC9709723 DOI: 10.1002/jia2.26039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Sarah W. Read
- Division of AIDSNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Peter Kim
- Division of AIDSNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Mary Marovich
- Division of AIDSNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Carl W. Dieffenbach
- Division of AIDSNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Anthony S. Fauci
- Office of the DirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
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Bonneton M, Sambourg J, Luong Nguyen LB, Trillou C, Dohou J, Saint Lary O, Schuers M, Lachâtre M, Launay O. A national platform for Covid-19 vaccine studies recruitment in France: Covireivac volunteer's characteristics. Hum Vaccin Immunother 2022; 18:2109364. [PMID: 36018773 DOI: 10.1080/21645515.2022.2109364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
During the Covid-19 pandemic, the urgent need for safe and effective vaccines has led to many vaccine trials, implying fast and extensive recruitment of volunteers. In France, until 2020, vaccine clinical research participants were usually recruited locally, through center-based pools of volunteers, and local communication plans. Covireivac is a French public online platform launched on 10/01/2020 that enables national, large-scale recruitment of volunteers for Covid-19 vaccine studies. On the Covireivac website, all adult participants registered online, gave their informed consent, and filled out two online forms with information on their identity, health status (comorbidities, treatments), and known exposure to SARS-CoV-2. Since July 2021, volunteers could mention if their children are interested in participating in a Covid-19 vaccine trial. The objective of this work is to describe Covireivac's volunteer characteristics registered from 10/01/2020 to 11/02/2022. To identify independent volunteer characteristics associated with a period of registration we performed a multivariate logistic regression. Among 54,424 registrations, 52,391 (96%) were analysed; 61% were male (n = 31,893), median age was 50 y; 13% (n = 6586) were healthcare workers. At registration, 15,879 volunteers (33%) reported at least one comorbidity, among whom 16% (n = 7349) were obese and 17% (n = 8346) had hypertension. Most volunteers registered during the first month (n = 35,876, 66%). The Covireivac platform allowed quick and large recruitment of potential volunteers for Covid-19 vaccine trials and could be used on a larger scale for vaccine trials in France. It could facilitate recruitment in vaccine trials and provide sponsors with better visibility of the recruitment capacities of clinical research centers.
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Affiliation(s)
- Marion Bonneton
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.,Innovative Clinical Research Network in Vaccinology (I-REIVAC), F-CRIN, Paris, France
| | - Jessica Sambourg
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.,Université Paris Cité, Paris, France
| | - Christine Trillou
- French Clinical Research Infrastructure Network (F-CRIN), Inserm, Toulouse, France
| | - Joyce Dohou
- French Clinical Research Infrastructure Network (F-CRIN), Inserm, Toulouse, France
| | - Olivier Saint Lary
- Collège National des Enseignants en Médecine Générale, Paris, France.,Primary Care and Prevention, CESP, Université Paris-Saclay, Le kremlin Bicetre, France
| | - Mathieu Schuers
- Collège National des Enseignants en Médecine Générale, Paris, France.,LIMICS, U1142, Sorbonne Université, Paris, France
| | - Marie Lachâtre
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Odile Launay
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.,Innovative Clinical Research Network in Vaccinology (I-REIVAC), F-CRIN, Paris, France.,Université Paris Cité, Paris, France
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Miner MD, Hatherill M, Mave V, Gray GE, Nachman S, Read SW, White RG, Hesseling A, Cobelens F, Patel S, Frick M, Bailey T, Seder R, Flynn J, Rengarajan J, Kaushal D, Hanekom W, Schmidt AC, Scriba TJ, Nemes E, Andersen-Nissen E, Landay A, Dorman SE, Aldrovandi G, Cranmer LM, Day CL, Garcia-Basteiro AL, Fiore-Gartland A, Mogg R, Kublin JG, Gupta A, Churchyard G. Developing tuberculosis vaccines for people with HIV: consensus statements from an international expert panel. Lancet HIV 2022; 9:e791-e800. [PMID: 36240834 PMCID: PMC9667733 DOI: 10.1016/s2352-3018(22)00255-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/16/2022] [Accepted: 08/30/2022] [Indexed: 11/06/2022]
Abstract
New tuberculosis vaccine candidates that are in the development pipeline need to be studied in people with HIV, who are at high risk of acquiring Mycobacterium tuberculosis infection and tuberculosis disease and tend to develop less robust vaccine-induced immune responses. To address the gaps in developing tuberculosis vaccines for people with HIV, a series of symposia was held that posed six framing questions to a panel of international experts: What is the use case or rationale for developing tuberculosis vaccines? What is the landscape of tuberculosis vaccines? Which vaccine candidates should be prioritised? What are the tuberculosis vaccine trial design considerations? What is the role of immunological correlates of protection? What are the gaps in preclinical models for studying tuberculosis vaccines? The international expert panel formulated consensus statements to each of the framing questions, with the intention of informing tuberculosis vaccine development and the prioritisation of clinical trials for inclusion of people with HIV.
