Reducing Socioeconomic Barriers to U.S. Cardiovascular Trial Participation Through Compensation, Flexible Scheduling, Childcare Support, and Equitable Recruitment Policies

Author

Leidy Sterling

Abstract

 Cardiovascular disease remains a leading cause of morbidity and mortality in the United States, yet clinical trials often inadequately represent the socioeconomic diversity of affected populations. Financial insecurity, inflexible employment schedules, caregiving responsibilities, and unequal recruitment practices can restrict research participation and undermine the generalisability of findings. This narrative review examines how participant compensation, flexible scheduling, childcare support, and equitable recruitment policies may reduce these interconnected barriers. Fair compensation can offset transportation expenses, lost wages, and participation costs, provided payment arrangements avoid undue influence. Evening appointments, decentralised visits, and adaptable follow-up procedures may accommodate employment demands, while childcare assistance can reduce burdens on parents and caregivers. Equitable recruitment policies should promote transparent eligibility criteria, consistent referrals, accessible information, and accountability for representation across socioeconomic groups. The review proposes an integrated, participant-centred framework linking financial assistance, operational flexibility, caregiving support, and institutional oversight throughout recruitment and retention. Implementation should be evaluated through participation patterns, informed consent quality, participant experiences, and retention outcomes. Sustainable inclusion requires structural changes that protect voluntary choice rather than relying solely on higher enrolment numbers.

Keywords

Cardiovascular clinical trials; Socioeconomic barriers; Participant compensation; Flexible scheduling; Childcare support; Equitable recruitment policies.

DOI : https://doi.org/10.5281/zenodo.23530981

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References

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