Representation Of Minority Groups Research Articles

The diabetes cardiovascular outcomes trials and racial and ethnic minority enrollment: impact, barriers, and potential solutions

Type 2 diabetes (T2D) affects millions of individuals worldwide and is a well-documented risk factor for cardiovascular (CV) disease and chronic kidney disease, both of which are leading causes of mortality. Racial and ethnic minority groups in the US, including but not limited to Hispanic/Latino, non-Hispanic Black, and Southeast Asian individuals, are disproportionately burdened by both T2D and its adverse outcomes. In recent years, there have been numerous cardiovascular outcomes trials (CVOTs) on novel antidiabetic therapies, including the dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors. CVOTs’s initial aim was to demonstrate the cardiovascular safety of these drugs. Unexpected CV and kidney protective effects were found, specifically among the GLP-1 RAs and the SGLT2 inhibitors. These benefits informed the new paradigm of the management of patients with T2D. However, some experts argued that the lack of racial and ethnic minority group representation in these trials represented a challenge. While the downstream effects of this lack of representation must be further elucidated, it is clear and recognized that efforts need to be made to include a more representative sample in future CVOTs, specifically including individuals from those groups most burdened by T2D and its complications, if clinicians are to have an accurate picture of the benefits and potential pitfalls of utilizing these drugs in a real-world setting. In this comprehensive review, we briefly summarize the significant findings from the CVOTs, report the lack of representation of Hispanic/Latino, non-Hispanic Black, and Southeast Asian individuals in the CVOTs, investigate the barriers to recruiting racial and ethnic minority groups into clinical trials, and suggest potential solutions to overcome these obstacles at the patient-, provider-, and sponsor/system-level in future trials.

Underrepresented Populations on Public Health Data Dashboards: Design Considerations for Improving Usability and Usefulness.

Representation of racial and ethnic minority groups and sexual and gender minority groups is limited on public health data dashboards. The small size of these populations leads to data being aggregated or suppressed to produce stable estimations and preserve individuals' information privacy. This might, however, limit the usefulness of the represented data for identifying individuals' risk factors and allocating services. To explore public health practitioners' concerns about underrepresented populations on public health data dashboards that emerged during a usability evaluation study. 20 public health practitioners from New York State, US. Virtual Zoom meetings were conducted to monitor the participants' use of a public health dashboard and ask about their experience using it. The collected data, in the form of researchers' notes and audio transcripts, were analyzed using the thematic analysis approach. Participants were very concerned about the underrepresentation of sexual and gender minority groups and racial and ethnic minority groups on public health data dashboards. Four themes emerged regarding the consequences of the underrepresentation: (1) misinterpretation of risk for underrepresented groups, (2) exacerbating the mistrust between underrepresented populations and the government, (3) a potential disservice to underserved populations if the data is used as the basis for allocating resources, and (4) and unknown impact for the individuals whose demographic information is unknown. We propose considerations for displaying underrepresented populations on public health data dashboards to improve the utility of the represented data.

Mainstreaming queerness in Thai boys’ love narratives: Impact on gay identity perceptions in Bangkok’s society

The intricate interplay between media representation and experiences of minority groups in Southeast Asia necessitates a comprehensive analysis of popular culture’s impact on marginalized communities. This mixed-method study investigates the portrayal of homosexual male characters in contemporary Thai Boy’s Love (BL) series and its connection to the authentic experiences of gay men in Bangkok. Through interviews with the casting team and producers of a prominent BL series, the research aims to elucidate the creative process underpinning these portrayals. The study further examines the perceptions and identity development of gay men as depicted in BL narratives, and how heterosexual women viewers interpret this representation. A questionnaire involving 330 participants of diverse orientations indicates that 78.6% of gay men consider BL narratives to be misrepresentative, while 69% of heterosexual women perceive them as accurate, raising concerns about the influence of media representations on identity formation within the gay community. Moreover, the marked disparities in beliefs regarding whether gay individuals aspire to the appearance portrayed by BL characters (with 98.3% of heterosexuals, 60% of bisexuals, and 100% of lesbians concurring, in contrast to 71.8% of gay respondents dissenting) emphasize the significance of diverse and accurate representation in shaping identities and self-perception.

