Posted in GJI Fellowship
G+JI Graduate Student Fellow 2021
Lady Nwadike, Research Assistant, Department of Psychiatry, Medstar Georgetown University Hospital
I received a Master’s in Biophysics and Physiology with a concentration in Complementary and Integrative Medicine from Georgetown University. I enjoy writing evidenced based articles in health, research, science and advocacy, with minority issues and interests always at the forefront. I am interested in exploring the mosaic we create for ourselves throughout our lives where parts of myself and others intersect, as I believe that it is at these points where individuals are most raw and vulnerable. Those two things breed passion and understanding, which in turn can lead to change in how we take care of ourselves and others.
Research Project: A Seat At the Table: A Look at Systematic Exclusion Based on Race and Sexual Orientation in Clinical Trials and Health Related Studies
What is your research topic and why?
While there are mechanisms to ensure equity in biomedical studies, there is still not a realistic representation of the current population being considered for study. Initial findings identified low African-American and Lesbian and Bisexual (LB) participation in clinical trials and systematic concerns which could impact published health outcomes for certain groups, no established mechanisms of accountability for not complying entirely with inclusionary research mandates, low continuity for studies focusing on participation in health related studies and existing barriers based on low trust for the medical a community within minority communities. This study will expand upon the existing literature by comparing the findings of my previous paper and analyzing any changes regarding clinical trial participation by sexual orientation, report, discuss and present these updated findings to encourage further study in addressing widening health disparities and explore feasible approaches to building trust and increasing participation of minority women in health related research studies.
Main Research Question(s)
My main research question is, how has minority participation changed through the years (from 2010 – Present) and how can we improve participation? What studies have had success in recruitment and why?
Each title must contain at least three elements from the following list as each element equals one point. Only research totaling three points or more shall be included in the final selection of titles for inclusion in the scoping review
- (1 point) Date Range: Titles must be published between the years of 2010-2021.
- (1 point) Gender: Titles or content must be discussing participation of women in clinical and research trials.
- (1 point) Age Range: Participation in the studies must include adult women over 18 years of age.
- (1 point) Minority Group: Titles must include at least ONE of the following groups: African-American, Indigenous, Latina/LatinX and LGBTQ (specifically discussing lesbian and bisexual participation).
- (1 point) Content: Literature contains discussion as to the current state of and the improvement of African-American, Indigenous, Latina/LatinX and LGBTQ participation in clinical or research trials.
Significant or Surprising Findings:
LGBTQ and Indigenous representation is seriously lacking. These groups may be systematically excluded from research studies based on research design, policy and less than optimal recruitment design and methods.
Summary of Findings or Progress:
After screening upwards of 1600 research articles, African American and LatinX women make up the majority of the content considered. Women who identify as LGBTQ and are Indigenous are seriously lacking in representation. The team is still working through the screening process so that a final conclusion can be drawn once the second round of screening is complete.
The advisory board to accompany the scoping review has 14 members. 3 out of 4 board meetings have occurred. In our second meeting, Building Trust and Diversifying Medical Research, barriers to trial participation were discussed. In our third meeting, Overcoming Barriers in Medical Research, we discussed what has and has not worked in terms of recruitment, as well as improvements to current practices. Our final meeting will see discussion about specific policy changes that can support improved recruitment.