ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
"I'm tired of seeing my friends die": Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The trial behind it
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Who cites it
3 citing papers in PubMed.
- Experiences of pregnant and postpartum people of color engaged in a randomized clinical trial of medication to treat opioid use disorder during pregnancy: A "Positive Outliers" analysis.Journal of substance use and addiction treatment · 2026Article
- Bridging the rural cancer gap: why clinical trials must include rural patients.Cancer causes & control : CCC · 2025Article
- Preferences for clinical trial participation among people who use drugs in rural Oregon and Appalachian Ohio.Drug and alcohol dependence · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
purposeParticipation in clinical trials among people who use drugs (PWUD) in rural areas remains disproportionately low compared to those in urban communities. Our objective was to describe the barriers and facilitators to clinical trial participation among this understudied and underserved population.
methodsWe conducted semi-structured in-depth interviews among rural PWUD in Kentucky, Ohio, and Oregon. Using the Ickovics and Meisler framework, we classified factors associated with participation in clinical trials among rural PWUD into five categories: the individual, trial and intervention characteristics, participant-trial staff relationship, clinical trial setting, and features of the disease. We used inductive qualitative analysis methods to identify salient themes.
findingsThirty-five rural participants (median age: 39, 51% men) completed in-depth interviews. Facilitators for rural clinical trial participation were mainly situated within the individual, trial and intervention characteristics, and clinical trial setting. Individual characteristics, such as altruistic motivations to help their communities and peers, as well as trial and intervention characteristics like visit reminders and resource assistance, were the most frequently noted facilitators of clinical trial participation. In contrast, participation barriers were mainly related to participant-trial staff relationships and disease features. Judgmental and untrustworthy trial staff, along with involvement in the criminal legal system, were obstacles to clinical trial participation.
conclusionsIndividual, intrapersonal, and logistical factors described by rural PWUD must be addressed to enhance the participation and retention of this population in clinical trials. Successful clinical trial participation may contribute to equitable access to essential health services by PWUD in rural communities.
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