Why cultural safety is key to achieving diversity in clinical trials

Have you caught up on the latest Demand Diversity research? The new report contains findings from interviews with Americans from different ethnic groups, exploring some of the discrimination and cultural insensitivity experienced in healthcare by Black Americans, Asian Americans, Hispanics and Native Americans. For successful and diverse patient recruitment to your clinical trial, it’s more important than ever to understand how these ethnic groups, and other ethnic minority communities, feel about healthcare and clinical research. Mistrust still remains a huge barrier to clinical trials, and only by having open conversations with people can we understand why, and implement changes that help to rebuild trust.

If you’ve already read the report, you might remember that a Black American participant said, “I wish people were more educated. Doctors are supposed to treat everyone the same, not have favourites. They need unconscious bias training.” So, the general public are aware that healthcare professionals need unconscious bias training — are you?

DD II - Doctors Need to Care


Cultural training for research staff

Some healthcare and pharma organisations have implemented cultural competency training for their staff. This helps improve people’s understanding of different cultures, which in theory should increase their ability to deliver care across a wider spectrum of different people. However, these training programs have several limitations:

  • People can falsely believe they are equipped to deliver culturally safe care purely from learning about other cultures
  • People remain unaware of their own biases that exist in all of us
  • Ethnicity is often the only aspect considered
  • Cultural competency often fails to mention systemic processes or privileges, and only focusses on the individual

Yes, it’s true that understanding other cultures is important, but alongside that, everyone on your study team also needs to be aware of their own culture, attitudes, biases and stereotypes. Cultural safety training allows people to be introspective, to evaluate how their own cultural identity can impact their interactions with patients. Importantly, being culturally safe doesn’t just mean regarding ethnicity. Cultural safety training covers other terms in the cultural umbrella too, such as sexual orientation, physical ability, religion, education, and gender, amongst many other influential factors.


Site Training Diversity Clinical Trials

Running a trial in a culturally safe way also encompasses language. Ensuring potential participants have access to information in their preferred language is important, but our research raised another important point:

“Language is a really important part of our culture for example certain words can’t be spoken. If tested for results and saying the word ‘cancer’ is said directly and immediately without referring to it as ‘it’ or ‘you have what we were talking about’ it is insensitive. This should be learnt about.”
Native American participant

This shows how critical it is to co-create patient recruitment materials with diverse communities and patient groups.

Besides being a way to achieve social justice and allow everyone an equal opportunity to take part, cultural safety training can improve the diversity of your study population, and also helps minimise dropouts. By giving your clinical trial team the right foundation, by providing materials in local languages with cultural considerations, and by engaging with people in their preferred way, patients from diverse backgrounds can be given an equal chance at taking part and can make an informed decision, with fewer barriers in place. And, participants are more likely to have a positive patient experience on your study.

Together, we need to support healthcare professionals and clinical research terms to deliver care in a culturally safe manner. Get in touch to find out about our cultural safety training programme and what it could do for your trial.

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Diversity in Clinical Trials

Katie Rishi

As our CEO and co-founder, Katie’s ultimate goal is to make sure there’s always seat at the table for patients in our industry. Kindness is at the heart of everything we do, and this determination and positive mindset is what drives her to make a positive impact on healthcare.

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