Building Equitable Partnerships Between Industry Sponsors And Indigenous Communities to Enhance Engagement in Clinical Trials.

Introduction: American Indians, Alaska Natives, and Native Hawaiians (AI/AN/NH) have among the lowest representation in clinical trial participation in the United States (US) compared with other racial/ethnic groups and experience many barriers to health care access. To promote equitable and justice-centered inclusion of Indigenous Peoples in clinical trials and improve health equity, industry sponsors need to be better attuned to community-based priorities. This article summarizes perspectives including strategies to build more effective and equitable partnerships with Indigenous communities in the US and to advance access to medical care.

Methods: A panel of advisors on AI/AN/NH health care assembled for a virtual roundtable discussion in March 2024. A narrative review, supported by key publications, was conducted to summarize and contextualize the discussions.

Results: AI/AN/NH face various health inequities and challenges in clinical trial enrollment, including justified distrust of medical research environments, inaccessible and unaffordable health care, and limited community engagement by the research community. Proposed methods for engagement based on advisor insights were developed to guide industry sponsors in building more effective partnerships with Indigenous communities. Engagement methods consist of several strategies such as investing in community priorities, building a long-term commitment, identifying trusted messengers, and co-developing engagement initiatives.

Conclusions: Current challenges regarding clinical trial diversity are impacting health outcomes among Indigenous Peoples, furthering disparities. Based on advisor engagement, establishing effective, equitable, and justice-centered partnerships between industry sponsors and Indigenous Peoples has the potential to result in community-driven priorities being recognized in clinical trials, and thus expanding benefit of medical innovation.