Building Trust, Not Just Enrollment: Amy Leader, DrPH, MPH, on Community Trial Success

Building trust through long-standing community relationships is essential to improving cancer clinical trial access and diversity, according to population scientist Amy E. Leader, DrPH, MPH, research faculty in medical oncology and associate director of community outreach and engagement, Thomas Jefferson University, Sidney Kimmel Comprehensive Cancer Center, who said successful academic-community partnerships depend on sustained, human-centered engagement rather than short-term outreach. She joined The American Journal of Managed Care^® for an interview at the Institute for Value-Based Medicine® event in Philadelphia on April 10, where she participated in “Collaborations in Today's Environment for Successful Clinical Trials” as a panelist.

Leader said many large cancer centers are working more closely with faith-based groups, social service agencies, and even libraries to bring trials directly into communities. These local organizations often serve as trusted messengers, helping make clinical trials feel less intimidating for patients who may otherwise view research as overwhelming or inaccessible.

“Trust is foundational,” Leader said, emphasizing that the strongest partnerships are built on mutual respect, long-term relationships, and shared benefit. Rather than approaching community groups only when enrollment is needed, institutions should invest in improving overall community health over time.

To better support community oncology practices that have strong patient relationships but limited research capacity, Leader said health systems need to provide high-touch, sustained support. Although tools such as remote consent can help, she said in-person presence remains critical. This can include deploying staff directly to community sites, training local research advocates, or using peer clinical trial navigators to help patients understand the process.

Leader said one of the most effective strategies for maintaining trust is simply showing up consistently. In some cases, academic centers may work with community partners for years before introducing a clinical trial.

She also highlighted persistent barriers to trial participation among underrepresented populations, including low awareness, mistrust of research, and logistical burdens such as transportation, time off work, and childcare needs. These barriers were worsened by the COVID-19 pandemic, which deepened skepticism toward medicine and science.

To address structural barriers, Leader said some logistical solutions—such as rideshare partnerships, lodging support, meal vouchers, and parking assistance—can ease access. But mistrust requires deeper investment. Peer navigators, especially those with shared lived experience, can help demystify trials and reassure patients.

Ultimately, improving trial diversity requires multilayered solutions that address individual, provider, and health system barriers while designing research with communities, according to Leader, not just for them.