Exploring Diversity in North American Academic Pediatric Otolaryngology.

Representation of women and minority groups is traditionally low in Otolaryngology-Head & Neck Surgery (OHNS). This cross-sectional study aims to assess the difference in gender and racial/ethnic representation within Academic North American pediatric OHNS. Cross-sectional study of North American pediatric OHNS faculty websites. North America. Canadian and American residency program registries were searched for accredited OHNS programs. Pediatric OHNS faculty were identified through program websites. Information regarding gender, race/ethnicity, time in practice, research productivity, academic title, and leadership positions was extracted from public profiles and Scopus. Demographic and academic data was also extracted for OHNS and pediatric OHNS department/division chairs. North American academic pediatric OHNS websites listed 516 surgeons, of whom 39.9% were women. Most surgeons were perceived as White (69.0%), followed by Asian (24.0%), Hispanic (3.7%), and Black (3.3%). Women surgeons had lower h-indices, less publications, and less citations than men (P < .001). Despite women surgeons having fewer years in practice (median 8.0 vs 13.0, P < .001), gender-differences in h-index persisted when controlling for years in practice (P < .05). Men surgeons had higher academic titles (P < .001), but there was no gender difference in leadership roles while accounting for years in practice (P = .559). White surgeons had higher academic titles than non-White surgeons (P = .018). There was no racial/ethnic difference in leadership roles (P = .392). Most pediatric OHNS surgeons are men and/or White. Significant gender-differences in research productivity and academic title exist, however surgeons of racial/ethnic minority have similar research productivity as their racial/ethnic majority counterparts.

Streaming with more diversity? A comparison of the representation of minorities in broadcasting versus streaming television content

This study focused on the representation of minority groups on television, following the idea(l) that television as a mirror of society should convey a well-balanced representation of society. The current study extends previous research in that it analyses the potential for differences between regular broadcasters and streaming platforms, due to the latter’s public commitments to diversity and inclusion. Our results reveal that on Dutch prime-time television and popular streaming platforms women and seniors are underrepresented, whilst sexual minorities are overrepresented on public broadcasters and ethnic minorities on all platforms. Furthermore, results revealed that public nor commercial broadcasters nor popular streaming platforms succeed in being a fully inclusive, diverse, equitable, and representative reflection of Dutch society.

PLURALISME PENYELENGGARAAN PENDIDIKAN BERBASIS KEAGAMAAN KRISTEN DAN KATOLIK DI KABUPATEN BANGKALAN

This research aims to take a space that has not received attention in the field of education that intersects with the complexity of community elements towards religious minority groups. Therefore, it is important to tackle the conception of pluralism in the implementation of non-Muslim religious-based education as a representation of the diversity of multicultural values of Madura. This research uses a qualitative methodology with an ethnomethodological approach. This study focuses on the assumption of "subjectivity" through the interpretive actions of community members who produce and organize daily experiences related to inter-religious tolerance values. The focus of this study concern a views of stakeholders, including the organizational structure of educational institutions and local government officials regarding the implementation of non-Muslim religious-based education as a representation of minority groups. Bangkalan Regency was chosen as the research location, referring to the highest proportion of Christian and Catholic population among the four regencies on Madura Island. The results of this study show the attitude of tolerance between religious communities as a representation of pluralism, especially for religious minority groups in the field of education provision that occurs in Bangkalan Regency.

