# Signals for change: A regional examination of rural clinical trial participant perspectives on values, health behaviors, and motivations for enrollment and retention in remote settings

## TL;DR

This study explores how rural residents in the U.S. view clinical trials and what motivates their participation, highlighting the need for adapted trial designs to improve equity.

## Contribution

The study provides novel insights into rural clinical trial participant perspectives and the effectiveness of adapted trial approaches in improving retention.

## Key findings

- Rural residents face barriers like financial constraints and travel burden in clinical trial enrollment.
- Adapted trial approaches in a rural healthcare system achieved strong retention of underrepresented populations.
- Thematic analysis revealed dualities between rural culture and traditional trial models, suggesting the need for design adaptations.

## Abstract

There is a known disparity in clinical trial enrollment of rural-dwelling residents in
the United States, largely due to financial constraints and travel burden. A big data
study of an Intermountain West rural-serving healthcare system reported strong retention
rates of historically underrepresented populations with adapted approaches. This
exploratory qualitative descriptive study describes the lived experience and perceptions
of eleven rural residents who participated or were interested in clinical trials from this
healthcare system. Thematic analysis of interviews identified co-existing dualities
between culture and traditional trial models, which suggest adapted designs are necessary
to achieve opportunity equity in rural regions.