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Affiliation(s)
| | - Mark Hatherill
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Vidya Mave
- Johns Hopkins India, Byramjee-Jeejeebhoy Government Medical College Clinical Research Site, Pune, India
| | - Glenda E Gray
- South African Medical Research Council, Cape Town, South Africa
| | - Sharon Nachman
- Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Sarah W Read
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Richard G White
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anneke Hesseling
- Desmond Tutu Tuberculosis Centre, Stellenbosch University, Stellenbosch, South Africa
| | - Frank Cobelens
- Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Sheral Patel
- US Food and Drug Administration, Silver Spring, MD, USA
| | - Mike Frick
- Treatment Action Group, New York, NY, USA
| | | | - Robert Seder
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Joanne Flynn
- Microbiology and Molecular Genetics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Deepak Kaushal
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Willem Hanekom
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | | | - Thomas J Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Elisa Nemes
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Erica Andersen-Nissen
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Cape Town HIV Vaccine Trials Network (HVTN) Immunology Laboratory, Cape Town, South Africa
| | | | - Susan E Dorman
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Grace Aldrovandi
- Department of Pediatrics, University of California, Los Angeles, CA, USA
| | - Lisa M Cranmer
- Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Cheryl L Day
- Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Alberto L Garcia-Basteiro
- ISGlobal, Hospital Clínic Universitat de Barcelona, Barcelona, Spain; Centro de investigação de Saúde de Manhiça, Maputo, Mozambique
| | | | - Robin Mogg
- Takeda Pharmaceutical Company, Cambridge, MA, USA
| | - James G Kublin
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Amita Gupta
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gavin Churchyard
- The Aurum Institute, Johannesburg, South Africa; School of Public Health, University of Witwatersrand, Johannesburg, South Africa; Department of Medicine, Vanderbilt University, Nashville, TN, USA.