Triage Discordance in an Academic Pediatric Emergency Department and Disparities by Race, Ethnicity, and Language for Care

Background Minoritized patients are disproportionately represented in low-acuity emergency department (ED) visits in the United States in part caused by lack of timely access to primary and urgent care. However, there is also the possibility that implicit bias during triage could contribute to disproportionate representation of minority groups in low-acuity ED visits. Triage discordance, defined as when ED resources used are different from initial triage score predictions, can be used as a proxy for triage accuracy. Recent data suggest that discordant triage may be common, although little is known about the interaction with race, ethnicity, and language for care. Objectives This study aims to determine the prevalence of discordant triage among moderate- and low-acuity pediatric ED encounters and the interaction with patient race, ethnicity, and language for care. Methods We performed a retrospective analysis of pediatric ED encounters from 2019 with Emergency Severity Index (ESI) scores of 3, 4, or 5 at an academic referral hospital. The primary outcome was triage discordance, encompassing overtriage (ESI 3 and 4) and undertriage (ESI 4 and 5). Logistic and multinomial regressions were used to assess discordant triage by race, ethnicity, and language group. Results Triage discordance occurred in 47% (n = 18,040) of encounters. Black and Hispanic patients had higher likelihood of undertriage for ESI 5 (adjusted odds ratio 1.21, 95% confidence interval [CI] 1.01–1.46 and 1.27, 95% CI 1.07–1.52, respectively), and Black patients were more likely to be overtriaged in ESI 3 (1.18, 95% CI 1.09–1.27). Those with a language other than English for care had higher proportions of overtriage for ESI 3 (1.08, 95% CI 1.04–1.12) and undertriage for ESI 5 (1.23, 95% CI 1.11–1.37). Conclusions We found high rates of triage discordance in our pediatric ED, with significant associations with race, ethnicity, and language for care. Future research should evaluate the source of triage discordance and develop quality improvement efforts to improve equitable care.

Feasibility of Improving Glycemic Control via Heat Therapy in individuals at risk for Alzheimer’s Disease (FIGHT-AD): a pilot study

Impaired glycemic control increases the risk for type 2 diabetes and Alzheimer’s Disease (AD). Mechanisms such as impaired energy metabolism, cellular bioenergetic function, reduced intracellular protein homeostasis, and inflammation are all potential contributors to AD pathology. Heat therapy, via hot water immersion, has been shown to improve blood glucose regulation, insulin resistance, and inflammation. Given the potential contribution of these factors to brain health, heat therapy could offer immense clinical benefit to individuals at risk for AD. We performed a pilot study to test the feasibility of utilizing heat therapy in older individuals at risk for AD due to metabolic risk. The study intervention involved two pre-visits which included a cognitive function screen, sleep, diet, and physical activity questionnaires, as well as a glucose tolerance test and MRI scan. The intervention consisted of four weeks of heat therapy (3 visits/wk) for a total of 12 visits, followed by two post-intervention study visits identical to the pre-study visits. A total of 18 individuals (9 male, 9 female), average age 71.1 ± 3.9 y completed the intervention. Participants demonstrated metabolic risk based on average HbA1c values of 6.6 ± 0.67, Body Mass Index (BMI) of 29.1 ± 5.4, and 15 of the 18 participants were on hypertensive medications. Our cohort was highly diverse, with 33% underrepresented minority group representation. We had 96% participant adherence for the study (8 missed visits out of 216 total visits), and 1 study related Adverse Event (mild dizziness/nausea) that was mild. Overall, the research participants responded to a post-intervention survey saying they enjoyed participating in the study and it was not a burden on their schedules. In addition, we obtained preliminary data demonstrating a significant effect of the heat therapy intervention on body mass index, mean arterial pressure, and cerebral perfusion (p&lt;0.05), and a trend for improved self-reported sleep quality (Pittsburgh Sleep Quality Index; p=0.06). Future studies of longer duration are needed to provide a comprehensive understanding of the impact of heat therapy on glucose homeostasis and brain health. NIH P30 AG035982 (KU ADRC), pilot funds to PCG. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

An Uneasy Peace: How STEM Progressive, Traditionalist, and Bridging Faculty Understand Campus Conflicts over Diversity, Anti-Racism, and Free Expression

