{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:33:08Z","timestamp":1792773188552,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Equitable participation in clinical trials is essential for ensuring that research evidence is scientifically robust, ethically just and representative of the populations it is intended to serve. In Australia, culturally and linguistically diverse (CALD) populations remain underrepresented in clinical trials despite increasing national policy attention to equity and inclusion. This review synthesized empirical evidence and Australian policy and practice documents to examine factors influencing CALD participation in clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To synthesize evidence on CALD attitudes, perceptions and factors influencing clinical trial participation in Australia; examine reported barriers and facilitators; describe how CALD populations have been conceptualized across the literature; and identify implications for research, practice and policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review was conducted in accordance with Joanna Briggs Institute guidance and reported using PRISMA\u2011ScR. Five electronic databases were searched for English\u2011language primary studies published between 2006 and June 2025. Eligible studies examined CALD adults' perceptions, experiences or participation in Australian clinical trials. A targeted synthesis of Australian grey literature was undertaken to contextualize empirical findings within the national policy and practice landscape. Data were charted and synthesized narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight empirical studies and seven Australian policy and practice documents were included. Five themes emerged from the empirical literature: (1) willingness to participate exists but opportunity is structurally constrained; (2) language and health literacy are pervasive barriers; (3) cultural values, family involvement and trust shape participation decision\u2010making; (4) system\u2010level practices limit equity monitoring and inclusion; and (5) inconsistent implementation of feasible facilitators. Policy documents increasingly recognized these same structural determinants and proposed system\u2010level strategies to improve equitable participation; however, nationally consistent implementation and accountability mechanisms remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinical trial participation among CALD populations should be understood as a dynamic, multi\u2010level decision\u2010making process rather than a single recruitment or informed consent event. Although Australia's policy landscape increasingly recognizes the structural determinants of equitable participation, implementation remains fragmented. Future efforts should prioritize culturally responsive, evidence\u2010informed and measurable approaches that support equitable participation throughout the clinical trial pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>This scoping review synthesized published literature and did not involve the direct collection of data from patients or members of the public. The analysis, interpretation and framing of the findings were directly informed by patient and community perspectives reported in the included studies, many of which involved CALD consumers, carers and community members. The review was designed to amplify these perspectives and identify system\u2011level changes to improve equity in clinical trial participation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70804","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:44:01Z","timestamp":1788515041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceptions, Barriers and Pathways Forward: A Scoping Review of CALD Participation in Australian Clinical Trials"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8556-8220","authenticated-orcid":false,"given":"Thy","family":"Vuong","sequence":"first","affiliation":[{"name":"Cardiology Department Canberra Health Services Garran Australian Capital Territory Australia"},{"name":"Rush University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-2137","authenticated-orcid":false,"given":"Manju","family":"Daniel","sequence":"additional","affiliation":[{"name":"Rush University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Lambert","sequence":"additional","affiliation":[{"name":"University of Canberra Bruce Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Australian Government Department of Health and Aged Care \u201cClinical Trials Activity Initiative \u201d published 2024 https:\/\/www.health.gov.au\/our-work\/mrff-clinical-trials-activity-initiative."},{"key":"e_1_2_12_3_1","unstructured":"Australian Government Department of Health Disability and Ageing \u201cNational Health and Medical Research Strategy 2026\u20132036 \u201d Commonwealth of Australia published 2026 https:\/\/www.health.gov.au\/sites\/default\/files\/2026-05\/national-health-and-medical-research-strategy-2026-2036.pdf."},{"key":"e_1_2_12_4_1","unstructured":"World Health Organization \u201cClinical Trials \u201d updated 2025 https:\/\/www.who.int\/health-topics\/clinical-trials\/."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2451190"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-42"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-016-1384-3"},{"key":"e_1_2_12_8_1","volume-title":"National Statement on Ethical Conduct in Human Research 2025","author":"National Health and Medical Research Council, Australian Research Council, Universities Australia","year":"2025"},{"key":"e_1_2_12_9_1","unstructured":"Council for International Organizations of Medical Sciences \"International Ethical Guidelines for Health\u2010related Research Involving Humans 4th ed. 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