Lessons Learned: Recruiting Research Participants from an Underrepresented Patient Population at a Safety Net Hospital.

Burden of treatment Recruitment methods Underrepresented patient population

Journal

Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834

Informations de publication

Date de publication:
03 2022
Historique:
received: 13 01 2021
accepted: 29 10 2021
pubmed: 21 1 2022
medline: 12 3 2022
entrez: 20 1 2022
Statut: ppublish

Résumé

Recruiting participants to clinical research studies is challenging, especially when conducted in safety net settings. We sought to compare the efficacy of different recruitment strategies in an NIH-funded study assessing treatment burden in patients with multiple chronic conditions (MCCs). Targeted mailing, in-person table-based recruitment ("tabling") in the waiting room, and telephone calling were used to enroll subjects into one of two studies of treatment burden: a survey study to validate a brief measure of treatment burden for quality assessment (study 1) or a qualitative study to develop a treatment burden clinical communication tool (study 2). Over 50% of subjects in each study were African American or African immigrants. In study 1, the enrollment goal of 200 was reached within 4 months. Tabling enrolled 78.5% of patients, while the remainder (21.5%) were enrolled from phone calls to eligible patients identified through the electronic medical record (EMR). In study 2, 340 eligible patients were identified through the EMR, and 7 (2.1%) were successfully enrolled via mailed invitations and responses. Retention rates (66% in study 1 and 71% in study 2) were reasonable in all groups. Study recruiting goals in our safety net population were rapidly reached using the tabling method, which had substantively higher enrollment rates than mailings or telephone calls based on EMR reports. Future trials could compare recruitment strategies across settings and clinical populations.

Sections du résumé

BACKGROUND
Recruiting participants to clinical research studies is challenging, especially when conducted in safety net settings. We sought to compare the efficacy of different recruitment strategies in an NIH-funded study assessing treatment burden in patients with multiple chronic conditions (MCCs).
METHODS
Targeted mailing, in-person table-based recruitment ("tabling") in the waiting room, and telephone calling were used to enroll subjects into one of two studies of treatment burden: a survey study to validate a brief measure of treatment burden for quality assessment (study 1) or a qualitative study to develop a treatment burden clinical communication tool (study 2).
RESULTS
Over 50% of subjects in each study were African American or African immigrants. In study 1, the enrollment goal of 200 was reached within 4 months. Tabling enrolled 78.5% of patients, while the remainder (21.5%) were enrolled from phone calls to eligible patients identified through the electronic medical record (EMR). In study 2, 340 eligible patients were identified through the EMR, and 7 (2.1%) were successfully enrolled via mailed invitations and responses. Retention rates (66% in study 1 and 71% in study 2) were reasonable in all groups.
CONCLUSIONS
Study recruiting goals in our safety net population were rapidly reached using the tabling method, which had substantively higher enrollment rates than mailings or telephone calls based on EMR reports. Future trials could compare recruitment strategies across settings and clinical populations.

Identifiants

pubmed: 35048288
doi: 10.1007/s11606-021-07258-7
pii: 10.1007/s11606-021-07258-7
pmc: PMC8769800
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

922-927

Subventions

Organisme : NINR NIH HHS
ID : R01 NR015441
Pays : United States

Informations de copyright

© 2021. Society of General Internal Medicine.