In recent years an uneasy peace has descended in U.S. academe between those who feel research universities have done too little to advance the representation of minority groups and women and those who feel that the administrative policies developed to improve representation can and sometimes do come into conflict with core intellectual commitments of universities. Using quantitative and qualitative evidence from interviews with 47 natural sciences, engineering, and mathematics faculty members at a U.S. research university, the paper examines the background characteristics of three sets of protagonists - academic progressives, academic traditionalists, and those whose views bridge the divide - and the way respondents discussed and justified their viewpoints. The paper draws on the theory of strategic action fields to illuminate the structure and dynamics of the conflict and suggests modifications to the theory that would improve its explanatory power for this case.

Reporting and representation of underserved groups in intervention studies for patients with multiple long-term conditions: a systematic review.

Globally, there is a growing number of people who are living with multiple long-term conditions (MLTCs). Due to complex management needs, it is imperative that research consists of participants who may benefit most from interventions. It is well documented that ethnic minority groups and lower socioeconomic status (SES) groups are at an increased risk of developing MLTCs. Therefore, the aim of this systematic review was to determine the level of reporting and representation of underserved groups (ethnic minority and low SES) in intervention studies addressing MLTCs. Systematic review. Four databases including Cochrane Library, MEDLINE, CINAHL and Scopus were searched for intervention studies from North America or Europe published between January 1990 and July 2023. Hospital and community-based interventions. We included interventional studies focusing on improving MLTC-related outcomes. Patients with MLTCs. Total number of studies reporting on ethnicity and SES. Number and proportion of studies reporting by ethnic/SES group. Thirteen studies met the inclusion criteria. Only 4 of 13 studies (31%) recorded and reported ethnicity information. Of these four studies that reported on ethnicity, three studies consisted of primarily White participants. Ethnic minority groups were underrepresented, but one study included a majority of African American participants. Moreover, 12 of 13 studies (92%) reported on SES with income and educational level being the primary measures used. SES representation of higher deprivation groups was varied due to limited data. For ethnicity, there was a lack of reporting, and ethnic minority groups were underrepresented in intervention studies. For SES, there was a high level of reporting but the proportion of study samples from across the spectrum of SES varied due to the variety of SES measures used. Findings highlight a need to improve the reporting and representation of ethnic minority groups and provide more detailed information for SES through using consistent measures (e.g. education, income and employment) to accurately determine the distribution of SES groups in intervention studies of people with MLTCs.

Sociodemographic and patient reported outcomes by racial and ethnicity status among participants in a randomized controlled trial for methamphetamine use disorder

BackgroundThere has been a significant increase in methamphetamine use and methamphetamine use disorder (Meth UD) in the United States, with evolving racial and ethnic differences. ObjectivesThis secondary analysis explored racial and ethnic differences in baseline sociodemographic and clinical characteristics as well as treatment effects on a measure of substance use recovery, depression symptoms, and methamphetamine craving among participants in a pharmacotherapy trial for Meth UD. MethodsThe ADAPT-2 trial (ClinicalTrials.gov number, NCT03078075; N=403; 69% male) was a multisite, 12-week randomized, double-blind, trial that employed a two-stage sequential parallel design to evaluate the efficacy of combination naltrexone (NTX) and oral bupropion (BUP) vs. placebo for Meth UD. Treatment effect was calculated as the weighted mean change in outcomes in the NTX-BUP minus placebo group across the two stages of treatment. ResultsOf the 403 participants in the ADAPT-2 trial, the majority (65%) reported non-Hispanic White, while 14%, 11% and 10% reported Hispanic, non-Hispanic Black, and non-Hispanic other racial and ethnic categories respectively. At baseline non-Hispanic Black participants reported less severe indicators of methamphetamine use than non-Hispanic White. Treatment effects for recovery, depression symptoms and methamphetamine cravings did not significantly differ by race and ethnicity. ConclusionsAlthough we found racial and ethnic differences at baseline, our findings did not show racial and ethnic differences in treatment effects of NTX-BUP on recovery, depression symptoms and methamphetamine cravings. However, our findings also highlight the need to expand representation of racial and ethnic minority groups in future trials.

