University of Wisconsin Health is working to improve diversity in clinical trials by including a diverse trial population in a series of clinical trials for a COVID-19 vaccine.
In recent statement, UW Health said they are renewing their emphasis on anti-racist strategies in their patient care, especially regarding diversity in their new COVID-19 vaccine clinical trials.
According to UW News, UW is one of the leading research universities working on developing a COVID-19 vaccine. UW is partnering with pharmaceutical company AstraZeneca to test the vaccine in a series of clinical trials.
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Chief Diversity Officer for UW Health Shiva Bidar-Sielaff said UW Health is working to expand the diversity of their trial participants.
“I think the most important part of having diversity in the clinical trial is so that we can make sure that people have trust in the findings,” Bidar-Sielaff said.
According to National Public Radio, diversity proves essential in these clinical trials as the virus both disproportionately affects members of BIPOC communities and is more harmful to those with preexisting conditions, which is the case for many BIPOC.
According to the New York Times, Black and Hispanic Americans are more likely to die from the COVID-19 virus, yet according to UW Health, BIPOC people remain underrepresented in these clinical trials.
Black and Hispanic patients only make up about three and six percent, respectively, of all clinical trial participants. Black Americans are also three times more likely to contract the virus compared to white Americans.
“I feel like there is a credibility issue with the trust in the results of the trial when the people that participated in the trial are not representing our communities,” Bidar-Sielaff said.
Bidar-Sielaff said the lack of trust in BIPOC communities comes from how the medical community has treated BIPOC in past trials.
UW oncology doctor and Chief of the Department of Medicine Diversity, Equity and Inclusion task force Narjust Duma said a vaccine’s validity comes into question as well.
“When [you] approve a vaccine that only has been tested in the majority group, while the disease is affecting the minority group, then [you] won’t get the same efficacy,” Duma said.
Duma added a history of mistreatment by the medical community fostered mistrust among communities of color.
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UW professor and epidemiology doctor Ajay Sethi said in an email statement to The Badger Herald that decades of unethical medical trials and research carried out in communities of color created this fear and mistrust of medical professionals.
“Because of the history of unethical research carried out on people of color, mistrust is justified,” Sethi said.
According to the Atlanta BlackStar, trials like the Tuskegee Syphilis Study, the Henrietta Lacks stem cell study and a plethora of others, including eugenic-like contraceptive trials done on indigenous and Black women, continue to make it difficult for BIPOC people to build a sense of solidarity and trust in the medical community.
But, UW Health says they continue working to assuage this mistrust in order to provide service to these communities that have been mistreated.
Duma said a strategy to increase diversity in the medical community is to have professionals in the field who are a part of the underrepresented group they are treating.
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“I think if you train people that have love for their community, we’re going to be able to work to improve disparities and improve the trust that communities of color have [towards] the healthcare system,” Duma said.
In a 2018 study done by the National Bureau of Economic Research, researchers found Black men who saw Black doctors agreed to more life-saving invasive surgeries. In another study done by doctors affiliated with the United Hospital Fund, the Harvard Business Review reported that the agreement to preventative surgeries seemed to be due to a greater sense of trust and communication between the two parties.
Bidar-Sielaff, also a current participant in the trial, said having BIPOC individuals see themselves actually represented in the trial may also ease this community distrust.
“If you don’t see yourself represented in the people that are enrolling for clinical trials then that trust, oftentimes, is hard to build,” Bidar-Sielaff said.
UW Health says they have made significant strides in promoting diversity and equity in its medical community on their website.
As chief of the Diversity, Equity and Inclusion program, Duma worked to implement more programs to improve diversity, including holistic review for resident applicants, implicit bias training for interviewers and a matching program pairs patients with doctors of similar backgrounds.
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“We’re also recommending that when people are going to be selected for Chief or Chairs, that trainees and nurse practitioners are part of the selection committee,” Duma said.
Recently, Bidar-Sielaff’s position as Chief Diversity Officer at UW Health was promoted to the executive level.
Bidar-Sielaff said her new position allows her to ensure the topic of equity is always in the medical conversation.
“[My promotion] really speaks to the need that this work around diversity, equity, inclusion and anti-racism is seen as foundational and critical work for the organization,” Bidar-Sielaff said.
According to WKOW News, the trials paused Sept. 8 due to a patient’s reaction to the vaccine.
According to another statement from UW Health, the university is also continuing its partnership with community organizations to promote wellness and knowledge in underrepresented groups in Madison.
“I think my message is that it’s not about trying to reach a target number, it’s about getting accurate, good information out in the hands of our BIPOC communities so people can make informed decisions,” Bidar-Sielaff said.