"I'm tired of seeing my friends die": Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States.

Purpose: Participation in clinical trials among people who use drugs (PWUD) in rural areas remains disproportionately low compared to those in urban communities. Our objective was to describe the barriers and facilitators to clinical trial participation among this understudied and underserved popula...

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Published in:Journal of Rural Health Vol. 41; no. 1; pp. 1 - 10
Main Authors: Lancaster, Kathryn E., Estadt, Angela T., Enderle, Madison N., Korthuis, Todd P., Young, April M.
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Jan2025
Online Access:View this record in EBSCOhost
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      dt: Jan2025
      vid: 41
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        183950441
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        183950441
        10.1111/jrh.70009
        183950441
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        atl: "I'm tired of seeing my friends die": Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States.
      aug:
        au:
          Lancaster, Kathryn E.
          Estadt, Angela T.
          Enderle, Madison N.
          Korthuis, Todd P.
          Young, April M.
        affil: Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston‐Salem North Carolina,, USA
      sug:
        subj:
          Health Services Accessibility United States
          Clinical Trials
          Rural Areas United States
          Persons with Substance Use Disorders United States
          Research Subjects
          Consumer Participation United States
          Special Populations
          Human
          Funding Source
          United States
          Semi-Structured Interview
          Kentucky
          Ohio
          Oregon
          Researcher-Subject Relations
          Qualitative Studies
          Adult
          Descriptive Statistics
          Male
          Female
          Interviews
          Motivation
          Communities
          Research Subject Retention
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: Participation in clinical trials among people who use drugs (PWUD) in rural areas remains disproportionately low compared to those in urban communities. Our objective was to describe the barriers and facilitators to clinical trial participation among this understudied and underserved population. Methods: We conducted semi‐structured in‐depth interviews among rural PWUD in Kentucky, Ohio, and Oregon. Using the Ickovics and Meisler framework, we classified factors associated with participation in clinical trials among rural PWUD into five categories: the individual, trial and intervention characteristics, participant‐trial staff relationship, clinical trial setting, and features of the disease. We used inductive qualitative analysis methods to identify salient themes. Findings: Thirty‐five rural participants (median age: 39, 51% men) completed in‐depth interviews. Facilitators for rural clinical trial participation were mainly situated within the individual, trial and intervention characteristics, and clinical trial setting. Individual characteristics, such as altruistic motivations to help their communities and peers, as well as trial and intervention characteristics like visit reminders and resource assistance, were the most frequently noted facilitators of clinical trial participation. In contrast, participation barriers were mainly related to participant‐trial staff relationships and disease features. Judgmental and untrustworthy trial staff, along with involvement in the criminal legal system, were obstacles to clinical trial participation. Conclusions: Individual, intrapersonal, and logistical factors described by rural PWUD must be addressed to enhance the participation and retention of this population in clinical trials. Successful clinical trial participation may contribute to equitable access to essential health services by PWUD in rural communities.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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