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Dr. Adrelia Allen, Executive Director of Clinical Trial Patient Diversity at Merck, talked to Urban Health Today about the urgent push for diverse research participation and Merck’s collaborations with organizations that foster diversity in clinical trials.
Urban Health Today: Please talk about your background and your work with Merck. 
Adrelia Allen: As Executive Director, Clinical Trial Patient Diversity at Merck, I focus on developing programs and initiatives that aim to increase diversity in clinical trials and help make clinical research more reflective of the patient population we serve. I’ve been working in healthcare for nearly 30 years, and I began my career as a pharmacist because I was intrigued by the process of bringing new medications to market. Along the way, I’ve had roles in clinical trial site management, clinical trial operations, and pharmaceutical sales.
UHT: Can you explain why diversity and inclusivity in clinical trials are important components of medical research? 
AA: By including participants from various backgrounds, such as different ethnicities, genders, ages, sexual orientations, and socioeconomic statuses, we can help ensure that the data generated from the clinical trials reflects the diversity of the population we hope to serve. This inclusive approach helps identify potential differences in treatment outcomes and side effects.
UHT: You have a strong commitment to improving the clinical trial recruitment process. What drives your dedication? Can you share any personal experiences you have? 
AA: When I reflect on my personal experiences and my family&#8217;s medical history, which includes cancer and comorbidities such as diabetes and hypertension, I gain a deeper understanding of the specific health hurdles that certain communities might encounter. When my father was diagnosed with prostate cancer, his deep-seated mistrust of the healthcare system, stemming from historical injustices, made it challenging to convince him to undergo necessary tests like an MRI. Witnessing my family&#8217;s hesitancy to consider clinical trial participation due to past injustices deeply impacted me. In my current role, I am focused on helping individuals, particularly those who share similar experiences, become aware of the opportunities available to them in clinical research. My goal is to increase awareness and education about clinical trials so that patients can access information and make informed decisions about their healthcare journey.
UHT: What strategies are being implemented by Merck to enhance diversity in clinical trials? 
AA: Merck’s Diversity &amp; Inclusion in Clinical Trials (DICT) team has increased engagement among underrepresented groups through collaborations with community-based organizations, institutions of higher education, and professional groups. We are prioritizing diversity planning for Phase 3 trials, communicating internally and with sites, and thoughtfully prioritizing placement of study sites in communities that have higher populations of people who have historically been underrepresented (e.g. Black Americans). We are also working to mitigate barriers to clinical trial participation. Some of our strategies include:
<ul>
<li style="font-weight: 400">Developing a comprehensive roadmap to help advance Diversity Plans for Phase 3 trials, manage strategies across therapeutic areas, and emphasize community engagement to heighten awareness of relevant clinical trials in diverse communities.</li>
<li style="font-weight: 400">Actively sponsoring training for physicians of color to become Principal Investigators (PIs) through the National Medical Fellowships’ Diversity in Clinical Research program to create a more diverse workforce. Fostering a more diverse workforce, notably by broadening the pool of PIs, helps instill trust and can enhance the diversity of clinical trial participants through culturally competent programming and education.</li>
<li style="font-weight: 400">Expanding outreach to Black Americans by listing trials and developing educational articles for the Clinical Trials Resource Center of BlackDoctor.org. This innovative approach serves as a crucial source of information, enhancing awareness and education about clinical trials within the Black American community.</li>
</ul>
UHT: What are some of the biggest challenges in achieving diversity and inclusion of marginalized patients in clinical trials? 
AA: Achieving diversity and inclusion in clinical trials presents significant challenges, including historical mistrust of the medical community due to past unethical practices and systemic discrimination. Socioeconomic factors like limited access to healthcare, transportation, and finances also hinder participation, alongside language and cultural barriers. Moreover, the lack of diversity among healthcare providers exacerbates disparities in recruitment and engagement strategies. Addressing these obstacles demands efforts to build trust, improve access to healthcare, provide education, and actively involve historically underrepresented communities in research.
