{"doi":"10.1007/s11606-024-09162-2","title":"Navigating the Path to Inclusion: Understanding Barriers and Facilitators to Clinical Trial Participation Among Chinese Older Adults in the United States with Multimorbidity","abstract":"CONTEXT: Older adults with multimorbidity are underrepresented in clinical trials, with enrollment of Asians particularly low. OBJECTIVE: Understand perspectives of US Chinese older adults regarding clinical trial participation. STUDY DESIGN AND ANALYSIS: Focus group interviews analyzed using thematic analysis. SETTING: Community/senior centers, academic health systems in Northern and Southern California, and a nationwide registry of Asian Americans/Pacific Islanders. POPULATION STUDIED: Mandarin- and English-speaking Chinese adults aged ≥ 65 years with multimorbidity. OUTCOME MEASURES: Themes related to barriers and facilitators of enrollment in clinical trials of medications. RESULTS: We conducted 12 focus groups: 7 with non-US-born and 5 with US-born Chinese older adults (n = 83 total). Mean age was 74 years (SD = 5.9), 43 (51.8%) were female, and 47 (56.6%) Mandarin-speaking. US-born participants had greater educational attainment than non-US-born participants. Participants took a mean of 6.1 prescriptions (SD = 1.5). Barriers to participation in clinical trials of medications included lack of awareness of/exposure for patients and community-based Chinese physicians, preference for natural/traditional medicine, risk aversion and safety concerns, desire for privacy, and inconvenience. Trusted influences included physicians, hospitals/health systems, Asian/Chinese community centers, and family (for non-US-born participants). Suggestions to enhance participation included using language and culturally concordant materials/personnel, educating community-based Chinese physicians about clinical trials, involving patient-trusted physicians in recruitment, promoting trials on conditions common in Chinese people or for an existing condition, and financial incentives. US-born participants expressed greater understanding and willingness to join trials. All groups attributed low clinical trial enrollment to non-US-born Chinese adults. CONCLUSIONS: Chinese older adults perceived obstacles to clinical trial participation that could be mitigated by involving trusted physicians in recruitment, using language and culturally concordant materials/staff, and educating patients and community-based physicians. Recognition of differences in attitudes among US- and non-US-born Chinese people may be important to tailoring recruitment strategies.","journal":"Journal of General Internal Medicine","year":2024,"id":460342,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.901,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1287872,"name":"Ruey‐Ying Liu","orcid":"0000-0002-2770-2147","position":1,"is_corresponding":false},{"id":1128380,"name":"Ting Pun","orcid":null,"position":2,"is_corresponding":false},{"id":650152,"name":"Janice B. Schwartz","orcid":"0000-0002-5171-7824","position":3,"is_corresponding":false},{"id":390921,"name":"Derjung M. Tarn","orcid":"0000-0001-7426-6387","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:04:03.568045Z","pmid":"39495453","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}