Increasing representation and diversity in clinical research has long been a top priority within the healthcare community, and in recent years, significant steps have been taken toward formalizing efforts to increase clinical trial diversity. Despite these efforts, gaps in representation remain, and mistrust and lack of access are often cited as two main barriers for underrepresented groups in clinical research. Building trust and increasing access look different across communities, and progress depends on recognizing the need for diverse approaches. Building upon the themes from the

The proliferation of digital health technologies (DHTs) and artificial intelligence & machine learning (AI/ML) has rapidly increased in recent years, partly spurred by the Covid-19 pandemic. This increased role of DHTs and AI/ML in healthcare presents a unique opportunity for advancement and innovation; however, also poses equity challenges as health disparities still plague the US healthcare system. Advantages of technology in healthcare include increased preventative measures, health education, improved detection and intervention, and increased patient engagement. However, the presence of coded bias, which describes the bias within tools, algorithms, and artificial intelligence that discriminate against already marginalized patient groups, may limit the scalability and impact of these innovations to improve the health of US communities. This workshop brings together digital health and technology experts, providers, health equity professionals, healthcare executives, investors, and researchers, to discuss the intersection of innovation, technology, and health equity. Building upon discussion from CHI’s 11th Annual Diversity, Inclusion, & Health Equity Symposium, this Workshop will foster a collaborative, engaging, and highly interactive exchange of ideas and information on digital health equity.

In recent years, there has been a renewed focus on the significant health disparities impacting communities of color and other marginalized communities. As a part of this renewed focus, the healthcare industry is committed to creating a more representative workforce. Across the industry, efforts to reduce systemic barriers and recruit, hire, and promote professionals of color and other underrepresented professionals expanded, with pipeline programs as a key element in health equity strategies. However, there is still work that needs to be done, especially when looking at leadership positions in healthcare careers. Only 13% of C-suite positions in healthcare are held by professionals of color, and despite representing 20% of healthcare’s entry-level workforce, women of color only represent 5% of C-suite executives. Furthermore, these workforce disparities extend into the clinical realm as well. As of 2019, only 12% of physicians in the U.S. are from historically underrepresented groups, with the percentage of black male physicians unchanged since 1940. While pipeline programs have long provided a unique opportunity to increase awareness and access for students from underrepresented groups, we must ensure that pipeline programs showcase opportunities and encourage representation of professionals from underrepresented groups in leadership. In order to create a healthcare workforce that represents the communities it serves, we must see workforce diversity and representation from entry-level to C-suite. This program will discuss the benefits and unintentional consequences of pipeline programs and best practices for how the industry can better structure pipeline programs to align with health equity priorities and address workforce diversity at all levels of an organization.

As the United States becomes an increasingly diverse nation, the needs of communities and patients will also continue to evolve. To create a more equitable, accessible, and innovative healthcare system in the United States, the disparities faced by communities of color and other underserved groups must be addressed. Since the COVID-19 pandemic, healthcare has seen an industry-wide commitment to Diversity, Equity, & Inclusion (DEI) and health equity. However, patients of color and those from underrepresented groups continue to face significant health disparities. For example, Black women are 3 times more likely to die from complications related to childbirth, Hispanics are 2 times more likely to be diagnosed with and die from liver cancer, and American Indians & Alaska Natives are 2 times more likely to contract COVID-19 than their white counterparts. Despite renewed awareness and efforts to address health disparities, the words diversity, equity, & inclusion have become increasingly politicized. Healthcare organizations now face the dual challenge of addressing health disparities while also navigating the discourse of DEI in America. This webinar will convene a distinguished group of healthcare & DEI experts to discuss strategies for navigating healthcare’s DEI landscape and best practices for continuing to work towards a more equitable healthcare system for all communities despite old and new challenges to achieving health equity.