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Rocque GB, Andrews C, Lawhon VM, Ingram SA, Frazier RM, Smith ML, Wagner LI, Zubkoff L, Wallner LP, Wolff AC. Physician Perspectives on Reducing Curative Cancer Treatment Intensity for Populations Underrepresented in Clinical Trials. Oncologist 2022; 27:1067-1073. [PMID: 36215065 PMCID: PMC9732232 DOI: 10.1093/oncolo/oyac191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Historically, clinical trials involved adding novel agents to standard of care to improve survival. There has been a shift to an individualized approach with testing less intense treatment, particularly in breast cancer where risk of recurrence is low. Little is known about physician perspectives on delivering less intense treatment for patients who are not well represented in clinical trials. METHODS Open-ended, individual qualitative interviews with medical oncologists explored their perspectives on trials that test less intense treatment for patients with cancer, with a focus on breast cancer. Interviews were audio-recorded and transcribed. Four independent coders utilized a content analysis approach to analyze transcripts using NVivo. Major themes and exemplary quotes were extracted. RESULTS Of the 39 participating physicians, 61.5% felt comfortable extrapolating, 30.8% were hesitant, and 7.7% would not feel comfortable extrapolating trial outcomes to underrepresented populations. Facilitators of comfort included the sentiment that "biology is biology" (such that the cancer characteristics were what mattered), the strength of the evidence, inclusion of subset analysis on underrepresented populations, and prior experience making decisions with limited data. Barriers to extrapolation included potential harm over the patient's lifetime, concerns about groups that had minimal participants, application to younger patients, and extending findings to diverse populations. Universally, broader inclusion in trials testing lowering chemotherapy was desired. CONCLUSIONS The majority (92%) of physicians reported that they would de-implement treatment for patients poorly represented in clinical trials testing less treatment, while expressing concerns about applicability to specific subpopulations. Further work is needed to increase clinical trial representation of diverse populations to safely and effectively optimize treatment for patients with cancer. TRIAL REGISTRATION NCT03248258.
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Affiliation(s)
- Gabrielle B Rocque
- Corresponding author: Gabrielle B. Rocque, MD, MSPH, The University of Alabama at Birmingham, WTI 240E, Birmingham, AL 35294, USA. Tel: +1 205 975 2914;
| | - Courtney Andrews
- Institute for Human Rights, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Valerie M Lawhon
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stacey A Ingram
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rachel M Frazier
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Lisa Zubkoff
- O’Neal Comprehensive Cancer Center, Birmingham, AL, USA,Division of Preventive Medicine, , Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA,Birmingham/Atlanta Geriatric Research Education and Clinical Center (GRECC), Birmingham VA Healthcare System, Birmingham, AL, USA
| | - Lauren P Wallner
- Rogel Cancer Center, Departments of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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43
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Castellon-Lopez Y, Landovitz R, Ntekume E, Porter C, Bross R, Hilder R, Lucas-Wright A, Daar ES, Chavez P, Blades C, Carson S, Morris D, Vassar S, Casillas A, Brown A. A community-partnered approach for diversity in COVID-19 vaccine clinical trials. J Clin Transl Sci 2022; 7:e23. [PMID: 36714798 PMCID: PMC9874035 DOI: 10.1017/cts.2022.471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/11/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Communities of color have faced disproportionate morbidity and mortality from COVID-19, coupled with historical underrepresentation in US clinical trials, creating challenges for equitable participation in developing and testing a safe and effective COVID-19 vaccine. Methods To increase diversity, including racial and ethnic representation, in local Los Angeles County NIH-sponsored Phase 3 SARS-CoV-2 vaccine clinical trials, we used deliberative community engagement approaches to form a Community Consultant Panel (CCP) that partnered with trial research teams. Thirteen members were recruited, including expertise from essential workers, community-based and faith-based organizations, or leaders from racial and ethnic minority communities. Results Working closely with local investigators for the vaccine studies, the CCP provided critical insight on best practices for community trust building, clinical trial participation, and reliable information dissemination regarding COVID-19 vaccines. Modifying recruitment, outreach, and trial protocols led to majority-minority participants (55%-78%) in each of the three vaccine clinical trials. CCP's input led to cultural tailoring of recruitment materials, changes in recruitment messaging, and supportive services to improve trial accessibility and acceptability (transportation, protocols for cultural competency, and support linkages to care in case of an adverse event). Barriers to clinical trial participation unable to be resolved included childcare, requests for after-hours appointment availability, and mobile locations for trial visits. Conclusion Using deliberative community engagement can provide critical and timely insight into the community-centered barriers to COVID-19 vaccine trial participation, including addressing social determinants of health, trust, clinical trial literacy, structural barriers, and identifying trusted messenger and reliable sources of information.
