Community Engagement Strategies Eliminate Racial and Ethnic Disparities in Patients With Gynecologic Conditions


Medical experts provide insights surrounding efforts to ensure equitable health for women across underserved patient populations.

Derek van Amerongen, MD, MS: We recently saw the passage of the Clinical Treatment Act, HR 913, to impact clinical enrollment for Black, Hispanic, and Asian women. Dr Hawkins, do you think this will impact the enrollment rates for minority women in clinical trials?

Soyini Hawkins, MD, MPH, FACOG: I absolutely hope so. What this passage is going to do is somewhat implement a need in the legislature where the National Institutes of Health [NIH], is going to have to come up with some broad stroking plans to be inclusive of underrepresented minorities of women in their clinical trials. What that's going to do, if they have these actionable plans where they're going to figure out ways to very concretely recruit and also retain, is going to help bolster the numbers that we know we're lacking in a lot of the clinical trials. Again, with the understanding that what we're researching really does impact these groups in large ways. I hope it does make a difference. That will take some time. I think everything that we've discussed thus far needs to be considered when they come out with these hard plans and strategize. They need to strategize around meeting the patients where they are, going to their communities, rebuilding the trust that they need, breaking down some of the barriers of the socioeconomic strongholds, and not being able to participate or get their information included or simple things like language.

Roxie Cannon Wells, MD: If I may add to that, one of our senators from North Carolina actually sponsored that bill, and I was proud of that because Medicaid patients now are able to participate in clinical trials without being concerned about whether their care is going to be paid for. I think that just opens up or broadens the way for minority or underserved patients to actually become part of clinical trials. Who's going to pay for the blood work, who's going to pay for whatever it is that needs to be paid for that's prohibiting them from participating? I think that that act kind of takes that away and gives them the opportunity to participate. We know that minorities or underserved individual members receive Medicaid. I think that that's just a way to add additional people to clinical trials.

Derek van Amerongen, MD, MS: Well, would each of you be able to share 1 or 2 strategies that you might suggest to our listeners in terms of how to promote higher clinical trial enrollment of minority women?

Roxie Cannon Wells, MD: I would definitely go back to actually getting into the communities. I think you mentioned churches and barbershops, those types of things. Places that are very well-trusted. Pastors are individuals that people trust. They're the true north for a lot of individuals. That was one of the ways that we actually got people to participate in clinical trials for the COVID-19 vaccine in our community. Our system actually participated in those trials, and we actually went into the community. We took the trial to the community to see if they would participate. I think we got some pretty decent participation from that.

Sharon Deans, MD, MPH, MBA: I think the opportunity for the payer is understanding what trials are going on in the clinical space, in addition to educating the members about what's available. Educating the providers that are conducting those trials and confirming that they have our support with the laboratory and hospitalization and all the other ancillary services that go along with clinical trials. I think there's probably an opportunity for us to help educate the members as well within the realm of what we do; making sure we provide Q&A [questions and answers] about clinical trials and whether they are covered. There are questions, even going to fill medications, or getting an HPV [human papillomavirus] vaccine, anything they're worried about having to pay out of pocket for. Solidifying that information but understanding what's going on out there in the first place and making those providers that are conducting their trials aware that Medicaid patients are eligible because those services are covered.

Derek van Amerongen, MD, MS: Dr Hawkins, any final comments?

Soyini Hawkins, MD, MPH, FACOG: I’m actually going to thank these ladies. Dr Deans, I did not know that as a PI [primary investigator] I had that resource where my Medicare and Medicaid patients could even have transportation to my site for their study visits. The fact that I didn't know that goes to your point that we need to be educating not just the patients and the subjects that we want to enroll, but also the providers of these services and the investigators and the physicians that are taking part so that we know how to help bolster numbers and get the right participants and support our participants in the ways that we know have been longstanding barriers for them. Then Dr Wells, earlier you talked about not only going to the community but absolutely making sure that the community understands what they're getting themselves involved with and honestly how it could be an improvement to their outcomes or the next generation's outcomes.

Roxie Cannon Wells, MD: Derek, may I add one thing? I think that this panel is an example of how we can move clinical trials and change disparities in health care. We have a payer, we have a systems person, and then we have a private physician. I think if we are all working together to move the dial forward and to improve outcomes for people of color, I think that that's an important thing. But this panel, I think really gives an example of what we could do as a community for our community.

Derek van Amerongen, MD, MS: Excellent point. Thank you. Thank you all.

Transcript edited for clarity.

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