Developing strategies to engage clinical trial participation in underrepresented groups will require a thorough understanding of past challenges, current attitudes, and future implications. Almost 50 years after the unethical research practices in the Tuskegee Syphilis study caused public outrage, remnants of mistrust among African American/Black communities continue to impact confidence in clinical trials. Despite decades of reforms aimed at establishing basic research standards and protecting the rights of trial participants, African American/Black communities remain underrepresented in clinical trials. In a 2020 FDA report on clinical trials resulting in 53 novel drug approvals, African Americans represented only 8% of U.S. clinical trial participants despite comprising 13% of the U.S. population. Across therapeutic areas, the gap between the disease population and trial representation widens. For example, in multiple myeloma (MM) oncology trials, a disease in which Black Americans account for approximately 20% of annual cases, the median percentage of Black Americans enrolled across 21 pivotal trials was just 4.5%. Strategies for proportional clinical trial representation must address cultural barriers to enrollment and improve upon outdated recruitment and retention practices. Increasing African American/Black participation in clinical trials ensures that treatments are adequately tested in populations to whom it will be marketed. Increased diversity in clinical trial populations can also yield racial and ethnic differences in disease progression and drug response across demographic groups.

By convening many of the country’s leading clinical trial and diversity experts, physicians, scholars, authors, and key opinion leaders, this program will explore health equity concerns of decentralized clinical trials in the U.S. This program will also provide best practices, new insights, and novel trends in building a more diverse and inclusive clinical trial ecosystem in the U.S.

This 10-part virtual program series provides an in-depth exploration and review of diversity in clinical trials in the U.S. According to the FDA, African Americans and Hispanics comprise only 8% and 11% of clinical trial participants in the U.S., while comprising 13% and 19% of the total U.S. population. CHI’s educational series will convene many of the country’s leading clinical trial and diversity experts, physicians, scholars, authors, and key opinion leaders to explore the factors that have led to the historical and current underrepresentation of BIPOC patients in U.S. clinical trials. This educational series also provides best practices, new insights, and novel trends in building a more diverse and inclusive clinical trial ecosystem in the U.S.

This educational program will explore strategies to engage members of LGBTQ communities for participation in clinical trials. The discussion will focus on best practices for patient-centered engagement that can result in better clinical trial patient recruitment and retention. According to the Human Rights Campaign Foundation (HRC), approximately 20 million adults, or 8% of the U.S. population, identified as lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) on the 2020 U.S. Census Bureau’s Household Pulse Survey. The LGBTQ community comprises an increasingly diverse group with unique health needs that remain underserved and understudied, resulting in health disparities. In the oncology space, LGBTQ individuals have lower rates of cancer screening, higher rates of anal and cervical cancer, and greater breast cancer mortality. Continued underrepresentation in clinical trials limits the generation of clinical data that is essential for developing effective treatments for LGBTQ patients. An analysis conducted by the American Association for Cancer Research revealed that out of 348 sexual and gender minority studies funded by the National Institutes of Health (NIH) in 2018, less than 8% focused on cancer. Furthermore, quantifying LGBTQ representation in cancer drug trials is impeded by inconsistent data collection practices for sexual orientation and gender identity (SOGI) demographics. In a survey of 53 NCI Community Oncology Research Program (NCORP) practice groups, only 24% routinely collected sexual orientation data.2 Common barriers that are unique to LGBTQ communities include mistrust and/or lack of understanding of the clinical trials process, fears of exploitation, confidentiality, and study design concerns. Strategies for addressing these barriers must start with engaging community members and advocacy groups to provide input on research design, cultural competency training for research staff, and research education.

This program explores the root causes that result in the underrepresentation of Latin Americans in U.S. clinical trials. According to the FDA, Latin Americans comprised only 11% of the total clinical population for drugs approved in 2020, while Latin Americans comprise almost 19% of the total U.S. population. Furthermore, the number of Latin Americans in the U.S. is rapidly growing, and Latin Americans currently account for over half of the country's population growth. This discordance results from a variety of factors, including social determinants of health, PI and clinical trialist demographics, and cultural and linguistic pitfalls. This program Group convenes a group of clinical trial experts, providers, and DEI executives to discuss best practices and recommendations for making clinical trials more inclusive for Latin Americans.

