{"entity":{"id":"idea-tr1-community-health-worker-recruitment","kind":"idea","name":"Community health workers and trusted local organisations paid to recruit for trials","aka":[],"tldr":"People join trials when someone they trust explains them. Paying community health workers, churches and local groups to inform and refer people would reach communities that hospitals do not.","summary":"Trial sponsors and networks contract community health workers and community organisations for outreach, education and referral in under-represented communities, with training in trial literacy and payment per activity rather than per enrolment (to avoid coercion). Evaluated in a cluster-randomised design against standard site-based recruitment.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Trials do not represent the people who get cancer): Loree et al., Disparity of race reporting and representation in trials leading to cancer drug approvals (JAMA Oncology 2019)","url":"https://doi.org/10.1001/jamaoncol.2019.1870"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["nci"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-trial-diversity","b-trial-enrolment"],"keyPapers":["paper-loree-jama-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Communities with paid CHW outreach will contribute at least twice the enrolment of minority and low-income participants compared with matched communities without it, and enrolled participants will have retention equal to others.","rationale":"CHW models raised vaccination, screening and HIV testing uptake in similar communities; trial participation shares the same trust and information barriers.","test":"Cluster-randomise 20 community areas around trial sites to CHW outreach or none for 18 months, with enrolment by demographic as the primary outcome.","maturity":"early-clinical","actor":"philanthropy","cost":"medium","horizonYears":2},"route":"/ideas/idea-tr1-community-health-worker-recruitment/","neighbours":{"institution":[{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","route":"/institutions/nci/"}],"bottleneck":[{"id":"b-trial-diversity","kind":"bottleneck","name":"Trials do not represent the people who get cancer","route":"/bottlenecks/b-trial-diversity/"},{"id":"b-trial-enrolment","kind":"bottleneck","name":"Trials enrol too few, too slowly","route":"/bottlenecks/b-trial-enrolment/"}],"paper":[{"id":"paper-loree-jama-oncol","kind":"paper","name":"Disparity of Race Reporting and Representation in Clinical Trials Leading to Cancer Drug Approvals From 2008 to 2018","route":"/key-papers/paper-loree-jama-oncol/"}]}}