IV 
113TH CONGRESS 
2D SESSION 
H. RES. 510 
Expressing the sense of the House of Representatives that the National 
Institutes of Health should develop a pilot program to improve medical 
trial participation, retention, efficiency, effectiveness, and diversity. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2014 
Mr. KINGSTON submitted the following resolution; which was referred to the 
Committee on Energy and Commerce 
RESOLUTION 
Expressing the sense of the House of Representatives that 
the National Institutes of Health should develop a pilot 
program to improve medical trial participation, retention, 
efficiency, effectiveness, and diversity. 
Whereas clinical trials are essential for improving our Na-
tion’s health; 
Whereas economically disadvantaged individuals, the elderly, 
females, and ethnic and racial minority groups, especially 
African-Americans, Hispanic or Latino Americans, Na-
tive Americans or Native Alaskans, Asian or Pacific Is-
landers, are underrepresented in clinical trials, thereby 
threatening the applicability of trial results for the gen-
eral population; 
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•HRES 510 IH 
Whereas minority groups account for more than 30 percent 
of the United States population, yet collectively rep-
resented only 12.3 percent of all publically funded cancer 
trials from 2003 to 2005; 
Whereas a 2012 study supported by the National Cancer In-
stitute found that in patients 65 and older lower income 
predicted lower trial participation, even while being near-
ly universally covered by the Medicare program; 
Whereas a national survey of cancer patients found that 85 
percent of respondents were unaware that participating 
in a clinical trial was an option for them; 
Whereas cancer patients with annual incomes of less than 
$20,000 are 44 percent less likely and those with annual 
incomes of less than $50,000 are 30 percent less likely 
to participate in clinical trials than cancer patients with 
higher incomes; 
Whereas in a 2001 survey of African-American physicians, 93 
percent of physicians cited lack of patient awareness as 
a possible factor contributing to low rates of African- 
American trial participants and 92 percent of physicians 
cited mistrust of the medical community; 
Whereas lack of health insurance is a major concern for po-
tential trial participants, with only 5.4 percent of all Na-
tional Cancer Institute sponsored cancer treatment trial 
participants being patients who choose to participate de-
spite not having health insurance; 
Whereas a 2007 to 2011 study found that 53 percent of pa-
tients earning less than $20,000 were concerned about 
how to pay for a trial, compared to 25 percent of patients 
that earned more than $100,000; 
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•HRES 510 IH 
Whereas the National Institute of Health Revitalization Act 
of 1993 requires applicants for Federal research funding 
to provide a strategy for inclusion of women and people 
of diverse racial and ethnic origins into clinical trials, but 
21 percent of studies having received Federal research 
funding since then have failed to report sample sizes by 
racial or ethnic group; 64 percent did not provide any 
analysis by racial or ethnic group; and 75 percent did not 
report any outcomes by sex; and 
Whereas increasing participation rates of underrepresented 
demographic groups in clinical trials would give physi-
cians and researchers greater confidence that the results 
of those trials would apply as broadly as possible to all 
patients in the population: Now, therefore, be it 
Resolved, That it is the sense of the House of Rep-
resentatives that— 
(1) the National Institutes of Health is encour-
aged to use its existing budget and authority to es-
tablish a pilot partnership with nonprofit organiza-
tions that hold prior experience and expertise in di-
verse community outreach and trial accrual in order 
to increase the efficiency and effectiveness of clinical 
trials of the National Institutes of Health, increase 
patient enrollment and retention in such trials, and 
address the lack of diversity in such trials; and 
(2) the goals of the pilot partnership should in-
clude, but should not be limited to, providing clinical 
trial navigation services to help patients find, enroll, 
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•HRES 510 IH 
and manage the logistical issues related to enroll-
ment and retention in federally supported clinical 
trials, and to improve participation by populations 
such as underrepresented and uninsured individuals 
in appropriate clinical trials. 
Æ 
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