Public Knowledge and Attitudes towards Clinical Trial Participation: A Mixed-Method Study in Pwani Region, Tanzania

Background: The clinical trials are important for advancing medical knowledge and improving healthcare delivery. However, participants’ knowledge and attitudes to-wards clinical trials remain a key challenge affecting clinical trial recruitment and retention of participants. Therefore, this study was aimed at assessing the knowledge and attitudes of the general community towards participation in clinical trials. Methods: A convergent parallel mixed-methods study was conducted, among adults in Bagamoyo district. A multistage Stratified random sampling was used to select participants. Quantitative data were analyzed descriptively and using logistic regression, while Qualitative data were analyzed thematically using NVivo. Results: Among 394 recruited participants, 293 (74.4%) were females and 101 (25.6%) males. Most participants had a primary level education (266, 67.5%), while 128 (32.5%) had secondary or tertiary education. The majority were married, 297 (75.4%) and 97 (24.6%) were either separated or unmarried. Regarding economic status, 244 participants (61.9%) earned less than Tsh. 50,000. The general population Knowledge regarding clinical trial was low with majority of participants scoring below 60%. However, we found a positive attitude towards participation in the clinical trial. Logistic regression revealed that poor knowledge was significantly associated with being male (AOR, 22.95 (95% CI: 10.27–51.28, p = 0.001)), age above 55 years (AOR of 2.43 (95% CI: 1.29–4.55, p = 0.006)) and unemployment (AOR of 2.39 (95% CI: 1.27–4.53, p = 0.007)). Positive attitudes towards clinical trial participation were significantly associated with being female (AOR) 7.61 (95% CI: 4.32–13.39, p < 0.001), Age of 44 years and below, (AOR: 2.22 (95% CI: 1.27–3.86, p = 0.005) and employment (AOR of 1.89 (95% CI: 1.08–3.32, p = 0.03). Conclusion: Despite low levels of knowledge, the general population in Bagamoyo district demonstrated a high willingness to participate in clinical trials. To address the knowledge gap, targeted educational interventions should focus on older adults and the unemployed. Furthermore, policies supporting community outreach and awareness campaigns may help strengthen public understanding and sustain positive attitudes toward clinical research.