Why are African Americans under-represented in medical research studies? Impediments to participation.
OBJECTIVE
In accordance with the NIH Revitalization Act of 1993, the National Institutes of Health and the Alcohol, Drug and Mental Health Administration require grant applicants and cooperative agreement participants to include minorities in human subject research. In an environment characterized by diminishing research dollars, this mandate has increased the pressure on investigators to determine factors that impede minority participation and to develop strategies to overcome these impediments.


METHODS
An extensive review of the literature was conducted to identify the factors possibly responsible for the low participation levels of African Americans in medical research studies and to highlight areas for further research. The items examined included the historical relationship between African Americans and medical researchers and the attitudes, perceptions and beliefs of potential participants and researchers as they relate to the low representation of African Americans in medical research.


RESULTS
The factors identified as possible impediments to African American participation included distrust of the medical/scientific community, poor access to primary medical care, the failure of researchers to recruit African Americans actively, the alienation of minority health professionals, lack of knowledge about clinical trials, language and cultural barriers.


CONCLUSIONS
Well-designed, relevant, ethical research in conjunction with an appreciation of the many barriers to participation are paramount to increasing African American presence in clinical research.
Shavers-Hornaday
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VL
Department of Preventive Medicine and Environmental Health, College of Medicine, University of Iowa 52240, USA.
Lynch
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CF
Burmeister
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LF
Torner
J C
JC
D001741:Black or African American / Q000523:psychology*; D001291:Attitude of Health Personnel; D001294:Attitude to Health / Q000208:ethnology*; D004992:Ethics, Medical; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009316:National Institutes of Health (U.S.); D018579:Patient Selection; D011287:Prejudice; D012106:Research; D012108:Research Personnel / Q000523:psychology*; D035842:Research Subjects; D012109:Research Support as Topic; D035502:Trust; D014481:United States