This program explores the root causes of the underrepresentation of Asian Americans in U.S. clinical trials. According to the FDA's 2015-2019 Drug Trials Snapshots Summary Report, Asian comprised just 2% of U.S. clinical trial participants while comprising 6% of the overall U.S. population. Additionally, the latest census bureau data indicated that 20 million Americans identified as "Asian," and another 4 million checked boxes as "Asian" combined with another race group, for a total of 7.2 percent of the population. The results make the Asian population the fastest growing racial group in the United States at 35.5%. Many of the nation's leading health equity advocates and clinical trial leaders are concerned with the underrepresentation of specific Asian subgroups, overall demographic trends, and a growing Asian population in the United States. These concerns stem from a variety of factors, including social determinants of health, P.I. and clinical trialist demographics, and cultural and linguistic pitfalls. This program convenes a group of clinical trial experts, providers, and DEI executives to discuss best practices and recommendations for making clinical trials more inclusive for Asian Americans.

This educational program will explore the relationship between communities of color, who are often underrepresented in clinical trials, and diverse teams of principal investigators. The discussion will focus on how building diverse teams of healthcare professionals and clinical trialists may result in better clinical trial patient recruitment and overall trial success. A 2020 study indicated that only 23% of African Americans and 26% of Latin Americans have a physician that shares the same race or ethnicity, while for white Americans, that number is 82% (1). Moreover, research often shows that minority patients prefer to be treated by minority doctors, and racial concordance between patients and providers may lead to better health outcomes. For example, in an analysis of over 100,000 patient surveys from 2014 to 2017, a team of Penn Medicine researchers found that patients were more likely to give the maximum patient rating score when they shared the same racial or ethnic background as their physician (2). This educational program convenes a group of clinical trial experts to discuss how increasing diversity among the ranks of providers, principal investigators, and other clinical trial professionals may result improve clinical trial recruitment among communities of color. This program is in partnership with the Black Healthcare & Medical Association.

The third and final program of CHI‘s obesity disparity series begins to offer actionable solutions for how communities, organizations, and individuals can work together to reduce obesity rates in black and brown communities. This program builds upon the first two programs in the educational series which explore obesity as a disease and why obesity disproportionately impacts communities of color. This educational program offers policy recommendations and practical steps that can address and ultimately reduce these disparities. This discussion brings together leading healthcare experts, community groups, and health equity champions to discuss the challenges outlined above as well as long-term solutions to reducing obesity disparities impacting communities of color.

Obesity is a serious disease that impacts millions of Americans. In fact, the US obesity prevalence was 42.4% in 2017 – 2018 and the number of Americans affected by obesity has grown significantly. According to the CDC, the prevalence of obesity increased from 30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2%” from 1999-2019. Obesity can also lead to other chronic diseases such as diabetes and heart disease. More than 100 million Americans – nearly half of all U.S. adults – suffer from diabetes or pre-diabetes, while one in three U.S. children born after 2000 is expected to develop Type 2 diabetes. However, like most chronic conditions in the U.S., obesity disproportionately impacts marginalized communities of color. African Americans (49.6%) had the highest age-adjusted prevalence of obesity, followed by Hispanics (44.8%), and whites (42.2%). JAMA has recently reported: “For the first time in American history, life expectancies are falling, with declines for three consecutive years due in part to significant increases in midlife mortality from diet-related diseases". This three-part virtual education series explores obesity disparities, how obesity disease disproportionately impacts marginalized groups, and steps for building healthier communities. The educational series begins with a review of the disease, the associated stigmas, and common misconceptions. Part 2 of the series specifically explorers the factors that make obesity more prevalent in marginalized communities, including a discussion on social and political determinants of health. Part 3 of the educational series provides the latest trends and insights in rooting out obesity disparities to create healthier thriving communities.

