Education, Income Level Influence Trial Perceptions, Study Says

U.S. patients with lower education and annual household income are less interested in and familiar with participation in clinical trials, according to a new study that recommends examining such socioeconomic factors when planning trials.

The recent Tufts Center for the Study of Drug Development (CSDD) survey of 4,006 U.S. respondents who have never taken part in a clinical trial, examined the association of such socioeconomic factors as education level and annual household income with trial familiarity, interest and perceived risks and benefits, among other topics.

“In recent years, there has been renewed interest and investment in improving diversity, equity, and inclusion in clinical trials. The focus, however, has been mostly on increasing racial and ethnic diversity,” the Tufts CSDD Impact Report reads. “The impact of social determinants of health — specifically socioeconomic status — on receptivity and willingness to participate in clinical trials has received relatively little attention.”

Of respondents with a maximum high school-level education, 60 percent said they were familiar with clinical trials compared to 72.8 percent of those with an undergraduate degree and 77.2 percent of graduate degree-holding respondents.

Interest in trial participation was strongest amongst graduate degree-holding respondents (48.5 percent), whereas only 39.8 percent and 38.2 percent of respondents with undergraduate degrees and high school diplomas or less, respectively, signaled interest in signing up.

Annual household income had a similar impact on trial familiarity, the survey found. Respondents with more than $40,000 in yearly household income were significantly more familiar with trials (71 percent) compared to those with a less than $40,000 yearly income (60.5 percent).

Interest in Clinical Trials by Education and Income Level
	Highest education achieved			Annual household income
	Up to high school	Undergrad	Graduate	<$40K	$40K-$80K	>$80K
Familiarity with clinical trials?
Yes	60.0%	72.8%	77.2%	60.5%	71.0%	71.0%
No	40.0%	27.2%	22.8%	39.5%	29.0%	29.0%
Interest in joining a clinical trial?
Interested	38.2%	39.8%	48.5%	38.2%	39.2%	42.7%
Not interested	32.2%	25.3%	20.0%	32.3%	26.8%	24.3%
Source: Tufts CSDD

The findings also highlight a persistent problem across all education levels and annual incomes: patients are rarely approached to participate in a trial, whether that’s by email, social media, patient advocacy groups or their doctor.

Just 16.2 percent of the graduate-degree subgroup reported having been asked to join a trial, while undergraduate-degree and high school-level respondents were approached even less (10.1 percent and 8 percent, respectively).

Access Tufts CSDD’s Impact Reports here.