Improving participation of culturally and linguistically diverse participants in clinical trials: an expert consultation

• Published in: Current controlled trials in cardiovascular medicine Vol. 26; no. 1; pp. 105 - 7
• Main Authors: Watson, Eliza, Gulline, Hannah, Jane, Stephen M., Woollett, Anne, Ayton, Darshini
• Format: Journal Article
• Language: English
• Published: London BioMed Central 25.03.2025; BioMed Central Ltd; BMC
• Subjects: Biomedicine; Clinical trials; Clinical trials as topic; Clinical Trials as Topic - methods; Co-design; Commentary; Communication Barriers; Community; Country of birth; Cultural Competency; Cultural Diversity; Culturally and linguistically diverse; Discrimination in medical care; Diversity; Ethnic and racial minorities; Ethnicity; Funding; Health care disparities; Health Sciences; Humans; Inclusion; Language; Medicine; Medicine & Public Health; Multiculturalism; Multiculturalism & pluralism; Participation; Patient Selection; Research Design; Research Personnel - psychology; Research Subjects - psychology; Statistics for Life Sciences; Variables; Australia; United Kingdom; Inclusion; Healthcare disparities; Ethnic and racial minorities; Diversity; Culturally and linguistically diverse; Clinical trials as topic; Cultural diversity
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/s13063-025-08803-z

Background Diversity and inclusivity have become increasingly important in the design and implementation of clinical trials. However, those from culturally and linguistically diverse (CALD) backgrounds are still underrepresented in the research landscape. Failing to include diverse participants can result in treatments and interventions that are not accessible to all who need them. Researchers in Australia and internationally are innovating new ways to address the barriers to increased participation of people from CALD backgrounds in clinical trials. Consultation and review We conducted a brief review, augmented by consultation with experts who have engaged CALD communities in research and who hold positions in diversity and inclusivity improvement. Through this, we identified three pillars that must be considered in all areas of design and implementation of trials and research projects: co-design the process of engagement, build trust, invest the time. We also identified seven areas for action where organisations and research teams can focus their activities to improve inclusion and diversity: toolkits and study design, building trust with CALD communities, education and awareness, staff training and communication, language and consent, logistics, resources: funding and time. Importantly, accurate collection of data related to CALD status is also needed to improve inclusivity. Conclusion Experts provided valuable insights from their own experiences of the most effective methods for improving the inclusion of CALD communities in clinical trials. Early and thorough planning, building long-term, mutually beneficial relationships with CALD communities and top-down changes to funding are all necessary elements to creating effective, sustainable improvements to the diversity of clinical trials.