Clinical Trial Enrollment · Diversity

Earning trust at the
speed of text.

Closing the diversity gap in clinical trials by sending pharma's already-tested messages to the right patients — in the voice of the one person they actually trust.

98%
SMS open rate within 3 minutes
Faster treatment starts
Higher adherence through trial
9:41
MP
Dr. Maya Patel
Hematology · Mass General
Today · 11:02 AM
Hi James — saw you yesterday at clinic. I want to share a 2-min video about a trial you'd qualify for.
Watch · From your doctor
What this trial is —
and what it isn't
2:14
No pressure. Watch with Renee. We'll talk Tuesday.
iMessage
The Diversity Gap
75%
of participants in trials for 53 FDA-approved drugs were white.
White (75%)
Hispanic (11%)
Black (8%)
Asian (6%)
Source: FDA Drug Trials Snapshots, 2020.
The Real Barrier

It isn't that diverse patients don't know about trials.
It's that they have very good reasons not to trust them.

22%
fear being treated like guinea pigs
31%
fear receiving placebo instead of real treatment
These aren't irrational fears — and they aren't fixed by a recruitment website. They are inherited, specific, and earned. Treating them as a marketing problem is why the gap hasn't closed in thirty years.
The Long Shadow

When patients say no, they're protecting themselves with information their grandparents earned the hard way.

1845–1849
J. Marion Sims
Father of modern gynecology performs surgical experiments on enslaved Black women — without anesthesia, without consent.
1932–1972
Tuskegee Syphilis Study
U.S. Public Health Service withholds treatment from 399 Black men with syphilis for 40 years to study disease progression. Penicillin existed by 1947.
1951
Henrietta Lacks
Cells taken without consent from a Black cervical cancer patient become the most-used cell line in research history. Her family learns 25 years later.
1907–1980
Forced Sterilizations
More than 60,000 Americans sterilized without consent under state programs — disproportionately women of color, the poor, and disabled.
This isn't ancient history. It is, for many families, two grandparents ago.
The Current Playbook

Pharma already does the hard work. The validated message just never reaches the patient.

01
Message Tested
Focus groups, IDIs, segmentation
02
Insight Validated
What works, segment by segment
03
Trapped in a Deck
Findings live in the research file
04
Patient · Ignored
Unknown number. Generic brochure.
The Break
The validated message never travels in the validated form — and the patient never hears it in the voice that would make them believe it.
The Hoot Solution

One physician. One year.
A trust relationship, told in text messages.

From the first outreach to the day the trial ends — every touchpoint is the patient's own doctor, on their phone, in the moment trust is at risk. Here is what that looks like.

365 Days · 1 Physician · 10 Touchpoints
Phase One · Earning Trust

Day 0 → Day 14

From referral to enrollment decision.
Day 0 · The Outreach

"This is your doctor."

Within 24 hours of referral, the patient hears from the one person they actually trust — not a recruiter from an unknown number.

98% read within 3 minutes
1
Day 0
11:02
MP
Dr. Maya Patel
Hematology
Today · 11:02 AM
Hi James — Dr. Patel here. After our visit yesterday, I want to share something important about a trial you'd qualify for.
From Dr. Patel
What this trial is —
and what it isn't
2:14
No pressure. Watch when you have a quiet moment.
2:18
MP
Dr. Maya Patel
Hematology
Day 2 · 2:18 PM
I know there's history that makes trust hard. I want to be direct with you.
From Dr. Patel
How modern trials are run
3:02
IRB oversight. No withholding of standard care. You can leave at any time.
2
Day 2
Day 2 · The Acknowledgement

The history named.

Most pharma copy avoids the word "Tuskegee." Hoot doesn't. We name what was done — and what's different now. That's how trust gets earned.

Patient & community-validated content
Day 4 · The Mirror

Someone who looks like you.

A patient story video — from a participant in the same community, who completed this same trial. The decision suddenly feels less alone.

Personalized to patient typology
3
Day 4
10:14
MP
Dr. Maya Patel
Hematology
Day 4 · 10:14 AM
I want to introduce you to Marcus. He went through this trial last year.
Patient Story
"Why I said yes —
and what I'd do again"
4:21
Watch when you have time. Renee can watch with you.
4:42
MP
Dr. Maya Patel
Hematology
Day 14 · 4:42 PM
No rush. When you and Renee are ready, here's how the first visit works — and what we do for transportation.
We cover travel. Childcare too. You decide on your timeline.
ok we're in. let's set it up
Thank you for trusting me with this. We'll set it up tomorrow.
4
Day 14
Day 14 · The Decision

Yes — without pressure.