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Affiliation(s)
- Yelba Castellon-Lopez
- Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Raphael Landovitz
- Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ejiro Ntekume
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Courtney Porter
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Rachelle Bross
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Robin Hilder
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Aziza Lucas-Wright
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Eric S Daar
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Pedro Chavez
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Savanna Carson
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - D'Ann Morris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Stefanie Vassar
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Arleen Brown
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Adeagbo M, Olukotun M, Musa S, Alaazi D, Allen U, Renzaho AMN, Sekyi-Otu A, Salami B. Improving COVID-19 Vaccine Uptake among Black Populations: A Systematic Review of Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11971. [PMID: 36231270 PMCID: PMC9565689 DOI: 10.3390/ijerph191911971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 09/19/2022] [Indexed: 05/28/2023]
Abstract
Given the growing body of evidence on COVID-19 vaccine hesitancy among Black populations, the aim of this systematic review was to identify the interventions and strategies used to improve COVID-19 vaccine confidence and uptake among Black populations globally. To identify relevant studies, we conducted a systematic review of the literature based on a systematic search of 10 electronic databases: MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Cochrane Library, Web of Science, Sociological Abstracts, Dissertations and Theses Global, and SocINDEX. We screened a total of 1728 records and included 14 peer-reviewed interventional studies that were conducted to address COVID-19 vaccine hesitancy among Black populations. A critical appraisal of the included studies was performed using the Newcastle-Ottawa Quality Assessment Scale. The intervention strategies for increasing COVID-19 vaccine uptake were synthesized into three major categories: communication and information-based interventions, mandate-based interventions, and incentive-based interventions. Interventions that incorporated communication, community engagement, and culturally inclusive resources significantly improved vaccine uptake among Black populations, while incentive- and mandate-based interventions had less impact. Overall, this systematic review revealed that consideration of the sociocultural, historical, and political contexts of Black populations is important, but tailored interventions that integrate culture-affirming strategies are more likely to decrease COVID-19 vaccine hesitancy and increase uptake among Black populations.
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Affiliation(s)
- Morolake Adeagbo
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Mary Olukotun
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Salwa Musa
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Dominic Alaazi
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Upton Allen
- Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Andre M. N. Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3004, Australia
| | - Ato Sekyi-Otu
- Department of Surgery, University of Toronto, Toronto, ON M5S 2J7, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Gilmore B, Gerlach N, Abreu Lopes C, Diallo AA, Bhattacharyya S, de Claro V, Ndejjo R, Nyamupachitu Mago E, Tchetchia A. Community engagement to support COVID-19 vaccine uptake: a living systematic review protocol. BMJ Open 2022; 12:e063057. [PMID: 36127122 PMCID: PMC9490295 DOI: 10.1136/bmjopen-2022-063057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/18/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Widespread vaccination against COVID-19 is one of the most effective ways to control, and ideally, end the global COVID-19 pandemic. Vaccine hesitancy and vaccine rates vary widely across countries and populations and are influenced by complex sociocultural, political, economic and psychological factors. Community engagement is an integral strategy within immunisation campaigns and has been shown to improve vaccine acceptance. As evidence on community engagement to support COVID-19 vaccine uptake is emerging and constantly changing, research that lessens the knowledge-to-practice gap by providing regular and up-to-date evidence on current best-practice is essential. METHODS AND ANALYSIS A living systematic review will be conducted which includes an initial systematic review and bimonthly review updates. Searching and screening for the review and subsequent updates will be done in four streams: a systematic search of six databases, grey literature review, preprint review and citizen sourcing. The screening will be done by a minimum of two reviewers at title/abstract and full-text in Covidence, a systematic review management software. Data will be extracted across predefined fields in an excel spreadsheet that includes information about article characteristics, context and population, community engagement approaches, and outcomes. Synthesis will occur using the convergent integrated approach. We will explore the potential to quantitatively synthesise primary outcomes depending on heterogeneity of the studies. ETHICS AND DISSEMINATION The initial review and subsequent bimonthly searches and their results will be disseminated transparently via open-access methods. Quarterly briefs will be shared on the reviews' social media platforms and across other interested networks and repositories. A dedicated web link will be created on the Community Health-Community of Practice site for sharing findings and obtaining feedback. A mailing list will be developed and interested parties can subscribe for updates. PROSPERO REGISTRATION NUMBER CRD42022301996.
