Florence Supports Diversity in Clinical Trials Through a Partnership with the Meharry-Vanderbilt Alliance

Florence Healthcare is committed to supporting Diversity, Equity & Inclusion (DE&I) initiatives in clinical trials, both through the use of its software and philanthropic investment in the community. Earlier this year, Florence’s executive leadership reached out to their colleagues and asked how Florence could do more to support diversity initiatives at the local level. 

The Meharry-Vanderbilt Alliance (MVA) offered an answer to this question.  Florence could fund an internship for a Meharry Medical College physician interested in connecting with underserved patients and helping them engage in clinical trials.  

Black physicians are underrepresented in medicine and often face discrimination, making Meharry Medical College’s work as a Historically Black College/University (HBCU) medical school vitally important. Florence’s fellowship allows a Meharry graduate to work on a range of clinical trials that serve underrepresented patients through the Meharry-Vanderbilt Alliance. 

The fellowship recipient for 2022 is Dr. Shantal Salandy, a Meharry graduate with a passion for pediatric medicine and mental health in underserved children and teens. When asked about her internship, she said, “My role is to break barriers when it comes to reaching out to underrepresented patients and introducing them to clinical trials.” 

Keep reading to learn about the process of building a diversity internship and how Dr. Salandy’s work will give more patients access to research.

How to Build a Diversity Internship

Faced with the prospect of creating a clinical trial diversity internship from scratch, Catherine Gregor, Florence’s Chief Clinical Trials Officer, turned to Dr. Karen Winkfield, MD, PhD. Dr. Winkfield is the Executive Director of MVA, as well as a presidential appointee to the National Cancer Advisory Board. Her work is largely focused on health equity and improving patient access to cancer care across all populations.    

Dr. Winkfield and her team suggested supporting a doctor who had graduated from Meharry but not yet started their residency. This physician would gain experience in clinical trials while also working with underrepresented populations. 

Gregor and Dr. Winkfield’s teams structured the internship role, determining that the physician would create a poster presentation for a major clinical research conference at the end of 9 months. They would also give a presentation to Florence on barriers to patient recruitment and inclusive clinical trial design.

“This program is exciting from a larger clinical trials perspective; in that it is not only an opportunity to learn more about patient engagement and barriers to participation, it is also an opportunity to contribute to the growth and diversification of the workforce by getting more physicians of different backgrounds involved in clinical research,” said Gregor. 

Unfortunately, 49% of investigators participate in just one clinical trial and never return. By giving physicians, especially diverse physicians, more training and support, MVA and Florence hope to reduce that number. 

In addition to working with clinical trial patients, Dr. Salandy will have the opportunity to attend Florence events, like the Research Revolution clinical trials conference. 

When asked why she chose to apply for the internship, Dr. Salandy said, “Florence is giving me the opportunity to learn about translational and clinical research post-medical school and to determine if it’s right for me.”

Dr. Salandy’s Health Equity Mission 

Dr. Salandy decided she wanted to work in pediatric medicine when she was 6 years old. “I knew I wanted to do pediatric medicine because I love children and babies,” she says. But her desire to work with children is accompanied by a desire to improve health equity. 

The same year she applied to medical school, Dr. Salandy worked with AmeriCorps as a community health worker in NYC. She provided:

• Educational sessions on harm reduction and overdose prevention
• Links to inpatient and outpatient substance abuse programs
• Treatment for Hepatitis C and HIV/AIDS across Brooklyn, Queens, and the Bronx
  

This experience brought her face-to-face with multiple health inequalities.

“For example, a lot of medication for HIV treatment was mostly geared toward white, gay males,” Dr. Salandy points out. “Men who identified as black and gay or women who were at high risk for HIV and AIDS weren’t getting treatment for years after it was already available. And they were left out of a lot of the clinical trials.” 

Although health inequalities with HIV treatment began in the 80s and 90s, they persist today–as do inequalities caused by the opioid pandemic. “A lot of the research was geared toward white families and white individuals who have used drugs, but not to Black or Hispanic families,” says Dr. Salandy. 

“And in New York, there’s a huge epidemic of HIV, AIDS, and Hepatitis C transmission going on specifically because of IV drug use. So new treatments for HIV, AIDS, and Hepatitis C ties into the Meharry-Vanderbilt Alliance and also to clinical trials.” This tie-in prompted Dr. Salandy to apply for the Florence-MVA internship.

If you’d like to learn more about improving health equity in clinical trials, the Florence team offers the following resources:

• How to Improve Patient Diversity in Clinical Trials
• FDA Guidance for Diversity in Clinical Trials: What You Need to Know
• Breaking Down the FDA’s 2022 Guidance on Diversity
• How Community Sites Can Improve the Lack of Diversity in Clinical Trials

Partnering with Florence and the Meharry-Vanderbilt Alliance

At Meharry Medical College, Dr. Salandy continued her commitment to diversity and inclusion, joining the Student National Medical Association’s HIV/AIDS Subcommittee and leading harm reduction initiatives on campus. 

She also continued her commitment to pediatric health. “Kids are still a huge part of the medical community that gets overlooked. They often miss out on treatments because we don’t know how they’re going to affect them.”

Dr. Salandy wants to see more of a focus on mental health and the management of chronic illnesses among children. This means building trust with their families and making trials more patient-centric. “Their family and their community may not be comfortable giving kids medication. Whether that means psychological medications, or taking preventative medicine for HIV while pregnant.”

“Kids also get left out of conversations about mental health in general. There’s a lot we don’t know about identifying and treating mental health needs in kids.” 

By participating in the Florence-MVA diversity internship, Dr. Salandy hopes to bring clinical trials to patients that have often been excluded from them, including Black patients, Latino patients, and children. 

The internship has already given her the opportunity to work with an HPV vaccine trial. Her role is to survey parents and guardians on whether they’ll choose HPV vaccination for their children and why. In the process, she hopes to learn more about how to build trust with families from underrepresented communities. 

“My role is to break barriers when it comes to reaching out to underrepresented patients and introducing them to clinical trials. We need to find out what those barriers are and how to overcome them so we can better reach local communities,” Dr. Salandy says. She plans for her internship to begin this process.

The Results of the Florence-MVA Internship

As of this writing, Dr. Salandy is involved in helping the HPV vaccine trial earn Institutional Review Board (IRB) approval. She hopes to continue learning more about clinical trials before presenting to Florence and creating her research poster in February 2023. She will then begin her residency. 

After Dr. Salandy’s departure, Florence will continue supporting internships and fellowships to make clinical trials more inclusive. 

As Catherine Gregor said in a presentation for Pharmaceutical Executive, “In terms of clinical trial staff, we want people in the room who look like the patients we’re trying to reach. We want to make sure that we have people who are representative of all cultures, all sexual orientations, and all socioeconomic backgrounds because they’re the ones who are able to make genuine connections and establish trust.” 

With this in mind, Florence and the Meharry-Vanderbilt Alliance are committed to supporting diverse clinical research teams who can serve underrepresented patients.

To learn more about the movement toward diversity and inclusion in clinical trials, check out Catherine Gregor’s discussion of the FDA 2022 diversity guidelines and how clinical trial organizations can not only follow them but go beyond them.