This program explores the root causes of obesity disparities in Black and Brown communities throughout the US. According to the CDC, obesity impacts 49.6% of African Americans and 44.8% of non-white Hispanic Americans, compared to only 42.2% of white Americans. Black and Brown children are also disproportionately affected by childhood obesity. 2017 CDC data indicates that among racial groups, obesity impacts 25.6% of non-white Hispanic children and 24.2% of African American children, compared to only 16.1% of white children. These obesity disparities result from a complex confluence of socioeconomic, environmental, cultural, and psychological factors. This webinar examines the causes that result in obesity disparities that disproportionately impact black and brown communities.

The COVID-19 pandemic has accelerated a paradigm shift in the execution of clinical trials from site based to decentralized with an emphasis on increasing convenience and access to patients. Regulators sentiment is in lockstep with the industry, issuing guidance for implementing use of telemedicine services, remote monitoring, and home health visits. As broader adoption of decentralized trial activities continues, efforts to address health equity concerns around the the “digital divide” or unequal access to internet technologies between low and high socioeconomic status (SES) population must also be broad. Patient recruitment strategies will need to mitigate the barriers experienced by low SES populations who more commonly lack the prerequisite tools, such as broadband internet, to benefit from the decentralized services such as electronic consent and video conferencing. According to the Health and Human Services (HHS), 45% of people in poverty lacked access to broadband internet with 26% having no internet access in 2019. This digital disparity becomes more pronounced based on age, race/ethnicity and geography. Low SES minority groups such as African Americans (57%) and Latinos (52%) were less likely to have broadband internet when compared to their White (44%) counterparts. The digital gap is just as stark in the elderly groups, with 40% of those living in poverty lacking internet access. Finally, low SES households living in non-metropolitan areas were 7% less likely to have internet access than their metropolitan dwelling counterparts. Low SES and minority populations have long been underrepresented in clinical trials and as such, decentralized or hybrid clinical trial designs could benefit from incorporating health equity best practices into enrollment and retention plans. By convening many of the country’s leading clinical trial and diversity experts, physicians, scholars, authors, and key opinion leaders, this program will explore health equity concerns of decentralized clinical trials in the U.S. This program will also provide best practices, new insights, and novel trends in building a more diverse and inclusive clinical trial ecosystem in the U.S. to explore health equity concerns in decentralized clinical trials.

In the United States, Black women have three times the risk of maternal mortality (MM) than white women and a significantly higher risk for severe maternal morbidities, such as preeclampsia and other cardiovascular conditions. Furthermore, the issue of high maternal mortality also stems from social stigma and health inequities. For example, regardless of insurance status, socioeconomic status, age, or severity of their condition, the pregnancy-related mortality rate for Black women with college degrees is 5.2 times that of their white counterparts. Moreover, the COVID-19 pandemic has exacerbated maternal mortality for women of color and worsened maternal health disparities. This webinar will bring together leading experts to discuss the causes of these significant maternal health disparities and discuss innovative solutions to combat this serious issue in healthcare. The discussion will include leveraging new technologies and policies and providing patient-centered care that is responsive to the needs of patients no matter their insurance status, race, socioeconomic status, or age. Other solutions will include expanding healthcare coverage and access to comprehensive, high-quality, safe reproductive healthcare. Finally, at an organizational level, the discussion will highlight quality improvement and patient safety initiatives that hospitals can undertake to address the disparities in maternal mortality rates between women of color and white women.

This educational program explores obesity as a chronic disease that impacts millions of Americans. Over the past 25 years, the prevalence of obesity has increased from 30.5% to 42.4%, and obesity affects well over 100 million Americans. The disease of obesity also impacts children. In 2017, 17% of American children over 2 are affected by obesity, and 1 in 8 preschoolers has obesity. Obesity also puts Americans at serious risk to develop diabetes, hypertension, heart disease, and other chronic conditions. This educational program discusses the disease of obesity and why obesity rates have increased over the past generation. The program also explores the complex socioeconomic factors that result in obesity disparities that impact demographic and socioeconomic groups. The discussion also lays the groundwork for part 2 of the series that explores obesity disparities and why obesity is more prevalent in communities of color.

