1
|
Treweek S, Banister K, Bower P, Cotton S, Devane D, Gardner HR, Isaacs T, Nestor G, Oshisanya A, Parker A, Rochester L, Soulsby I, Williams H, Witham MD. Developing the INCLUDE Ethnicity Framework-a tool to help trialists design trials that better reflect the communities they serve. Trials 2021; 22:337. [PMID: 33971916 PMCID: PMC8108025 DOI: 10.1186/s13063-021-05276-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Ensuring that a trial is designed so that its participants reflect those who might benefit from the results, or be spared harms, is key to the potential benefits of the trial reaching all they should. This paper describes the process, facilitated by Trial Forge, that was used between July 2019 and October 2020 to develop the INCLUDE Ethnicity Framework, part of the wider INCLUDE initiative from the National Institute for Health Research to improve inclusion of under-served groups in clinical research studies. Methods Development of the Framework was done in seven phases: (1) outline, (2) initial draft, (3) stakeholder meeting, (4) modify draft, (5) Stakeholder feedback, (6) applying the Framework and (7) packaging. Phases 2 and 3 were face-to-face meetings. Consultation with stakeholders was iterative, especially phases 4 to 6. Movement to the next phase was done once all or most stakeholders were comfortable with the results of the current phase. When there was a version of the Framework that could be considered final, the Framework was applied to six trials to create a set of examples (phase 6). Finally, the Framework, guidance and examples were packaged ready for dissemination (phase 7). Results A total of 40 people from stakeholder groups including patient and public partners, clinicians, funders, academics working with various ethnic groups, trial managers and methodologists contributed to the seven phases of development. The Framework comprises two parts. The first part is a list of four key questions:
Who should my trial apply to? Are the groups identified likely to respond in different ways? Will my study intervention make it harder for some groups to engage? Will the way I have designed the study make it harder for some groups to engage?
The second part is a set of worksheets to help trial teams address these questions. The Framework can be used for any stage of trial, for a healthcare intervention in any disease area. The Framework was launched on 1st October 2020 and is available open access at the Trial Forge website: https://www.trialforge.org/trial-forge-centre/include/. Conclusion Thinking about the number of people in our trials is not enough: we need to start thinking more carefully about who our participants are. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05276-8.
Collapse
Affiliation(s)
- Shaun Treweek
- Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Aberdeen, AB25 2ZD, UK.
| | - Katie Banister
- Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Aberdeen, AB25 2ZD, UK
| | - Peter Bower
- NIHR Clinical Research Network, Manchester Academic Health Science Centre, Centre for Primary Care and Health Services Research, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Seonaidh Cotton
- Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Aberdeen, AB25 2ZD, UK
| | - Declan Devane
- National University of Ireland Galway, School of Nursing and Midwifery, University Road, Galway, Ireland
| | - Heidi R Gardner
- Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Aberdeen, AB25 2ZD, UK
| | - Talia Isaacs
- UCL Centre for Applied Linguistics, UCL Institute of Education, University College London, London, UK
| | - Gary Nestor
- NIHR Clinical Research Network Cluster E, Campus for Ageing and Vitality, Newcastle University, Newcastle, NE4 5PL, UK
| | | | - Adwoa Parker
- York Clinical Trials Unit, University of York, York, UK
| | - Lynn Rochester
- Translational and Clinical Research Institute; NIHR Clinical Research Network Cluster E, Campus for Ageing and Vitality, Newcastle University, Newcastle, NE4 5PL, UK
| | | | - Hywel Williams
- Centre of Evidence-Based Dermatology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - Miles D Witham
- NIHR Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle University and Newcastle upon Tyne NHS Trust, Newcastle, NE4 5PL, UK
| |
Collapse
|