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Affiliation(s)
- Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Nina Gerlach
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Claudia Abreu Lopes
- International Institute for Global Health United Nations University, Kuala Lumpur, Malaysia
| | - Alpha A Diallo
- READ-GROUP, Conakry, Guinea
- Health Research Ethics Committee, Conakry, Guinea
| | - Sanghita Bhattacharyya
- Public Health Foundation of India, Gurugram, Haryana, India
- Community Health-Community of Practice Collectivity, United Nations Children's Fund (UNICEF) Headquarters, New York City, New York, USA
| | - Vergil de Claro
- RTI International, Pasig City, Philippines
- Evidence for Health, Pasig City, Philippines
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Adalbert Tchetchia
- Community Health-Community of Practice Collectivity, United Nations Children's Fund (UNICEF) Headquarters, New York City, New York, USA
- Expanded Programme on Immunization, Yaounde, Cameroon
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Zhang J, Van Spall HGC, Wang Y, Thabane L, Wang R, Li G. Twenty-year trends in racial and ethnic enrollment in large diabetes randomized controlled trials. BMC Med 2022; 20:294. [PMID: 36109742 PMCID: PMC9479279 DOI: 10.1186/s12916-022-02501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of representativeness in Black, Indigenous, and People of Colour (BIPOC) enrollment could compromise the generalizability of study results and health equity. This study aimed to examine trends in BIPOC groups enrollment in diabetes randomized controlled trials (RCTs) and to explore the association between trial factors and high-enrollment of BIPOC groups. METHODS We systematically searched the literature on large diabetes RCTs with a sample size of ≥ 400 participants published between 2000 and 2020. We assessed temporal trends in enrollment of racial and ethnic groups in the included trials. Logistic and linear regression analyses were used to explore the relationship between trial factors and the high-enrollment defined by median enrollment rate. RESULTS A total of 405 RCTs were included for analyses. The median enrollment rate of BIPOC groups was 24.0%, with 6.4% for the Black group, 11.2% for Hispanic, 8.5% for Asian, and 3.0% for other BIPOC groups respectively. Over the past 20 years, the BIPOC enrollment showed an increased trend in the diabetes RCTs, ranging from 20.1 to 28.4% (P for trend = 0.041). A significant trend towards increased enrollment for Asian group was observed. We found that weekly or daily intervention frequency (OR = 0.48, 95% CI: 0.26, 0.91) and duration of intervention > 6.5 month (OR = 0.59, 95% CI: 0.37, 0.95) were significantly related to decreased odds of high-enrollment, while type 2 diabetes (OR = 1.44, 95% CI: 1.04, 1.99) was associated with high-enrollment of BIPOC groups. CONCLUSIONS The enrollment of BIPOC was found to increase in large diabetes RCTs over the past two decades; some trial factors may be significantly associated with BIPOC enrollment. These findings may highlight the importance of enrollment of BIPOC groups and provide insights into the design and implementation of future clinical trials in diabetes.
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Affiliation(s)
- Jingyi Zhang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Harriette G C Van Spall
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Yaoyao Wang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada.,St Joseph's Healthcare Hamilton, ON, Hamilton, Canada.,Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Ruoting Wang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guowei Li
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China. .,Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada.
