"It's Like Disrupting Internally:" a Qualitative Study of Opportunities and Limitations to Promote Diversity in Participant Recruitment in Health Research.

Despite bearing a disproportionate burden from poor health outcomes, members of racial and ethnic groups who experience health disparities are consistently underrepresented in health research. While many have sought to understand this problem by focusing on community mistrust of science, there is increasing recognition that research teams' attitudes and practices contribute to the lack of diversity in research participation in multiple ways. In this study, we explored the experiences of research team members as they attempted to implement practice changes to increase the recruitment of underrepresented participants from racial and ethnic minoritized groups. Investigators and research team members (n = 33) who attended a one-day workshop on inclusive strategies in research recruitment were interviewed three months after the training. The interviews were virtual, audio-recorded, and fully transcribed. Thematic analysis followed the guidelines set out by Braun and Clarke. Analysis revealed themes including the importance of team culture, the presence or absence of shared values, and resources (time, funds, relationships), as well as leadership "buy-in" for participants' ability to implement inclusive recruitment strategies. Findings point to the structure, culture, and history of conducting science as obstacles to researchers' ability to implement strategies to address the lack of diversity in research participation.