{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:33:14Z","timestamp":1789522394582,"version":"build-2803163510"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017540","name":"NHLBI Division of Intramural Research","doi-asserted-by":"publisher","award":["OT2 HL156812"],"award-info":[{"award-number":["OT2 HL156812"]}],"id":[{"id":"10.13039\/100017540","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>The COVID-19 pandemic revealed glaring problems with clinical research enterprise. Faced with crisis, several trials opened rapidly but enrolled homogenous populations with few Black, Indigenous, and People of Color (BIPOC) individuals. Inclusive trial enrollment is important to inspire trust and confidence in BIPOC populations that have been historically excluded or harmed from research and to improve the generalizability of research findings. Safety-net hospitals and institutions often care for BIPOC populations, and thus it is essential to improve equitable participation in research at these institutions. In this study, we sought to understand barriers and facilitators to research participation at safety net institutions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted semi-structured interviews among principal investigators, research assistants, research coordinators, and research nurses who conducted human subjects research at an urban, safety-net hospital from October, 2022 to December, 2022. We used inductive qualitative methods to identify themes associated with barriers and facilitators to clinical research participation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We completed 28 interviews and identified five themes: (1) compared to non-safety net systems, safety-net systems were perceived to require additional resources and funding to achieve comparable research recruitment and retention; (2) language barriers and translational processes are burdensome for researchers; (3) interactions between research staff and patients impact trust; (4) social determinants of health specific to safety-net populations are a barrier to participation; (5) competing priorities between clinical staff and researchers exist.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Safety net institutions face several barriers to conducting human subjects research. However, identified facilitators may help inform future efforts to reduce inequities in research participation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313530","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T19:23:30Z","timestamp":1736364210000},"page":"e0313530","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Barriers and facilitators to conducting human subjects research at a safety net institution from the perspective of researchers"],"prefix":"10.1371","volume":"20","author":[{"given":"Sarah J.","family":"Barnes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yewon","family":"Na","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari-Lynn","family":"Drainoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A.","family":"Linas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7161-5254","authenticated-orcid":true,"given":"Nicholas A.","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Autumn L.","family":"Tamlyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"issue":"12","key":"pone.0313530.ref001","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1001\/jama.2021.3284","article-title":"Emerging Lessons From COVID-19 for the US Clinical Research Enterprise","volume":"325","author":"DC Angus","year":"2021","journal-title":"JAMA"},{"issue":"17","key":"pone.0313530.ref002","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1001\/jama.2021.17272","article-title":"Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial","volume":"326","author":"JM Connors","year":"2021","journal-title":"JAMA"},{"issue":"27","key":"pone.0313530.ref003","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine","volume":"383","author":"FP Polack","year":"2020","journal-title":"N Engl J Med"},{"issue":"3","key":"pone.0313530.ref004","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1164\/rccm.202105-1210ST","article-title":"Enhancing Recruitment and Retention of Minority Populations for Clinical Research in Pulmonary, Critical Care, and Sleep Medicine: An Official American Thoracic Society Research Statement","volume":"204","author":"N Thakur","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"pone.0313530.ref005","doi-asserted-by":"crossref","first-page":"e0258858","DOI":"10.1371\/journal.pone.0258858","article-title":"Increasing Black, Indigenous and People of Color participation in clinical trials through community engagement and recruitment goal establishment","volume":"16","author":"MP Andrasik","year":"2021","journal-title":"PLOS ONE"},{"issue":"12","key":"pone.0313530.ref006","doi-asserted-by":"crossref","first-page":"A297","DOI":"10.1289\/ehp.123-A297","article-title":"Racial and Ethnic Disparities in Research Studies: The Challenge of Creating More Diverse Cohorts","volume":"123","author":"L Konkel","year":"2015","journal-title":"Environ Health Perspect"},{"issue":"6","key":"pone.0313530.ref007","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/bdi.12638","article-title":"Racial disparities in bipolar disorder treatment and research: a call to action","volume":"20","author":"MO Akinhanmi","year":"2018","journal-title":"Bipolar Disord"},{"issue":"1","key":"pone.0313530.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3758\/s13415-022-01040-w","article-title":"Racial disparities in EEG research and their implications for our understanding of the maternal brain","volume":"23","author":"F Penner","year":"2023","journal-title":"Cogn Affect Behav Neurosci"},{"key":"pone.0313530.ref009","unstructured":"Institute of Medicine (US) Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers. 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