A Collaborative Framework to Enhance Clinical Trial Participation and Health Equity in Sulawesi Island, Indonesia

Introduction: In this study, we aimed to develop and evaluate a collaborative framework for integrating clinical trials into primary health care within the context of addressing health disparities in Sulawesi Island, Indonesia. With notable regional disparities in health service utilization and participation in clinical trials reported in the 2018 Indonesian Basic Health Survey, our objective was to bridge gaps in clinical trial access and improve health outcomes in underserved areas. Methods: This quasi-experimental post-test control group study involved the implementation of a collaborative framework conducted across primary health care settings in Sulawesi over a six-month period. A total of 200 participants were enrolled, and data were collected through electronic health records (EHRs), surveys, and interviews. Ethical approval was obtained from the relevant ethics committee, and participants provided written informed consent. Results: The primary outcome of the study was a significant increase in clinical trial participation, with rates rising from 25% to 60% in the intervention group, compared to 20% to 30% in the control group. Additionally, health outcomes improved, including reductions in average blood pressure (140/90 mmHg to 130/85 mmHg) and blood glucose levels (160 mg/dL to 140 mg/dL). Statistical analyses revealed a p-value of <0.05 for these changes. Key factors contributing to these results included training on digital health technologies and integration of trial data into EHRs. Conclusion: In conclusion, our study contributes to the understanding of health equity by demonstrating the effectiveness of a localized collaborative framework in improving clinical trial participation and health outcomes. This research provides insights into the importance of tailored interventions, digital health infrastructure, and training programs in addressing disparities in underserved regions. Future studies should address the scalability and long-term impact of this framework, ultimately advancing health equity in Indonesia.