Adapting the QuinteT Recruitment Intervention (QRI) to optimise the recruitment of ethnic minority groups in clinical trials: insights from workshops with diverse public contributors

Introduction: The global majority, often called ethnic minority (EM) groups in the UK, are under-served in clinical trials despite a greater disease burden. This means that trial results are often not applicable to the global majority, perpetuating inequities. Despite extensive evidence on barriers to inclusive research, there is little evidence on strategies to achieve successful EM participation. The QuinteT Recruitment Intervention (QRI) has been successfully employed in over 80 trials to optimise recruitment and informed consent in the general population. We aimed to adapt the QRI to optimise EM recruitment in trials through public contributor workshops in the UK.

Methods: We conducted five workshops with 43 public contributors from diverse ethnic backgrounds. We explored concerns of interest to contributors and sought their views on adapting three QRI components (audio-recordings of trial discussions, patient interviews and feedback provided to healthcare professionals, HCPs) and the QRI information sheets and consent forms.

Findings: Contributors were most interested in discussing barriers to EM research participation (mistrust, inadequate compensation, lack of workforce diversity in research and inadequate community outreach). Key suggestions for QRI adaptation included: a) offering a copy of the audio-recorded trial consultation, providing patient interview questions in advance and avoiding small print in patient-facing documentation (to foster trust); b) involving EM groups with lived experience of health conditions in training HCPs (to avoid perpetuating harmful stereotypes; ensure training is ‘with’ EMs and not ‘about’ EMs); c) providing QRI team’s expectations of participants in advance (clarity on emotional/mental labour involved); d) discussing participants’ expectations of the research team (QRI interviews are not for medical information provision); e) providing ample reassurance around confidentiality (to avoid identity disclosure to their communities, HCPs or the government).

Conclusion: It is important to initiate community engagement by focussing on key concerns in the community, even where this has been previously well studied (e.g., barriers to EM research participation). Providing the space for this prior to discussing our research topic of interest fostered trust. This led to contributors’ insightful suggestions to ensure QRI adaptation and acceptability to EM groups, with the aim of ensuring their representation in clinical trials.