Black Americans bear the highest burden of cancer deaths than any other race/ethnicity in the United States, yet they remain vastly underrepresented in cancer clinical trials. Although they make up more than 13% of the U.S. population, only about 5% of cancer trial participants are Black. For Dr. Vida Henderson, a behavioral scientist and former Assistant Professor at Fred Hutchinson Cancer Center, those numbers represent not only a data problem but a communication failure; one rooted in history, trust, and the way science reaches people.
In her new paper in BMC Public Health, Henderson and colleagues turned to an unlikely discipline for answers: marketing. Their project, called FOR US (short for Fostering Opportunities in Research Using marketing Strategies) adapted business-world marketing tools to create culturally responsive messages about clinical trials for Black communities. Rather than crafting messages behind closed doors, the team co-created them with the people they hoped to reach.
The researchers conducted six focus groups with 54 Black participants from around the country, including cancer survivors, caregivers, and community members. Participants spoke openly about why they distrusted medical research, what would make them consider participating, and how information should be delivered. The conversations revealed enduring skepticism shaped by racism in medicine and by the collective memory of exploitation in research. As one participant put it, “…Historically, the trust has been shattered. For us, no one’s ever had our best interests at heart. So, it’s just hard. Even though part of you [feels] scientifically, yes, you should probably be a part of this, there’s always going to be something in the back of our minds.”
Younger participants and those who had joined trials in the past were more open to trusting medical science. They wanted clarity, honesty, and representation. “I would have to see [in the PSA] Black doctors, Black nurses, people that look like me. Representation matters,” one person said. The sentiment was that the messenger mattered just as much as the message.
That input became the foundation of the FOR US public service announcement—The more I know, the more you know—a short film that tells the story of a father and daughter reflecting on a relative’s death from cancer. The father, now facing his own diagnosis, hesitates when offered a clinical trial. His daughter, a healthcare provider, meets his doubts with information and compassion rather than persuasion.
The researchers tested different versions of the video with additional focus groups, asking for honest feedback about tone, realism, and impact. Viewers called the story “relatable,” “clear,” and “real.” One participant said, “It makes me want to look into clinical trials and maybe how I can spread the word or participate myself. [I feel] motivated, empowered. The more I know, the more you know.” Another added, “It would start the conversation for sure—that uncomfortable conversation that a lot of people don’t want to have.”
The final version came in three lengths–30-, 60-, and 120-seconds so it could fit different platforms, from waiting room TVs to Instagram reels. Each included links to trusted resources such as cancer centers, advocacy organizations, and ClinicalTrials.gov the government’s listing of all clinical trials available to patients. The production cost—about $35,000—was modest for a professional campaign, yet the team designed it to be freely available and easily shared.
Dr. Henderson says the study shows that even in public health, communication can benefit from creativity and collaboration. “Our study demonstrates that marketing strategies traditionally used in business can be successfully adapted to public health to address inequities in cancer clinical trial participation,” she explained. “By partnering with Black community members, survivors, and caregivers to co-create culturally responsive PSA videos, we developed a pragmatic, low-cost, and scalable tool to increase awareness and knowledge about clinical trials. Importantly, the PSA directly acknowledged medical mistrust rooted in racism, incorporated authentic voices, and provided credible resources. This work expands the evidence base for culturally tailored dissemination strategies in cancer research, offering a new model for bridging gaps between clinical science and underrepresented communities.”
After completing the video, the team tested it with 109 Black cancer patients to measure its effect. The results were encouraging. “We piloted the PSA with 109 Black cancer patients to measure its impact on trust, knowledge, and decision-making self-efficacy,” Henderson said. “Intention to participate in a clinical trial, knowledge, and decision-making self-efficacy increased after participants viewed the video.”
Those early findings raise bigger questions, Henderson added. “How effective are culturally tailored marketing-based interventions at increasing actual enrollment in trials, not just awareness? What are the most cost-effective ways to share these tools across multiple platforms? And how might similar approaches be used with other groups who face barriers to trial participation?”
The FOR US project doesn’t claim to solve the long history of exclusion in medical research, but it does show what’s possible when science starts by listening. By blending community insight with marketing craft, Henderson’s team reimagines how research can reach those who have been left out or left behind.
This research was supported through funding from The V Foundation for Cancer Research and supplemental support from the Fred Hutchinson Cancer Center, the Andy Hill CARE Fund, and the University of Illinois Chicago.
Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium Member Dr. Vida Henderson contributed to this research.
Henderson, V., Carnahan, L., Cohn, E. B., Waite, A. W., Mersha, T., Block, R., Kolpack, M., Sommers, J., Salum, K., Hoskins, K. F., & Nguyen, R. (2025). "The more I know, the more you know" Using culturally responsive marketing strategies to develop tools that increase awareness about clinical trials among Black communities. BMC Public Health, 25(1), 3003.
Science Spotlight writer Darya Moosavi is a postdoctoral research fellow within Johanna Lampe's research group at Fred Hutch. Darya studies the nuanced connections between diet, gut epithelium, and gut microbiome in relation to colorectal cancer using high-dimensional approaches.
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