Abstract
African Americans (AA) are underrepresented in clinical trials in the United States for a variety of reasons. The majority of studies examining this issue were conducted >10 years ago and since then, efforts have been implemented to improve AA enrollment in research. We took advantage of the cardiovascular research data of a large community academic center in New Orleans, Louisiana to examine whether race was associated with participation in cardiovascular research. We used a nested case control design with 80% power to detect a doubling in odds of non-participation. Individuals could be included if they were offered participation in any of the 4 largest studies conducted in 2012, were White or AA and were American citizens (n=974). Median income household income was inferred using postal codes. Cases were defined as individuals who declined to participate and did not sign a consent form. Controls were defined as individuals who agreed to participate and signed a consent form. We identified 100 cases and selected 200 controls matched on age (within 1 year) and sex using a random selection algorithm. Of the 974 eligible for analysis, mean (SD) age was 65 (14) years, median household income in thousands was 51.92 (19.9), and 65.3% were men. Of those who agreed to participate, 32.2% were AA while of those who refused, 31.0% were AA. The unadjusted Mantel-Haenszel odds ratio for non-participation by race was 1.06 (95% CI: 0.60 to 1.94) for AA individuals compared to their White age and sex matched counterparts. Using multivariable conditional logistic regression, the odds ratio for participation in a study was 1.04 (95% CI: 0.56 to 1.92) for AA as compared to their White age and sex matched counterparts, after adjustment for median household income, employment, and marital status. Our findings suggest that, at a large community academic center, race does not significantly affect willingness to participate in cardiovascular research independent of age, gender, socioeconomic and marital status.
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