Table 1

Recommendations

Recommendation	Action required
1. Policymakers, organisations, institutions and individuals need to take responsibility and address institutional racism, identifying and tackling issues that contribute to this (eg, lack of culturally adapted information, practices that may be contributing to institutional racism)	This requires: Leadership Identification of best practice Open discussion of culturally sensitive research ethics throughout the social system (eg, values, beliefs and practices) Organisations and institutions should inform and educate their staff about institutional racism, what it is and how to address it.
2. Build relationships with communities from diverse cultural and ethnic backgrounds to provide opportunities for patient and public involvement (PPI) and empower individuals so that study designs become more relevant and culturally appropriate	Employ more staff from diverse ethnic and cultural backgrounds in academic institutions and health research organisations. Ethics committees should seek community members from diverse ethnic and cultural backgrounds. Provide cultural competency training for all involved in health research. Identify local champions and/or leads to raise awareness of cultural competency in health research.
3. Develop tailored informed consent in health research that offers choices (eg, written, audio, multi-media), which may require additional resources	Ensure greater patient and public involvement (PPI) by people of diverse ethnic and cultural backgrounds in study designs.
4. Organisations and institutions need to develop cultural competence within them, increasing capability, knowledge and awareness of other cultures	This requires cultural competence training that covers capability, knowledge and awareness in relation to research participation. All who are involved in health research should undertake cultural competency training.