Effective interventions to increase representation of under-served groups in randomised trials in UK and Ireland: a scoping literature review.

Participants in clinical trials often do not reflect the populations that could benefit from the treatments being investigated. There are known barriers to trial participation for under-served groups, but limited evidence on strategies to alleviate these barriers to improve representation. This scoping review aimed to identify effective interventions and design features that improve the representation `of under-served groups in trials, focusing on the UK and Ireland. We included methodological research studies that reported interventions to improve representation of ethnic minority groups, socioeconomically disadvantaged groups, older people, or those with impaired capacity to consent to randomised controlled trials, conducted in the UK and Ireland, published between 2000-2021. Systematic searches were conducted in November 2021 and data were independently extracted by two authors and narratively synthesised. Seven studies were included: one randomised controlled study embedded in five trials, one mixed-methods study, and five studies reporting 'lessons learnt' from one trial. We categorised the 47 reported interventions or strategies into nine broad themes: Recruitment sites, recruitment settings, community engagement, and communication with participants, incentives, inclusion criteria, flexibility, patient documentation, and the consent process. Only 28/47 interventions were evaluated, 23 of which were comparison of recruitment pathways.The randomised study found that a £100 incentive mentioned in the invitation letter increased positive responses overall across drug trials in cardiovascular disease and hypertension, but not for older people or those living in the most deprived areas. Invitation letters via GPs and working with communities were reported as successful recruitment pathways in recruiting different under-served populations. Interventions aiming to improve the recruitment of under-served groups in the UK and Ireland were reported across seven papers, but their effectiveness was rarely rigorously evaluated. Included studies were context specific. Using a variety of recruitment methods is likely to help achieve a more diverse cohort.

Edward F. Adolph Distinguished Lecture. Age and sex differences in the limits of human performance: fatigability and real-world data.

High-level athletic performances may be a proxy for the trajectory of optimal function of human biology with advanced aging and the differences between males and females. Males are faster, stronger, and more powerful than females and these physical attributes decline dramatically with advanced aging for both sexes. Experimental mechanistic studies determine the physiological mechanisms for these sex and age differences in human physical performance. The assumption however, that real-world performances solely reflect the biological and physiological differences between the sexes and with advanced aging, even among elite athletes, is not complete. This review presents evidence that an integrated approach encompassing analysis of real-world data and experimental mechanistic studies is necessary to determine the biological and sociocultural factors attributed to the limits of performance with aging and between males and females. First, experimental studies are presented that focus on the sex and age differences in performance fatigability that determine the physiological mechanisms of absolute and relative exercise performance. Second, analysis of current and historical real-world data including world records, and performances of elite, collegiate, and competitive age-group athletes are highlighted. These data illustrate that the upper limits of physical performance that have changed historically, and other factors such as sociocultural influences, explain the widening of the sex and age gaps in human performance observed in real-world data even in present-day performances. These approaches have broader significance when applied to understanding the impact of the historically low representation of females and minority groups in biomedical research on health outcomes.

LGB+ identity and its implications for the policy positions of parliamentary candidates

Abstract Several studies concentrate on the representation of minority groups and the policy goals that members of these groups highlight when becoming candidates for public offices. However, we do not know much about the degree of parliamentary representation of sexual minorities and what ideological profile politicians with an LGB+ identity adopt. We aim at filling this gap by analysing the ideological stances of LGB+ candidates on key policy dimensions. Using data from the 2021 German candidate study, we find that the self-identification as LGB+ contributes significantly to adopting progressive stances on the socio-cultural dimension and more favourable positions on welfare state expansion, regardless of further important factors like party affiliation. Moreover, candidates who consider themselves LGB+ do take on significantly less traditional positions on the socio-cultural dimension compared to the position of their party, indicating that increasing descriptive representation of LGB+ individuals in parliament leads to a strengthening of more progressive voices in parliament and a stronger substantive representation of LGB+ interests.

