The high enrollment of Black participants in Winship Cancer Institute’s clinical trials were thought to be due to high trust and strong human connections, according to results of a study published in Ethics, Medicine and Public Health.

In the United States, multiple myeloma is the most common hematologic malignancy among Black persons. Despite its high prevalence, Black patients only comprised 1.8% of the clinical trial population of a promising trial conducted in 2015. Conversely, the Winship myeloma trials, conducted between 2014 and 2021, included 34% Black patients.

To evaluate potential reasons why Winship Cancer Institute successfully enrolled a larger proportion of Black participants, this study surveyed 61 Black patients who enrolled in one of the Winship clinical trials between 2018 and 2021, and met with clinicians at Winship. Trust in Medical Research (TMR) and Human Connection (THC) outcomes were compared with results from the Hall study and Mack trial, respectively.

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Of the study participants, 50.8% were women and nearly half (47.5%) were retired.

The average TMR score was higher in this group (mean, 14.9) than the Black (mean, 11.65; P <.001) and White (mean, 12.46) patients in the Hall study. Similarly, THC scores in this group (mean, 57.7) were higher than the Mack trial (mean, 54.6; P <.001), of whom 85% were White.

During the meeting with providers, clinicians discussed their awareness of social issues in healthcare, stressed the importance of treating all patients with respect, endorsed building patient trust from the first visit, and thought that involving patient families was important for effective care.

The study authors conclude that building high levels of trust in healthcare providers can successfully overcome major barriers to clinical trial participation by Black patients, as demonstrated by the proportion of participants from this population in the Winship Cancer Institute myeloma trials.


McClary TS, Blee SM, Avinger AM, et al. Accounting for the high enrollment of African Americans on Winship Cancer Institute’s myeloma clinical trials. Ethics Med Public Health. 2023;27:100877. doi:10.1016/j.jemep.2023.100877