Behavioral Economics to Transform Trial Enrollment Representativeness (BETTER)

Randomized clinical trials (RCTs) are the best way to determine if interventions are safe and effective. RCTs fail to enroll and retain diverse patients in research studies. These subjects do not represent the diverse groups of patients that have the disease that is being studied.

Behavioral economics (BE) tell us how people make decisions. We have used BE to understand health behaviors. No one has studied how BE could improve how diverse and representative patients are that enroll in RCTs. We have done some research to address this problem but more needs to be done. As part of the BETTER Center, we are trying to develop and test BE methods that address the problem we have described above.

As part of the BETTER Center, we are conducting three projects.

Project 1 aims to answer the question: what makes it easier for RCTs to be diverse and representative? What makes it harder?

Project 2 aims to answer the question: what are BE methods that improve the diversity and representativeness of people in heart disease studies?

Project 3 aims to answer the question: what are the BE methods that improve the diversity and representativeness of people in heart disease RCTs?

The three BETTER Projects are designed to help us better understand how to make RCTs more diverse and representative for people who have heart disease or who are at risk of developing heart disease. Our center plan also includes training students and fellows who are from under-represented backgrounds. This will ensure that this work is sustained long term.

Overall, we want RCTs to be designed so that they enroll participants who accurately represent the population to whom the trial results would be applied. We are particularly committed to trials being representative of the sex, gender identity, race, ethnicity, age, socioeconomic status.