Race, Medical Researcher Distrust, Perceived Harm, and Willingness to Participate in Cardiovascular Prevention Trials

Minority patients are underrepresented in medical research, including cardiovascular clinical trials. In order to determine whether distrust in medical researchers plays a role, researchers had patients from 13 Maryland outpatient cardiology and general medicine clinics complete self-administered surveys regarding their willingness to participate in a cardiovascular drug trial. Of 717 eligible responses, 36 percent were African American and 64 percent White.

Key Findings:

  • African-American participants, on average, were 41 percent less willing to participate in a cardiovascular drug prevention trial than White participants.
  • The lesser willingness of African-American participants was unaffected after adjusting for socioeconomic status.
  • African Americans expressed markedly higher levels of distrust toward medical researchers and a greater perceived chance of experiencing harm or injury from joining the trial.

The authors conclude that greater distrust of medical research and researchers among African-American participants relative to White participants may stem from a general distrust of mainstream society, past examples of grossly unethical medical research with ethnic minorities, and perpetuated racial and ethnic biases affecting minority experiences within the health care system. Effective strategies for overcoming distrust would incorporate collective community-based approaches, education, and improved responsiveness and sensitivity to cultural and local social norms.