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Calder T, Tong T, Hu DJ, Kim JH, Kotloff KL, Koup RA, Marovich MA, McElrath MJ, Read SW, Robb ML, Renzullo PO, D’Souza MP. Leveraging lessons learned from the COVID-19 pandemic for HIV. COMMUNICATIONS MEDICINE 2022; 2:110. [PMID: 36045906 PMCID: PMC9423691 DOI: 10.1038/s43856-022-00175-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022] Open
Abstract
The rapid development of COVID-19 vaccines and their deployment in less than a year is an unprecedented scientific, medical, and public health achievement. This rapid development leveraged knowledge from decades of HIV/AIDS research and advances. However, the search for an HIV vaccine that would contribute to a durable end to the HIV pandemic remains elusive. Here, we draw from the US government experience and highlight lessons learned from COVID-19 vaccine development, which include the importance of public-private partnerships, equitable inclusion of populations impacted by the infectious pathogen, and continued investment in basic research. We summarize key considerations for an accelerated and re-energized framework for developing a safe and efficacious HIV vaccine. Calder, Tong et al. discuss how the rapid development of COVID-19 vaccines benefited from HIV/AIDS research. They highlight lessons learned from the COVID-19 vaccine development experience that could accelerate and re-energize the development of a safe and efficacious HIV vaccine.
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Levy V, Bengoa RY, Romero PP, Bollyky J, Singh U. Successful recruitment of monolingual Spanish speaking Latinos to university phase II and III outpatient COVID-19 clinical treatment trials in Northern California. Contemp Clin Trials 2022; 120:106891. [PMID: 36002110 PMCID: PMC9392894 DOI: 10.1016/j.cct.2022.106891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/20/2022]
Abstract
Through a public County/University partnership, we employed a Spanish/English bilingual research coordinator to increase awareness of newly available treatments with FDA Emergency Use Authorization and clinical trial opportunities for Latino outpatients with mild to moderate COVID-19. Out of the 550 San Mateo County outpatients with COVID-19 referred to Stanford University between July 2020 and April 2022, 9.5% elected to receive monoclonal antibody EUA treatment. COVID-19 treatment trial enrollment of County patients, 5% of those recruited, was commensurate with non-County populations enrollment. Recruitment models such as ours have the potential to increase US Latino populations' recruitment in outpatient COVID-19 treatment trials and contribute to decreasing COVID-19 health disparities.
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Affiliation(s)
- Vivian Levy
- San Mateo Medical Center, 222 West 39th Avenue, San Mateo, CA 94403, United States of America; Stanford University School of Medicine, Infectious Diseases and Geographic Medicine, 300 Pasteur Dr., Lane Bldg 134, Stanford, CA, 94305, United States of America.
| | - Ruth Yanes Bengoa
- San Mateo Medical Center, 222 West 39th Avenue, San Mateo, CA 94403, United States of America
| | | | - Jenna Bollyky
- Stanford University School of Medicine, Department of Pediatrics, Division of Infectious Disease, Center for Academic Medicine. MC 5660, 453 Quarry Road, Palo Alto, CA 94304-5660, United States of America.
| | - Upinder Singh
- Stanford University School of Medicine, Infectious Diseases and Geographic Medicine, 300 Pasteur Dr., Lane Bldg 134, Stanford, CA, 94305, United States of America.
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Abstract
PURPOSE OF REVIEW The coronavirus disease 2019 pandemic resulted in cataclysmic changes to the research enterprise, causing a forced shutdown or rapid pivot to virtual methods. Adapting studies to the virtual environment also impacted recruitment and retention strategies. This review elucidated challenges and offered pragmatic recommendations, drawing on published literature and our prior work, to assist researchers in re-evaluating and amending best-practice techniques to bolster inclusive recruitment and study engagement of people using substances, particularly for virtual interviews or focus groups. RECENT FINDINGS Ameliorating recruitment strategies and research protocols to better fit virtual methods of recruitment and study administration required careful consideration of ethical and logistical implications. Many procedures to increase enrollment of underrepresented populations, such as building mutually beneficial and respectful community partnerships, recruiting via social media, or providing ambulatory research centers, existed prior to this specific pandemic. However, unprecedented disruptions in resources needed to participate in virtual interviews or focus groups, privacy concerns, and possible deteriorating trust in research necessitated continued adaptation and expansion of these strategies. SUMMARY Building upon prepandemic, community-engaged strategies may continue to facilitate diverse recruitment efforts and advance science productivity in the substance use and addiction field during the pandemic and thereafter.
