Fig. 1

Caption: [CREATE-Culture, Respect, Educate, Advantage Trust, Endorse]. Notes: Experiences engaging an underserved population in a rigorous clinical trial led to the development of the “CREATE-Culture, Respect, Educate, Advantage Trust, Endorse,” framework to describe the process of engaging people who use drugs into clinical research. The initial step necessitates laying the groundwork through listening to the community and understanding its culture. Acknowledging and accepting the patient-participants’ unique lifestyles demonstrates respect. Researchers identified the need to educate both patient-participants and staff about hepatitis C virus (HCV). Equipping opioid treatment program staff with HCV-related knowledge enables them to confidently speak about HCV care to their patients. Patient-participants readily appreciate the advantage of facilitated telemedicine compared to offsite referral. The presence of the familiar faces of the onsite clinician and the case manager during telemedicine encounters demonstrate trust by providing patient-centered care. Dissemination of the positive benefits of facilitated telemedicine through the peer pipeline and staff appreciation of the value of an HCV cure promoted patients to endorse facilitated telemedicine and more broadly, clinical research. Abbreviation: OTP; opioid treatment program