If you spend enough time inside clinical research, you understand something that isn’t written into a protocol or a sponsor’s deck: sites are where the magic actually happens. They’re the places where scientific plans meet real people, each with their own history, concerns, and hopes.
I’ve met with site teams across the country, and the truth is always the same. Research doesn’t move forward because a document says it will. It moves because the people inside those sites care enough to guide each participant through the process.
But that magic is happening within a system facing a real equity challenge. A BMJ Medicine study from January 2023 found that just 16% of sponsors adequately represented communities of color in pivotal trials, meaning approximately 84% of sponsors did not meet adequate inclusion. This number hasn’t shifted enough, even with more attention on outreach and access.
Why do clinical trials face this gap? It isn’t about advertising. It isn’t about incentives. It’s about trust—which must be built with communities, not around them. And that means reframing how we see research sites: not as passive endpoints that simply follow instructions, but as essential partners in ensuring every study is conducted with integrity and inclusion at the center.
Before we can build stronger partnerships, we have to understand what sites are actually up against. That’s why our conversations with site teams never start with a long explanation of what Acclinate does. Instead, we begin by asking questions:
Across sites, the answers tend to echo one another.
Coordinators and site staff are carrying heavy loads. They’re running day-to-day operations, managing regulatory tasks, checking on participants, communicating with sponsors, juggling scheduling, and handling more administrative work than most people realize. Many of them want to connect with the community, but they don’t have the time to design strategies or attend local events. They also haven’t been trained as community engagement specialists, and expecting them to pick up that skill overnight isn’t realistic.
Some sites share past attempts at outreach that fell flat—not because they didn’t care, but because pulling off a successful event takes planning, staffing, and support they simply didn’t have. Others are almost completely reliant on their internal patient pool for recruitment, even when that pool lacks the diversity the study needs.>
This puts sites in a tight spot. They see the importance of connecting with underrepresented communities. They understand the value of inclusive trials. But without extra hands or expertise, they can’t build trust at the pace research requires.
This is where integrity comes into play. We can’t solve problems we haven’t bothered to fully understand. Listening is the starting point for any honest partnership.
Before we can build stronger partnerships, we have to understand what sites are actually up against.
A strong partnership should never add pressure to an already busy site. If anything, it should clear space for the site to do what it does best. At Acclinate, our model is designed to be a practical support system—one that blends into the site’s world instead of disrupting it.
This support comes to life in two steps.
We hold regular working sessions with our site partners. These aren’t check-the-box conversations. They’re open discussions where we learn about their patient population, the surrounding community, and the specific barriers their team has encountered. We also ask about the ways they prefer to show up.
The strategy has to match what the site can realistically sustain.
Once we understand their world, we act. Activation is where partnership becomes tangible. Instead of handing a site a stack of materials and wishing them good luck, we step in as their hands-on engagement arm:
These steps will never replace the sites themselves but amplify them. Community members can feel when a site is showing up with genuine interest—and that’s what builds trust.
The moments that stay with me most are the ones where sites see the impact of collaboration firsthand.
At one event, a site partnered with us to offer blood pressure checks. That simple service opened the door to meaningful conversations, allowing the team to identify five potential participants for ongoing studies.
At another, site staff watched community members freely share stories about their health challenges. Those conversations made the staff feel more confident engaging with people who had never considered research before. By the end of the event, they had identified three potential participants.
These examples may seem small, but they reveal an important truth: sites become far more approachable when they step into the community instead of staying behind clinic walls. People recognize them. They ask questions. They feel safe.
That sense of safety builds what many call affective trust—the kind of trust grounded in feeling understood, not just informed. Affective trust is often the tipping point that turns curiosity into willingness.
And willingness is the heart of enrollment.
Collaboration alone isn’t enough to achieve better health outcomes. Integrity must play an equal role. Integrity, in this work, looks like:
Integrity shows up when the site is transparent about what a study involves. It shows up when our team reinforces accurate expectations. And it shows up when community members feel empowered—not overwhelmed—after a conversation.
This steady, grounded approach is what strengthens long-term relationships between sites and the people they hope to serve.
Building a Future Where the Magic Grows
Eighty-four percent of trials missing diversity goals can feel heavy. But it also tells us something encouraging. Communities are not uninterested. Sites are not unwilling. Sponsors want better representation. The missing piece is shared effort.
When sites are supported, community members feel seen. When collaboration is real, recruitment becomes more accessible. When integrity guides every choice, the entire process becomes safer and more transparent.
The magic at clinical research sites isn’t accidental. It grows when collaboration feels natural and when integrity guides every step.
Our responsibility is to keep clearing barriers for the teams doing the work on the ground. When we do that, sites become stronger partners. Communities feel more comfortable exploring research. And health outcomes begin to shift in the direction we all want.
Because this isn’t just about running studies. It’s about building relationships that last long after a protocol closes.
And that’s where the real magic lives.
Want to know more about our novel approach to clinical site partnerships? Schedule a 1:1 with our team.