No salesy follow-ups. No countdown. Just the doctor returning when ready. Patients who arrive this way enroll faster and stay longer.

10–20% faster time to full enrollment
Phase Two · Keeping Trust

Week 2 → Month 12+

15–40% of trial patients drop out. Hoot intercepts every moment of doubt.
Week 2 · The First Doubt

Side effects hit.
Most patients quit here.

Before the patient calls anyone — before they Google their symptoms in panic — the doctor returns to explain what's happening, and why feeling worse first is part of how the treatment works.

Intercept window: 24–72 hours
5
Week 2
7:08
MP
Dr. Maya Patel
Hematology
Week 2 · 7:08 AM
James — Day 14 is the hardest. You're probably feeling worse than before. That's expected.
From Dr. Patel
Why you feel worse first
1:48
Two minutes. Please watch before you decide anything.
9:30
MP
Dr. Maya Patel
Hematology
Week 6 · 9:30 AM
James — six weeks. You made it through the hardest part. I'm proud of you.
Milestone
First six weeks: what your
numbers are showing us
2:55
6
Week 6
Week 6 · The First Win

"I'm proud of you."

Doctor returns by name. Reinforces that early discomfort was worth it. Shares the patient's own data back to them. The patient feels seen — not surveilled.

Milestone reinforcement reduces churn
Month 3 · The Quiet Drift

Routine sets in.
Motivation fades.

Months 2–3 are when patients start to ask "why am I still doing this?" Hoot intercepts with a peer story — someone from the same community, mid-trial, doing fine.

Routine-fatigue intervention
7
Month 3
3:14
MP
Dr. Maya Patel
Hematology
Month 3 · 3:14 PM
Marcus checked in this week. He's at month 14 now, doing great. He wanted me to send you this.
From Marcus
"Month 3 was the hardest
for me too"
3:47
11:50
MP
Dr. Maya Patel
Hematology
Month 6 · 11:50 AM
Halfway, James. I want you to see what your participation is teaching us.
Trial Update
What we're learning
from your data
3:21
This is real. You're part of it.
8
Month 6
Month 6 · The Halfway Point

"You're part of it."

Doctor shares what the trial is actually teaching — so the patient knows their participation matters. Meaning is the strongest retention force we have.

3× higher adherence at this stage
Month 9 · Visit Fatigue

The home stretch.
Family wobbles.

By month 9, life intervenes. Spouses worry. Visits feel endless. Hoot pivots — content goes to the caregiver, not just the patient. The household holds the trial.

Caregiver-direct touchpoint
9
Month 9
6:22
MP
Dr. Maya Patel
Hematology · For Renee
Month 9 · 6:22 PM
Renee — this part is hard on you too. I see it. Three more months.
For Caregivers
The home stretch:
what to expect
2:33
10:00
MP
Dr. Maya Patel
Hematology
Month 12 · 10:00 AM
James — you did it. Today is your last visit. I want you to know what your year meant.
From Dr. Patel
Thank you, James.
Here's what you contributed.
2:04
This trial will help thousands. Because of people like you.
thank you doc 🙏
10
Month 12
Month 12 · The Close

"You did it."

The trial ends — but the relationship doesn't. The patient knows what they contributed, why their data matters, and that the door is open. They become advocates.

The next patient comes from this one
10–20%
Faster time to full enrollment, especially in diverse populations
Higher adherence among patients engaged with Hoot content
$8M
Cost of every trial-day delay — even small acceleration pays for the program many times over
The Four Pillars of Trust

Trust isn't built by a brand.
It's built by a person.

01

Familiarity

The doctor isn't a stranger from a 1-800 number. They diagnosed the patient. They know the family, the fears, the back story. Trust starts with someone who already knows you.

02

Authority

Patients consistently rank their own physician as the single most trusted source of health information — above pharma, above advocacy groups, above family. No call center comes close.

03

Continuity

Day 0, Day 14, Month 6, Month 12 — the same doctor's voice returns at every touchpoint. Consistency is a trust signal patients feel even when they can't articulate it.

04

Specificity

Content names the patient, the diagnosis, the trial. Watched at home, on the couch, with the spouse. Generic recruitment can't earn trust because it never tries to.

Let's Build It

Trust isn't built
in a focus group.
It's built in a text.

Let's design a trial program that earns trust at enrollment — and keeps it through every month of the trial.

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