Breaking Barriers: Perspectives on Clinical Trial Participation Among Older Hispanic/Latino Adults of Mexican Origin

Context: Older adults with multiple chronic conditions are underrepresented in clinical trials, with especially low enrollment of Hispanic/Latino populations.

Objective: Understand the perspectives of older Hispanic/Latino adults regarding clinical trial participation.

Study Design and Analysis: Thematic analysis of focus group interviews.

Setting: Senior centers and large academic health systems in Northern and Southern California.

Population Studied: English- and Spanish-speaking adults aged 65 and above, self-identifying as Hispanic/Latino of Mexican origin, and self-reporting polypharmacy.

Outcome Measures: Themes related to participation in clinical trials of medications.

Results: We conducted 13 focus groups (FGs) with 90 participants, 9 FGs involving those who had never participated in any research studies (n=61 participants) and 4 FGs involving those who had previously participated in research studies (n=29, including 6 participants with clinical trial experience). The mean age was 72.3 years (SD=5.3), 53 (58.9%) were female and 48 (53.3%) spoke Spanish. Participants took a mean of 7.1 (SD=3.6) prescriptions. Major barriers to clinical trial participation included limited awareness and knowledge of clinical trials, language barriers, and fear of side effects. Culture-specific barriers included preference for traditional/home remedies and mistrust of institutions due to previous experiences and absence of health services. Participants with prior research experience expressed greater trust in their health care providers than their counterparts. Participants with clinical trial experience stated that they would recommend clinical trial participation to their friends and families. Participants emphasized the role of family support and their reliance on adult children for decision-making and assistance with transportation and interpretation. Recommended facilitators for enrollment included producing materials in different Spanish dialects, employing culturally sensitive personnel, involving patients’ family members, and promoting community-based outreach.

Conclusions: Older Hispanic/Latino adults of Mexican origin perceived barriers to clinical trial participation that could be mitigated by involving family members and using culturally tailored materials/staff for trial conduct.