This program focuses on the intersections of genetics, Black Breast Cancer, and clinical trials. Black women are 41% more likely to die of breast cancer than white women, with Black breast cancer patients experiencing the lowest 5-year survival rate of any race or ethnicity. Overall 5-year relative survival rates are 81% for Black women vs 91% for white women. Black women under 35 get breast cancer at twice the rate and die at three times the rate. A 2021 study published in Cancer Medicine found that Black women have a nearly three-fold increased risk of Triple-Negative Breast Cancer–an aggressive subtype of breast cancer. Despite these disturbing statistics, Black women are largely excluded from trials that study breast cancer drugs and treatments, which means that these fundamental safety and efficacy concerns aren't being answered for Black women's bodies. Moreover, with low participation rates in clinical trials, Black women miss access to newly emerging and often life-extending treatments not otherwise available. As documented by JCO Precision Oncology, Memorial Sloan Kettering Cancer Center, and many others, Black women experience many cancer drug side effects differently. Trial data, the resulting treatment protocols, and product development don't account for the many factors of Black Breast Cancer. We will not be able to change the devastating Black Breast Cancer mortality numbers unless we understand the physiology of Black women. We cannot do that until we have more Black women participating in clinical research. Featuring the expertise of Ms. Ricki Fairley, a breast cancer survivor and clinical trial expert, the webinar will discuss how to address common pitfalls that result in the underrepresentation of Black women in cancer clinical trials.

This education program focuses on chronic medical conditions in underrepresented groups and how these conditions impact clinical trial participation. Specifically focusing on kidney diseases, the discussion will center around eligibility criteria, safety, and dialogue with patients from underrepresented communities. One study found that a“lack of diversity in clinical trials is a moral, scientific, and medical issue. When trial participants are homogenous (e.g., primarily one gender, race/ethnicity, or age group), findings may be skewed and result in a body of clinical knowledge that is not generalizable”. New NIH data shows “35% of African Americans suffer from kidney failure and Hispanics have experienced a 70% increase in kidney failure cases since 2000”. Furthermore, African Americans are “10 times more likely to develop kidney failure related to hypertension, and three times more likely to progress to kidney failure than Caucasians”. In a study through the American Journal of Nephrology, in 3,000 chronic kidney disease-related clinical trials, only 34 were directed toward African Americans. With African Americans comprising 13.4% of the US population and having an elevated risk, this number is low. This educational program brings together industry experts to discuss the impact of chronic conditions on clinical trial enrollment in underrepresented groups and solutions to address barriers in trial participation related to chronic diseases through patient communication, revised eligibility criteria, and community engagement.

Next year will be the 40th anniversary of the Orphan Drug Act, which established incentives to research and develop drugs for rare diseases. Since that time, 1,039 “orphan drugs” have been approved by the FDA for previously unaddressed medical conditions with 26 approved in just 2021 alone. Advancing technologies have enabled healthcare providers to more effectively diagnose rare conditions that impact 1 in 10 Americans - thanks largely to advocacy and legislative efforts to expand and fund newborn screening. But it is not always easy for people living with rare diseases to be aware of and have access to these treatments, particularly for patients of color. Communities of color, who are impacted by alarming and stark health disparities. Rare diseases consume a disproportionate quantity of healthcare resources relative to their prevalence. In this webinar, distinguished panelists representing diverse patient communities, healthcare providers, multifaceted manufacturers, and patient support providers, will address opportunities and challenges to equitable access to rare disease therapies.

This program explores the intersection of health literacy and equitably recruiting patients of color to make clinical trials more diverse, equitable, and accessible. The U.S. Department of Health and Human Services defines health literacy as “the degree to which individuals can find, understand, and use information and services to inform health-related decisions and actions for themselves and others .”Data indicates that only 36% of Americans have only basic or below basic health literacy skills. Lower health literacy is also more common in older adults, communities of color, medically underserved Americans. Additionally, limited health literacy costs the healthcare system money and results in higher than necessary morbidity and mortality. The CDC estimates improving health literacy could prevent nearly 1 million hospital visits and save over $25 billion a year. Moreover, health literacy can impact clinical trial patient recruitment. According to Clinedge, Over 75% of all trials fall short of patient enrollment goals, and health literacy is a significant cause. Furthermore, patients of color and other diverse groups are underrepresented in clinical research. This program brings together experts to discuss effective strategies for properly communicating clinical trials to under-represented groups to make trials more diverse and representative of the U.S. population.

