The influence of socioeconomic status on individual attitudes and experience with clinical trials

Abstract

Characterizing perceptions of clinical trials among the socioeconomically disadvantaged is necessary for understanding how social determinants of health such as socioeconomic disparities in education and income can affect people’s awareness of and exposure to clinical trials A survey was distributed in spring 2023 among a survey taking sample stratified by demographic variables to reflect the U.S. population. The survey assessed the socioeconomic status of the respondent and related covariates, as well as outcome measures including interest in joining a clinical trial, concerns relating to participation, and whether the respondent had previously been asked to participate. Multiple and logistic regression were used to assess the relationship between predictor and outcome variables Here we show the results of outcome measures regressed on main predictors related to socioeconomic status and related demographic predictors. Education, employment status, insurance coverage, and English proficiency were significant predictors of interest in clinical trial participation. Education and the presence of a healthcare professional or former clinical trial participant in the respondent’s personal network were significant predictors of whether the respondent had previously been asked to participate in a clinical trial The results of the analysis reveal how socioeconomically vulnerable groups, including those from low income and low education groups, are being excluded in clinical research. Analyses also uncovered the impact of clinical trial social influence—the presence of having a family or friend in one’s social network who participated in a clinical trial—on willingness to participate and exposure to clinical trials. Participation in clinical trials has remained largely inaccessible to historically underrepresented communities, which includes groups that are low income and low education. Here, we examine socioeconomic and demographic factors that can influence individuals’ willingness to participate in clinical trials and their experience being asked to participate in clinical trials. Using several types of analysis, we show that those who are low income and less educated are less willing to participate in clinical trials and are less likely to be asked to participate in clinical trials when compared to those with higher income and more education. This highlights the need for improved outreach among healthcare providers and clinical research staff to include these communities and provide individuals with the knowledge, awareness, and opportunity to participate in clinical trials. Kim et. al explore the impact of socioeconomic vulnerability on clinical trial participation. Findings highlight barriers to trial entry including participant concerns and implications of exclusion of specific groups.