Indigenous populations, including people of American Indian and Alaska Native origin, are underrepresented in clinical trials.

Researchers collaborated to modify the "trust triangle" model used in clinical trial recruitment and expanded it to a new model called, "The Trust Circle." This new model takes into account the various entities that are part of the recruitment process and the trust that must be developed between trial participants, researchers and other individuals such as physicians, ministers and community leaders.

The authors assert that physicians, ministers and community leaders can promote trust and assist in the recruitment of AI/AN populations to clinical trials. This in turn can promote health improvement of these populations.