Research Discovery: Bringing Clinical Trials Closer to Home

How remote and local research options may make participation possible for more people

What It Is

Clinical trials help researchers learn whether new treatments, tests, and approaches are safe and effective. But traveling to a major medical center for study visits can make participation difficult, especially for people in rural communities, those who live far away, and people balancing transportation, work, cost, or caregiving challenges.

Mayo Clinic's Clinical Trials Beyond Walls program seeks to make clinical research more accessible by offering opportunities for selected study activities to be completed remotely or closer to where participants live. This approach can reduce travel requirements and enhance convenience for participants.

How It Works

A decentralized clinical trial is not necessarily conducted entirely at home. Depending on the study, participants may be able to:

• Review and sign consent forms remotely

• Meet with the research team through video appointments

• Have blood samples collected at home

• Share health data using mobile or wearable devices

• Complete questionnaires and symptom reports electronically

• Receive eligible study medications remotely

Research teams are supported through training and consultation on technical, budgeting, and regulatory considerations. Recognizing that access to technology can be a challenge for some participants, the program can provide cellular-enabled devices, participant education, and dedicated technical support to facilitate engagement.

Community input helped shape the program before the pilot launched. Tufia Haddad, M.D., and her team met with the Midwest Rural Health Research Community Advisory Board (CAB) to gather feedback on the proposed program. CAB members shared perspectives on participant needs, challenges, and ways to make trials more practical for rural and underserved communities. Their feedback helped inform the program's design.

Researchers evaluated participation data from January 2024 through March 2025, including 7,469 participants in 765 decentralized clinical trials.

Key Findings

The evaluation found encouraging trends:

• Distance: Participants living more than 120 miles from a Mayo Clinic academic medical center increased from 18.9% to 29.6%.

• Rural participation: Participation among people living in rural communities increased from 16.6% to 24.9%.

• Broader representation: Participation among populations identified as historically underrepresented in clinical trials increased from 12.5% to 17.4%.

• Age and sex: Age distributions were generally similar across distances, and participation by men and women remained nearly equal.

These findings suggest remote and local options may expand access, but the study was not designed to prove the program directly caused the increases. Other changes in available trials or participant populations may also have contributed.

Community Impact

Bringing parts of a clinical trial closer to home may reduce travel, time, and financial burdens and make participation more realistic for people who live far from medical centers, face transportation challenges, balance work or caregiving, or have historically been underrepresented in research.

More representative participation can help researchers understand how treatments and health care approaches work across the communities that may ultimately use them, making findings more relevant and supporting more equitable access to research.

Although decentralized clinical trials can expand access to research, remote participation may not be feasible for everyone. Challenges such as limited internet access, technology concerns, and operational requirements can affect both participants and research teams. In addition, this evaluation was conducted within a single health system and did not assess participant satisfaction, study retention, or outcomes at other organizations. Further research is needed to better understand the broader impact of these approaches.

Questions to Ask a Research Team

• Which study activities can be completed remotely or close to where I live?

• Which visits or procedures require travel to a study site?

• What technology, equipment, or training will be provided?

• What support is available if I have technical difficulties?

• Are transportation, lodging, or other participation-related expenses covered or reimbursed?

Key Takeaway

Clinical trials should be designed with participants' daily lives and communities in mind. Remote and local options may expand access and broaden participation. Continued partnership with participants, community advisors, and local organizations can help make research more accessible, practical, and representative.

Researcher: Tufia C. Haddad, M.D. (ACTS RP)