This educational program explores microaggressions and biases in the healthcare industry, including how they impact both patient health outcomes as well as employees of healthcare organizations. Microaggressions and implicit biases in the clinical care setting have a detrimental impact on patients’ evaluation of needed services, health outcomes, patients’ perception of the healthcare system, and overall quality of care. A recent study found that 73% of white medical students held “at least one false belief about the biological differences between races.” In another example, the 2015 National Healthcare Quality and Disparities Report found that Black, Latin, American Indian, and Alaskan Native individuals receive worse care than White individuals for approximately 40% of quality measures. Moreover, microaggressions and implicit biases in the workplace impact employee productivity, organizational development, and external perception, among other negative outcomes. A 2019 Deloitte study found that “whether based on gender, age, race, ethnicity, sexuality, disability or military status, more than 60% of respondents reported a presence of bias in their workplace.” Additionally, 70% of Black physicians and 69% of Asian physicians have experienced patient bias. This educational program brings together a distinguished group of industry experts to discuss strategies for patients, providers, teams, and organizations to address, reduce, and ultimately eliminate microaggressions. Click here to see the post-event recap.

This webinar will highlight the importance of ensuring healthcare providers are representative of United States demographics. Most qualitative studies suggest that BIPOC respondents prefer a provider of a similar “racial, ethnic and/or cultural background, and/or thought some diseases were better treated by a provider of the same racial, ethnic, and/or cultural background.” This conversation will underpin the importance of patient-clinician racial concordance as a way to improve communication, shared decision-making, patient comprehension, and overall health outcomes and quality. The conversation will discuss ways to increase and retain underrepresented populations in nursing, medical, and dental training programs. Finally, the conversation will highlight strategies to increase overall BIPOC representation in the workforce. Strategies discussed will include financial/academic support, ensuring board diversity, cultural competency training, and employee resource groups for BIPOC and other underrepresented populations in the workforce. Click here to see the post-event recap.

This webinar will discuss clinical trials and Black and Brown communities. It is critical to educate BIPOC communities on this process because Americans of Color are less likely to enroll in randomized clinical trials for vaccines than White Americans. For example, The COVID-19 Prevention network found that 10% of the 350,000 registrants in the COVID-19 randomized controlled trials were Black or Latinx. Meanwhile, Black and Latinx individuals account for 31.9% of the United States population, according to 2019 United States Census data. This program will focus on conscious efforts to ensure BIPOC representation in clinical trials and what this means for the future of pharmaceutical innovation. Finally, the conversation will highlight trusted sources to find more information about vaccine safety, adverse reactions, and other facts related to the COVID-19 vaccine. Click here to see the post-event recap.

This 4-part education series provides an in-depth exploration of why vaccine hesitancy is prevalent in Communities of Color, the current challenges with COVID-19 vaccine administration in BIPOC communities, and proposed solutions that may be effective in addressing vaccine hesitancy. As the United States rolls out its COVID-19 immunization campaign, BIPOC communities continue to voice high levels of vaccine hesitancy. In fact, a 2020 Pew Research poll found that only 32% of Black Americans are likely to receive the COVID-19 vaccine. Moreover, 77% of Black Americans do not plan to or remain uncertain about receiving the COVID-19 vaccination. Similarly, 67% of Latinx Americans do not plan to or remain uncertain about receiving the COVID-19 vaccination. This is compared to 47% of White respondents who do not plan to or remain uncertain about receiving the vaccine. This initiative will bring together leading experts in vaccine hesitancy to focus on implementing evidence-based, culturally-competent strategies to increase vaccine uptake in vaccine-hesitant Communities of Color.