In FasterCures’ extensive work to capture lessons learned from the COVID-19 pandemic, it became clear that the US lacked sufficient infrastructure near communities to run trials efficiently or to engage potential participants in the places where they live, work, and receive care. To address this gap, we created the Enabling Networks of Research Infrastructure for Community Health Through Clinical Trials (ENRICH-CT) Coalition, a forum to foster collaboration among organizations in this ecosystem and share best practices. As the coalition continues to cement its presence as a neutral convener of diverse stakeholders, various solutions have already demonstrated pathways to support infrastructure for more inclusive research.
From transforming South Texas into an Alzheimer’s research hub to strengthening the research workforce in the Great Plains region, ENRICH-CT members have continued to push the boundaries of our traditional research system to truly meet people where they are.
After more than 30 presentations from ENRICH-CT members, cross-cutting learnings have emerged that demonstrate what drives success in bringing trials closer to communities.
It has long been recognized that the transactional approach many sponsors take—engaging sites for a single study and then exiting—has contributed to site burnout and high turnover. Too often, sponsors assume they know what sites need rather than asking and partnering in a meaningful way. Addressing this challenge requires collaborating with sites to codesign solutions that strengthen site readiness. ENRICH-CT has shown that site sustainability improves when capacity-building efforts are directed by sites.
The Association of Clinical Research Organizations’ diversity and inclusion grant program demonstrates this approach by allowing sites to define their own needs and apply for funding that will truly bolster capacity, whether infrastructure, equipment, or education.
Another approach, demonstrated through Altura’s Building Clinical Trial and Health Research Access project, surveyed 41 community health centers (CHCs) to better understand the real and perceived barriers sites face. Rather than assuming challenges, the project asked CHCs directed questions, identified the most common needs, and translated insights into actionable solutions through a white paper and toolkit.
Inato’s model provides custom recommendations and matches more than 5,000 research sites to trials, allowing sites to raise their hands for best-fit trials. Inato’s platform reduces burden and increases access at scale, resulting in shortened activation timelines and increased diverse patient enrollment
When the research workforce is adequately trained, supported, and recognized, patient interest in and comfort with research improves. Additionally, new research investigators and staff face numerous challenges, making targeted support for their vital roles essential to bolster workforce stability. ENRICH-CT members have proven that supporting research professionals has twofold benefits.
Organizations like the Association of Clinical Research Professionals (ACRP) emphasize that improving access to clinical trials starts with the people who make research possible. By standardizing workforce expectations through core competency guidelines, building a strong brand identity for clinical research professionals through the Partners Advancing the Clinical Research Workforce consortium, and creating a pipeline of career pathways in research, ACRP ensures these professionals are supported and prepared to improve research operations.
Ochsner Health System models how to build an in-house workforce pipeline. Its clinical research internship program provides hands-on training and early exposure to clinical research, improving workforce readiness and diversity while creating unexpected benefits such as expanded collaboration and increased retention. Initial results from the program demonstrate that 80 percent of matched interns remain with Ochsner more than two years after graduation.
To better support investigators, the National Medical Fellowship’s Diversity in Clinical Trials Research Program has trained and supported over 200 clinicians from underrepresented groups in medicine to serve as principal investigators. Through targeted training, industry collaboration, and sustained post-training support, the program reduces barriers for new investigators and helps ensure that research is more inclusive and reflects the population it serves.
Meaningful and low-friction trials encourage people to participate and remain engaged. Embedding patients’ voices and returning value to patients leads to trials that are more inclusive, feasible, and faster. Throughout the course of the coalition, we’ve learned that putting patients first is not only the right thing for people but also makes for better trials.
Emerson Clinical Research Institute (ECRI) embeds patient-centeredness into its research by bringing trials and information directly into the communities it serves. Through partnerships with local consulates to educate patients about trials, its community-focused television program Tu Salud, Tu Familia, and its mobile health units, ECRI creates a comfortable and familiar environment for its patient populations to learn about and participate in research.
Epic advances patient-centered research by embedding research opportunities directly in MyChart, enabling patients to receive targeted invitations and providing clinicians with patient-specific insights through Cosmos. This approach empowers patients to participate in research and supports shared decision-making between patients and their providers.
Lastly, Choose Healthy Life empowers patients to improve their health by meeting them in trustworthy spaces. Its Blueprint for Wellness screening tool provides individuals with personalized health insights. By returning actionable information and connecting patients to navigators who support next steps, the model reduces barriers to improving health outcomes.
ENRICH-CT members have developed a range of practical, impactful solutions that bring research closer to communities, strengthen sites, build the workforce, and center participants in the trial experience. Despite these unique solutions being advanced by ENRICH-CT members, many structural, regulatory, and mindset barriers continue to create inefficiencies in trial execution.
Collaborating with its members, ENRICH-CT will continue to highlight successful solutions and drive systems-level change. ENRICH-CT will focus on advancing sustainable funding models for community-serving organizations; identifying the highest-burden areas for sites and spotlighting creative approaches to smooth the path for newer sites to participate in research; and identifying and advancing policy and practice enablers that support community-based research across agencies and organizations.
Together, ENRICH-CT and its partners are poised to create a research ecosystem that is more efficient, accessible, and aligned with communities.
FasterCures’ Access Point: Trends in Clinical Trials Transformation is a quarterly horizon scan examining how emerging trends, organizations, and initiatives are transforming clinical trial access and...
The United States biomedical research and innovation enterprise has long been a source of global leadership, scientific breakthroughs, and lifesaving treatments.
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