Recognizing that trust is at the root of someone’s decision to participate in a clinical trial and that building this trust starts with listening to patients and learning about the challenges experienced by different communities, Merck is collaborating with community-based organizations, institutions of higher education and professional groups to expand its outreach to meet and engage volunteer participants.
UHT: Merck has collaborated with organizations like Greenphire and Acclinate to foster diversity in clinical trials. Can you expand on how these collaborations work and what their impact has been so far? 
AA: Time, travel, and out-of-pocket costs have consistently been cited as obstacles to clinical trial recruitment and retention. Recent research from Tufts University identified that the top two enhancements to increase patient participation in clinical trials are expense reimbursement and transportation assistance. Merck’s agreement with Greenphire helps to ease transportation barriers for Merck’s trial participants to increase access and participation.
We are also collaborating with Acclinate to help increase the participation of members of the Black American community in Merck’s oncology clinical trials. As part of the initiative, Acclinate utilizes its NOWINCLUDED platform, a trusted health education and engagement source created by and for the Black American community. NOWINCLUDED provides health information and resources on conditions that affect members of underserved communities and allows them to connect and share experiences.
UHT: In your estimation, what steps does the pharmaceutical industry need to take to further improve diversity in clinical trials? 
AA: In my view, the pharmaceutical industry can take several steps to enhance diversity in clinical trials:
<ul>
<li style="font-weight: 400">Building trust and collaboration with marginalized communities and organizations is crucial, achieved through open communication and transparent engagement efforts.</li>
<li style="font-weight: 400">Tailoring recruitment strategies and using culturally appropriate messaging and outreach methods to attract a broader participant pool.</li>
<li style="font-weight: 400">Removing barriers to participation, such as transportation and language issues, is essential for inclusivity. Support services like transportation assistance and language interpretation facilitate access for needy individuals.</li>
<li style="font-weight: 400">Educating individuals about the importance of clinical research so that they can make informed health decisions.</li>
</ul>
Merck&#8217;s ongoing commitment to diversity and inclusion in clinical research complements these industry-wide efforts. It fosters more inclusive trial environments with the goal of generating research findings that reflect the diversity of the population we hope to serve.
 UHT: How important is patient education and engagement in improving clinical trial diversity? 
AA: Patient education and engagement are at the heart of improving clinical trial diversity. Providing information about available clinical trials and access points can help patients make informed decisions about care and choose clinical trials that align with their interests. It’s important that we understand patients’ access needs. These simple steps can make a significant difference in their healthcare journey.
Education is the cornerstone of patient empowerment; it’s imperative that patients are equipped with knowledge about available resources and clinical trial opportunities. 
UHT: How can the medical community support the movement toward more inclusive clinical research? 
AA: The medical community can promote more inclusive clinical research through various avenues. Healthcare providers are instrumental in educating patients about the significance of clinical research. Additionally, healthcare institutions and professional organizations can prioritize diversity and inclusivity in their research practices by offering training on cultural competence and collaborating with community organizations. By collectively prioritizing diversity and inclusivity, the medical community can help advance research efforts that are representative, equitable, and beneficial for different populations.
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Adrelia Allen, Pharm.D., is a 22-year veteran of the pharmaceutical industry working in sales and clinical research at Merck. She has held positions of increasing experience as a clinical research associate, clinical trial project manager and clinical research manager (CRM). She is currently the executive director of clinical trial patient diversity and is responsible for the strategy and execution of activities for the diverse representation of patients in clinical trials. Allen has a Doctor of Pharmacy degree from Florida A&amp;M University College of Pharmacy.

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Q & A: Dr. Adrelia Allen Talks about The Urgent Push for Diversity in Clinical Trials

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Dr. Adrelia Allen, Executive Director of Clinical Trial Patient Diversity at Merck, discusses Merck’s collaborations with organizations that foster diversity in clinical trials.

Q &amp; A: Dr. Adrelia Allen Talks about The Urgent Push for Diversity in Clinical Trials