African Americans are less likely to enroll in preclinical Alzheimer's disease clinical trials

Zhou, Yan; Elashoff, David; Kremen, Sarah; Teng, Edmond; Karlawish, Jason; Grill, Joshua D.

doi:10.1016/j.trci.2016.09.004

Cited by 79 publications

(84 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that the representation of blacks among RCT participants has decreased since 2006-2011 in the USA, which is consistent with reviews of race/ethnic representation in other disease states [16]. Reasons for minority under-representation in RCTs are multifactorial and often involve system-level actors-e.g, clinicians, hospitals, and the community [21][22][23][24]. Historical acts of discrimination and marginalization in healthcare settings (e.g., the Tuskegee Syphilis Study) have been hypothesized as reasons why racial minorities are more distrustful of health systems and may also contribute to the under-representation of these groups in RCTs.…”

Section: Discussionsupporting

confidence: 83%

The Representation of Gender and Race/Ethnic Groups in Randomized Clinical Trials of Individuals with Systemic Lupus Erythematosus

Falasinnu¹,

Chaichian

Bass

et al. 2018

Curr Rheumatol Rep

View full text Add to dashboard Cite

Purpose of ReviewThis review evaluated gender and race/ethnic representation in randomized controlled trials (RCTs) of patients with systemic lupus erythematosus (SLE).Recent FindingsWhites comprise 33% of prevalent SLE cases and comprised 51% of RCT enrollees. Blacks encompass 43% of prevalent SLE cases, but only represented 14% of RCT enrollees. Hispanics comprise 16% of prevalent SLE cases and 21% of RCT enrollees, while Asians comprise 13% of prevalent SLE cases and 10% of RCT enrollees. Males encompass 9% of SLE cases and 7% of RCT enrollees. The reporting and representation of males have remained stable over time, although their representation in RCTs is slighter lower than the prevalence of SLE in males. The representation of Hispanics, Asians, and Native Americans increased over time. However, the representation of blacks among RCT participants has decreased since 2006–2011.SummaryRCTs among SLE patients need larger sample sizes in order to evaluate heterogeneity in outcomes among racial subgroups. It is imperative that novel strategies be developed to recruit racial minorities with SLE by identifying and improving barriers to RCT enrollment in order to better understand the disease’s diverse population.

show abstract

Section: Discussionsupporting

confidence: 83%

The Representation of Gender and Race/Ethnic Groups in Randomized Clinical Trials of Individuals with Systemic Lupus Erythematosus

Falasinnu¹,

Chaichian

Bass

et al. 2018

Curr Rheumatol Rep

View full text Add to dashboard Cite

show abstract

“…Many articles have published goals and strategies for recruiting Blacks/African Americans and other marginalized groups into clinical studies—one major goal discussed in these articles is to build long-term trust within the Black/African American community [35, 40, 84]. Some recommendations for building trust are as follows: 1) publicly acknowledging the historical mistreatment of Blacks/African Americans in biomedical research [24, 36, 83–85], 2) adequately explaining the consent process [24, 36, 86], and protections in place to prevent mistreatment, 3) engaging in ongoing Q&A discussions with the community [24, 30, 40, 84, 85, 87, 88], and 4) creating relationships that include patients, caregivers, health-care providers, community leaders, researchers, and study coordinators [89]. Secondly, ADCs should actively enroll Blacks/African Americans, attach specific research questions, and perform power analyses so that it can be ensured that comparisons among individuals from different racial/ethnic groups will be valid.…”

Section: Addressing the Problem: Considerations For The Fieldmentioning

confidence: 99%

Challenges and Considerations Related to Studying Dementia in Blacks/African Americans

Ighodaro

Nelson

Kukull

et al. 2017

JAD

View full text Add to dashboard Cite

Blacks/African Americans have been reported to be ~2–4 times more likely to develop clinical Alzheimer’s disease (AD) compared to Whites. Unfortunately, study design challenges (e.g., recruitment bias), racism, mistrust of healthcare providers and biomedical researchers, confounders related to socioeconomic status, and other sources of bias are often ignored when interpreting differences in human subjects categorized by race. Failure to account for these factors can lead to misinterpretation of results, reification of race as biology, discrimination, and missed or delayed diagnoses. Here we provide a selected historical background, discuss challenges, present opportunities, and suggest considerations for studying health outcomes among racial/ethnic groups. We encourage neuroscientists to consider shifting away from using biologic determination to interpret data, and work instead toward a paradigm of incorporating both biological and socio-environmental factors known to affect health outcomes with the goal of understanding and improving dementia treatments for Blacks/African Americans and other underserved populations.

show abstract

“…Among NH Blacks, study participation may have been impaired. There is evidence to suggest that NH Blacks in the United States may be cautious about participating in research studies due to historical abuses by the research community (e.g., Tuskegee Syphilis Study) (Cuerda & López‐Muñoz, ; Harris, Gorelick, Samuels, & Bempong, ; Zhou et al, ). Reasons for under‐participation may include: lack of awareness, economic factors, communication issues, and mistrust (Harris et al, ).…”

Section: Discussionmentioning

confidence: 99%

Acculturation and selected birth defects among non‐Hispanic Blacks in a population‐based case–control study

Hoyt

Ramadhani

et al. 2020

Birth Defects Research

View full text Add to dashboard Cite

Background There are noted birth defects prevalence differences between race/ethnicity groups. For instance, non‐Hispanic (NH) Black mothers are more likely to have an infant with encephalocele, although less likely to have an infant with anotia/microtia compared to NH Whites. When stratifying by nativity and years lived within the United States, additional variations become apparent. Methods Data from the National Birth Defects Prevention Study were used to calculate descriptive statistics and estimate crude/adjusted odds ratios (aORs) and 95% confidence intervals (95%CIs) among NH Blacks with one of 30 major defects and non‐malformed controls. Total case/controls were as follows: U.S.‐ (2,773/1101); Foreign‐ (343/151); African‐born (161/64). Study participants were also examined by number of years lived in the U.S. (≤5 vs. 6+ years). Results Compared to U.S.‐born, foreign‐born NH Black controls tended to be older, had more years of education, and were more likely to have a higher household income. They also had fewer previous livebirths and were less likely to be obese. In the adjusted analyses, two defect groups were significantly attenuated: limb deficiencies, aORs/95%CIs = (0.44 [0.20–0.97]) and septal defects (0.69 [0.48–0.99]). After stratifying by years lived in the United States, the risk for hydrocephaly (2.43 [1.03–5.74]) became apparent among those having lived 6+ years in the United States. When restricting to African‐born mothers, none of the findings were statistically significant. Conclusions Foreign‐born NH Blacks were at a reduced risk for a few selected defects. Results were consistent after restricting to African‐born mothers and did not change considerably when stratifying by years lived in the United States.

show abstract

African Americans are less likely to enroll in preclinical Alzheimer's disease clinical trials

Cited by 79 publications

References 37 publications

The Representation of Gender and Race/Ethnic Groups in Randomized Clinical Trials of Individuals with Systemic Lupus Erythematosus

The Representation of Gender and Race/Ethnic Groups in Randomized Clinical Trials of Individuals with Systemic Lupus Erythematosus

Challenges and Considerations Related to Studying Dementia in Blacks/African Americans

Acculturation and selected birth defects among non‐Hispanic Blacks in a population‐based case–control study

Contact Info

Product

Resources

About