Increasing Diversity in Clinical Trials: Overcoming Critical Barriers.

Clinical trial results provide the critical evidence base for evaluating the safety and efficacy of new medicines and medical products. Efficacy and safety may differ among population subgroups depending on intrinsic/extrinsic factors, including sex, age, race, ethnicity, lifestyle, and genetic background. Racial and ethnic minorities continue to be underrepresented in cardiovascular and other clinical trials. Although barriers to diversity in trials are well recognized, sustainable solutions for overcoming them have proved elusive. We investigated barriers impacting minority patients' willingness to participate in trials and-based on literature review and evaluation, and input from key stakeholders, including minority patients, referring physicians, investigators who were minority-serving physicians, and trial coordinators-formulated potential solutions and tested them across stakeholder groups. We identified key themes from solutions that resonated with stakeholders using a transtheoretical model of behavior change and created a communications message map to support a multistakeholder approach for overcoming critical participant barriers.

Policy perspectives of major nursing organizations, part II. Interview by David M Keepnews.

Understanding the roles of interest groups is an important element of examining policy change. There are a number of interest groups that affect the policy environment for nursing and that shape the profession's impact on health policy. This article, the second of a two-part series, presents interviews with executive directors and chief executive officers of major nursing organizations about their organizations' policy priorities and policy-related activities. Included in this article are the American Organization of Nurse Executives, the National League for Nursing, Sigma Theta Tau International, and the National Black Nurses Association.