Community-Engaged Approaches for Improving Inclusion of Diverse Communities in a Nutrition Precision Medicine Clinical Trial

Objectives: African American (AA) and Latino adults experience a higher burden of modifiable cardiovascular risk factors. Exacerbating these disparities is the underrepresentation of minority populations in randomized nutrition clinical trials. The objective of this study is to provide a framework for increasing diversity in nutrition clinical trials in Los Angeles County (LAC) using a community engagement approach.

Methods: We used deliberative community engagement (DCE) approaches to form a precision nutrition community consultant panel (CCP). Candidates for the CCP were participants in prior community panels or advisory boards, and leaders in community-based organizations who represented individuals and organizations that provide services to diverse Latino and AA clients. Through eleven virtual sessions over the course of a year, the CCP worked to 1) identify key barriers and facilitators to participation in the Nutrition for Precision Health study among AA and Latino communities and 2) provide insights on recruitment and retention derived from their lived experience and extensive community connections to enhance clinical trial participation of diverse communities.

Results: The PNCCP consisted of 17 adults, the majority of whom identified as AA (35%) or Latino (47%). The research team and PNCCP worked to develop culturally tailored recruitment materials (imaging modified to reflect diverse communities) and provided strategies for outreach and dissemination of information to diverse communities. Panelists also identified potential barriers to participation in their communities (medical mistrust, restricted study hours, transportation costs, relatability to research staff). To mitigate these barriers modifications were made to enhance the clarity of recruitment materials, study staffing and hours (diverse study staff added), and services (transportation discounts).

Conclusions: This study demonstrates the use of a DCE approach to develop strategies for the improvement of recruitment and retention of diverse communities in a nutrition for precision clinical trial. Use of this framework has the potential to increase the representation of diverse communities in nutrition clinical trials and enhance our understanding of racial and ethnic health disparities.