How In-Home and Community Strategies Boost Recruitment and Diversity

In a recent video interview Applied Clinical Trials, Caroline Potts, general manager of sites and patient services, Medical Research Network (MRN), discussed operational flexibility in clinical trials, emphasizing the need to avoid staff burnout due to inflexible SOPs and budget constraints. She highlighted strategies such as in-home visits and community outreach as essential for reducing recruitment delays and improving trial diversity. Potts also touched on budgetary issues as a major barrier to patient-centric models, with a call for better dialogue and innovative solutions. She stressed the importance of community engagement, temporary clinic sites, and collaborative efforts among key stakeholders to better serve diverse populations in clinical trials.

ACT: How can site-enabled strategies like in-home visits or community outreach reduce recruitment delays and improve trial diversity in practice?

Potts: I think for something like home trial support, I think all too often it is seen—not necessarily by sites, but sometimes by trial sponsors or by CROs—that is something that should be deployed when the trial is not going the way that it should go, and by that I mean that patients are dropping out of the study, or perhaps they're not even managing to recruit patients. I think that it's a real shame that it's seen as something that is a bolt-on or something that only applies in a rescue situation. In a conversation I had earlier on today, I was saying that people's lives are incredibly busy. Yes, they may have a chronic illness, but that doesn't mean that people are sitting at home seven days a week with no other commitments that they don't have in their lives. A lot of people will find a way to work. A lot of people have childcare or carer commitments. Home trial support should not be seen as something that, ‘Well, let's only offer it if they ask for it.’ It should be something that's made available from the word go. It's not suitable for everyone. Sometimes patients don't like having an individual that they don't know come to their house and take their blood or give them their drug infusion. It's not the be all and end all, but it certainly should be something that's offered up front.

I think from a trial diversity point of view, I think everything that is being done is great from a diversity point of view, but again, I think that more can be done. I was very fortunate enough to spend a day in Nevada, of all places, last year, and the Nevada district were talking about some of the real rich experiences they had in their community about going to the hair salon and working with women who really weren't comfortable going for breast screening appointments, but by going into an environment where women spend a lot of time, where they know each other, feel comfortable to talk about the things that they are perhaps embarrassed about or feel awkward about, you learn a lot about how something like breast care screening can be changed to encourage participation. I think it's the same with trial diversity, whatever the population is, learn about the population. Understand what matters to populations of people, and make sure that you can support people in that local community—truly support, not lip service—but truly support communities.