Transitioning (on the) Internet: Shifting Challenges and Contradictions of Ethics of Studying Online Gender Transition Narratives

The use of social media in qualitative research has become extremely popular. YouTube, in particular, has attracted attention from scholars working on (self-)representation of minority groups, including the transgender community (e.g., Dame 2013; Horak 2014). Most academic disciplines, however, have been slow in responding to the increasingly challenging nature of social media in terms of their ethics and methodologies. For example, there is a common misconception that any publicly available YouTube videos can be freely used for research. Many studies openly reference the YouTube channels they discuss (Wotanis and McMillan 2014) or anonymize data, but do not seek informed consent from creators (Raun 2020). What is more, researchers rarely reflect on how their work could impact the communities under study or the way creators use social media (Leonelli et al. 2021). At the same time, researchers wishing to protect vulnerable communities may find themselves falling short of FAIR (findable, accessible, interoperable, and re-usable) research principles required by funders. In this contribution, I discuss these and other challenges using, as a case study, my project, which investigates gender transition narratives on Polish social media. I wish to show that there is no one-fits-all approach to the ethics of social media studies—as the very nature of social media is in constant flux—and call for attentiveness and reflexivity as an inextricable component of qualitative social media research methodology.

Advancing Diversity in Microbiology: A 55-Year Retrospective Analysis.

Background For over 50 years, affirmative action helped advance equity, diversity and inclusion (EDI) in educational institutions in the United States (U.S.). However, the recent U.S. Supreme Court decision to end affirmative action in college admissions threatens the progress toward EDI. Objective This study aimed to assess the progress in promoting gender and racial diversity within the discipline of microbiology over a 55-year period. We sought to analyze the representation of women and minority groups in faculty ranks, tenure positions, and leadership to identify disparities and trends and determine who will likely be impacted most with the end of affirmative action. Materials and methods This longitudinal retrospective study utilized publicly available and non-identifiable Association of American Medical Colleges (AAMC) data on full-time microbiology faculty from 1967 to 2021. Faculty members were categorized based on academic ranks and tenure status, while gender and racial data were also considered. Results The analysis revealed a consistent dominance of white faculty, with over 60% representation across all academic ranks throughout the study period. The Asian and female faculty representation decreased in senior academic ranks. We observed a positive trend in the annual increase of women in faculty positions, academic ranks, chairs, and tenure positions. Furthermore, Asian faculty demonstrated the most robust surge in representation. However, disparities persisted for black, Hispanic, and Native American faculty members, reflecting broader challenges in their representation. Discussion Although efforts to enhance diversity within microbiology have yielded positive results, underrepresented minority groups still face obstacles in attaining leadership positions and senior academic ranks. The diminishing proportion of women at higher academic ranks raises concerns about potential attrition or lack of promotion opportunities. The end of affirmative action poses a risk of perpetuating this trend, leading to a decline in diversity among microbiology faculty.

Aspects of Success in Studies for Higher Education Students From Minority Groups: The Case of Ultra-orthodox Women in Israel

The low representation of minority groups in higher education challenges many countries. Integrating these groups requires the presence of a multi-faceted support system to include financial aid, educational support, and cultural adaptation of content, but most of the support is directed to bachelor's degrees. The current study aims to examine differences in measures of success for a bachelor’s degree and those for a master’s degree among Ultra-orthodox women in Israel. The study was carried out using a quantitative paradigm and was based on 116 female students who completed master's degrees in special programs for Ultra-orthodox women. The findings indicate that measures of success were found to be significantly higher in advanced degree studies than in bachelor’s degree studies. At the same time, it appears that the components of making a degree accessible for ultra-orthodox society are also considered higher for master’s degrees. This shows that the importance of cultural adaptation does not end with a bachelor’s degree, and it is very important for master’s degrees A culturally adapted environment, and specifically, content that is suitable for minorities, encourages a sense of belonging, which has been found to contribute to success.