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Cespedes M, Das M, Hojilla JC, Blumenthal J, Mounzer K, Ramgopal M, Hodge T, Torres TS, Peterson C, Shibase S, Elliott A, Demidont AC, Callaghan L, Watson CC, Carter C, Kintu A, Baeten JM, Ogbuagu O. Proactive strategies to optimize engagement of Black, Hispanic/Latinx, transgender, and nonbinary individuals in a trial of a novel agent for HIV pre-exposure prophylaxis (PrEP). PLoS One 2022; 17:e0267780. [PMID: 35657826 PMCID: PMC9165827 DOI: 10.1371/journal.pone.0267780] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Black and Hispanic/Latinx cisgender men who have sex with men (MSM), transgender women, transgender men, and gender nonbinary (TGNB) individuals have been historically underrepresented in HIV pre-exposure prophylaxis (PrEP) clinical trials. There is an urgent need for ongoing engagement with communities that have been the most impacted by HIV and diverse representation in clinical trials. Here we describe strategic approaches undertaken in the PURPOSE 2 trial to optimize engagement of underrepresented individuals. METHODS AND RESULTS PURPOSE 2 is an ongoing Phase 3 trial evaluating the safety and efficacy of lenacapavir as PrEP in cisgender MSM and TGNB individuals. In PURPOSE 2, we used a multipronged approach aimed at enriching participation of underrepresented individuals. We conducted a review to identify evidence-informed recommendations from literature, engaged with stakeholders, and established the Global Community Advisory and Accountability Group (GCAG) to represent the needs of the community. Insights from stakeholders and GCAG members resulted in an expansion of the study population to include transgender men, gender nonbinary persons, and adolescents, and evaluation of population-specific outcomes. Feedback from stakeholders and GCAG members also informed investigator and site selection; these were selected based on prior experience working with persons from diverse racial, ethnic and gender identities, and estimates of local HIV incidence. Site selection was also expanded to include community-based clinics with services tailored towards Black, Hispanic/Latinx, and TGNB populations. We established a study-wide recruitment goal of 50% Black MSM and 20% Hispanic/Latinx MSM in US sites and 20% transgender women globally. Site-specific recruitment goals were also developed based on local demographics and HIV incidence. Mandatory trainings included Good Participatory Practice guidelines, gender inclusivity, and antiracism. CONCLUSION While further work is needed to achieve equitable representation, the strategies we describe may serve as a framework for future clinical trials. TRIAL REGISTRATION Clinical Trial Number: NCT04925752.
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Affiliation(s)
- Michelle Cespedes
- Division of Infectious Disease, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Moupali Das
- Gilead Sciences, Foster City, CA, United States of America
| | | | - Jill Blumenthal
- Department of Medicine, University of California San Diego, San Diego, CA, United States of America
| | - Karam Mounzer
- Philadelphia FIGHT Community Health Centers, Philadelphia, PA, United States of America
| | - Moti Ramgopal
- Midway Research Center, Fort Pierce, FL, United States of America
| | - Theo Hodge
- Washington Health Institute, Washington, DC, United States of America
| | - Thiago S. Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Charles Peterson
- Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL, United States of America
| | | | - Ayana Elliott
- Gilead Sciences, Foster City, CA, United States of America
| | - A. C. Demidont
- Gilead Sciences, Foster City, CA, United States of America
| | | | | | | | - Alex Kintu
- Gilead Sciences, Foster City, CA, United States of America
| | | | - Onyema Ogbuagu
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
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