Dismantling Barriers: Washington State Works to Improve Diversity in Clinical Trials

In 2023, Washington State Governor Jay Inslee signed WA HB1745 into law. This bill has the goal of increasing diversity in clinical trials by addressing systemic barriers that can limit participation. This bill adds a requirement that any state entity or hospital receiving funding from the National Institutes of Health must take the following steps to update their clinical trials conduct:

• Adopt a policy promoting the identification and recruitment of persons who are members of underrepresented demographic groups to participate in clinical trials. This policy must include requirements that investigators who are conducting clinical trials collaborate with community-based organizations and use methods recognized by the United States Food and Drug Administration to identify and recruit such persons to participate in those clinical trials.
• Provide information to trial participants in languages other than English.
• Provide translation services or bilingual staff for trial screening.
• Provide culturally specific recruitment materials alongside general enrollment materials and provide electronic consent when not prohibited by the granting entity or federal regulations.

These additions align with recommendations in a report by the Washington State Department of Health. The report, “Improving Diversity in Clinical Trials,” was released in 2023 and is a component of HB1745. It provides additional recommendations on improving diversity in clinical trials by analyzing:

• Which demographic groups and populations are currently represented and underrepresented in clinical trials in Washington, including geographic representation.
• Barriers for members of underrepresented demographic groups to participation in clinical trials in the state, including those related to transportation.
• Approaches for how clinical trials can partner with community-based organizations and others to connect with underrepresented communities

The report found that building relationships with community-based organizations and community members is a key aspect of improving diversity, since many existing barriers vary among demographic groups, with no universal solution removing all barriers.

Washington State’s approach to removing clinical trial participation barriers is particularly proactive in considering not only current tangible barriers, but also by reflecting on the history that has created those barriers. It mirrors prospective federal legislation like the Clinical Trial Modernization Act, which is progressing through Congress in 2024. To ensure that federal standards maintain parity with those at the state level, please consider writing to Congress in support of this bill here.