Representation of ethnic and racial minority groups in European vaccine trials: a quantitative analysis of clinical trials registries

ObjectivesThe representation of ethnic minority groups in European vaccine trials is an important and hitherto unaddressed gap in the literature. The objectives of this study were to determine the proportion...

Co-producing principles to guide health research: an illustrative case study from an eating disorder research clinic

BackgroundThere is significant value in co-produced health research, however power-imbalances within research teams can pose a barrier to people with lived experience of an illness determining the direction of research in that area. This is especially true in eating disorder research, where the inclusion of co-production approaches lags other research areas. Appealing to principles or values can serve to ground collaborative working. Despite this, there has not been any prior attempt to co-produce principles to guide the work of a research group and serve as a basis for developing future projects.MethodsThe aim of this piece of work was to co-produce a set of principles to guide the conduct of research within our lived experience led research clinic, and to offer an illustrative case for the value of this as a novel co-production methodology. A lived experience panel were recruited to our eating disorder research group. Through an iterative series of workshops with the members of our research clinic (composed of a lived experience panel, clinicians, and researchers) we developed a set of principles which we agreed were important in ensuring both the direction of our research, and the way in which we wanted to work together.ResultsSix key principles were developed using this process. They were that research should aim to be: 1) real world—offering a clear and concrete benefit to people with eating disorders, 2) tailored—suitable for marginalised groups and people with atypical diagnoses, 3) hopeful—ensuring that hope for recovery was centred in treatment, 4) experiential—privileging the ‘voice’ of people with eating disorders, 5) broad—encompassing non-standard therapeutic treatments and 6) democratic—co-produced by people with lived experience of eating disorders.ConclusionsWe reflect on some of the positives as well as limitations of the process, highlighting the importance of adequate funding for longer-term co-production approaches to be taken, and issues around ensuring representation of minority groups. We hope that other health research groups will see the value in co-producing principles to guide research in their own fields, and will adapt, develop, and refine this novel methodology.

Insufficient Reporting of Race and Ethnicity in Breast Cancer Clinical Trials.

Reporting race and ethnicity in clinical trial publications is critical for determining the generalizability and effectiveness of new treatments. This is particularly important for breast cancer, in which Black women have been shown to have between 40 and 100% higher mortality rate yet are underrepresented in trials. Our objective was to describe changes over time in the reporting of race/ethnicity in breast trial publications. We searched ClinicalTrials.gov to identify the primary publication linked to trials with results posted from May 2010-2022. Statistical analysis included summed frequencies and a linear regression model of the proportion of articles reporting race/ethnicity and the proportion of non-White enrollees over time. A proportion of 72 of the 98 (73.4%) studies that met inclusion criteria reported race/ethnicity. In a linear regression model of the proportion of studies reporting race/ethnicity as a function of time, there was no statistically significant change, although we detected a signal toward a decreasing trend (coefficient for quarter = -2.2, p = 0.2). Among all studies reporting race and ethnicity over the study period, the overall percentage of non-White enrollees during the study period was 21.9%, [standard error (s.e.) 1.8, 95% confidence interval (CI) 18.4, 25.5] with a signal towards a decreasing trend in Non-White enrollment [coefficient for year-quarter = -0.8 (p = 0.2)]. Our data demonstrate that both race reporting and overall representation of minority groups in breast cancer clinical trials did not improve over the last 12 years and may have, in fact, decreased. Increased reporting of race and ethnicity data forces the medical community to confront disparities in access to clinical trials. This may improve efforts to recruit and retain members of minority groups in clinical trials, and over time, reduce racial disparities in oncologic outcomes.