DISCUSSION
The paucity of AA participation barriers associated with genomic health-related research is wide-ranging and could account for difficulty in both recruitment and retention in addition to health disparities. AAs may be more difficult to recruit in genomic health-related research studies due to mistrust of investigators, psychosocial impacts, and cultural beliefs. Historically, these factors have led to missed economic opportunities, inequalities, poor health, reduced quality of life, and premature death. As research continues to uncover unethical human experimentation and as governmental regulatory bodies became increasingly aware of research misconduct practices, the importance of understanding historical underpinnings of research ethics will be key to helping strengthen ethical guidelines in medical and health research practices (Tuskegee University, 2021; National Institute of Environmental Health Sciences, 2019; Office for Human Research Protections, 2016, 2017, 2019; World Medical Association, 2019). These efforts will be instrumental in reinforcing the importance of stringent regulations needed to promote basic ethical principles of research involving humans. Research participants believe that participating in genomic-related health research would impose a change in lifestyle; require time and commitment they are not willing to invest; infringe upon cultural or religious beliefs and norms; cause discomfort and/or pain during collection of biospecimens; promote insurance and employment; would result in misuse of genomic data or failure to return genomic results; family members being adversely impacted by genetic results; result in incurred financial barriers and costs; provide no benefit to health or possibly cause irreparable consequences; induce diagnoses of a life threatening health condition; would lack of support from the community; would not provide education about the research or would exacerbate health education and health literacy challenges; would not provide language translation services; would induce concerns about privacy and confidentiality in protecting health information; there would be a lack of trustworthiness among investigators; there would be a lack of interest to participate in research; would not acknowledge past unethical research practices involving human experimentation; participation would induce psychosocial factors (e.g., stress, hostility, depression, embarrassment, hopelessness, and despair); and would lead to research stigmatization, encompassing the convergence of 1) identifying and labeling differences in human beings; 2) linking labeled individual’s cultural belief to unfavorable characteristics and negative stereotype constructs; 3) categorizing individuals into groups of “us” and “them” in the application of said stereotype constructs; 4) loss of status and discrimination experienced by labeled individuals; and 5) employing social, economic, political, or other influences that reinforce and translate the aforementioned processes into detrimental outcomes for labeled individuals.