Références

Yancey AK, Ortega AN, Kumanyika SK. Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006;27:1-28. https://doi.org/10.1146/annurev.publhealth.27.021405.102113 .
doi: 10.1146/annurev.publhealth.27.021405.102113 pubmed: 16533107
Oh SS, Galanter J, Thakur N, et al. Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled. PLOS Med. 2015;12(12):e1001918. https://doi.org/10.1371/journal.pmed.1001918.
doi: 10.1371/journal.pmed.1001918 pubmed: 26671224 pmcid: 4679830
UyBico SJ, Pavel S, Gross CP. Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions. J Gen Intern Med. 2007;22(6):852-863. doi: https://doi.org/10.1007/s11606-007-0126-3
doi: 10.1007/s11606-007-0126-3 pubmed: 17375358 pmcid: 2219860
Lindsey K. Racial and Ethnic Disparities in Research Studies: The Challenge of Creating More Diverse Cohorts. Environ Health Perspect. 2015;123(12):A297-A302. https://doi.org/10.1289/ehp.123-A297.
doi: 10.1289/ehp.123-A297
Witte SS, El-Bassel N, Gilbert L, Wu E, Chang M, Steinglass P. Recruitment of minority women and their main sexual partners in an HIV/STI prevention trial. J Womens Health 2002. 2004;13(10):1137-1147. https://doi.org/10.1089/jwh.2004.13.1137.
doi: 10.1089/jwh.2004.13.1137
Brannon EE, Kuhl ES, Boles RE, et al. Strategies for Recruitment and Retention of Families from Low-Income, Ethnic Minority Backgrounds in a Longitudinal Study of Caregiver Feeding and Child Weight. Child Health Care J Assoc Care Child Health. 2013;42(3):198-213. https://doi.org/10.1080/02739615.2013.816590.
doi: 10.1080/02739615.2013.816590
George S, Duran N, Norris K. A Systematic Review of Barriers and Facilitators to Minority Research Participation Among African Americans, Latinos, Asian Americans, and Pacific Islanders. Am J Public Health. 2014;104(2):e16–e31. https://doi.org/10.2105/AJPH.2013.301706.
doi: 10.2105/AJPH.2013.301706 pubmed: 24328648 pmcid: 3935672
Otado J, Kwagyan J, Edwards D, Ukaegbu A, Rockcliffe F, Osafo N. Culturally Competent Strategies for Recruitment and Retention of African American Populations into Clinical Trials. Clin Transl Sci. 2015;8(5):460–466. https://doi.org/10.1111/cts.12285.
doi: 10.1111/cts.12285 pubmed: 25974328 pmcid: 4626379
Grundmeier RW, Swietlik M, Bell LM. Research subject enrollment by primary care pediatricians using an electronic health record. AMIA Annu Symp Proc AMIA Symp. Published online October 11, 2007:289–293.
Gilliss CL, Lee KA, Gutierrez Y, et al. Recruitment and Retention of Healthy Minority Women into Community-Based Longitudinal Research. J Womens Health Gend Based Med. 2001;10(1):77–85. https://doi.org/10.1089/152460901750067142 .
doi: 10.1089/152460901750067142 pubmed: 11224947
Heerman WJ, Jackson N, Roumie CL, et al. Recruitment methods for survey research: Findings from the Mid-South Clinical Data Research Network. Contemp Clin Trials. 2017;62:50–55. https://doi.org/10.1016/j.cct.2017.08.006.
doi: 10.1016/j.cct.2017.08.006 pubmed: 28823925
Eton DT, Ridgeway JL, Egginton JS, et al. Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions. Patient Relat Outcome Meas. 2015;6:117–126. https://doi.org/10.2147/PROM.S78955.
Eton DT, Linzer M, Boehm DH, et al. Deriving and validating a brief measure of treatment burden to assess person-centered healthcare quality in primary care: a multi-method study. BMC Fam Pract. 2020;21(1):221. https://doi.org/10.1186/s12875-020-01291-x .
doi: 10.1186/s12875-020-01291-x pubmed: 33115421 pmcid: 7594460
Goodman RA. Defining and Measuring Chronic Conditions: Imperatives for Research, Policy, Program, and Practice. Prev Chronic Dis. 2013;10. https://doi.org/10.5888/pcd10.120239.
U.S. Department of Health and Human Services. Multiple Chronic Conditions: A Strategic Framework Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions. Published online December 2010. https://doi.org/10.1037/e507192011-001.
JL Ridgeway, TJ Beebe, CG Chute, DT Eton, LA Hart et al. A brief patient-reported outcomes quality of life (PROQOL) instrument to improve patient care. PLoS Med. 2013;10(11): e1001548.
Eton DT, Ridgeway JL, Egginton JS, Tiedje K, Linzer M, Boehm DH, Poplau S, Ramalho de Oliveira D, Odell L, Montori VM, May CR, & Anderson RT (2015). Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions. Patient Related Outcome Measures, 6:117-126
doi: 10.2147/PROM.S78955
Brod M, Tesler LE, Christensen TL. Qualitative research and content validity: Developing best practices based on science and experience. Qual Life Res. 2009;18(9):1263–1278.
doi: 10.1007/s11136-009-9540-9
Henry Y, Harkins V, Ferrarie A, Berger PB. Use of an Electronic Health Record to Optimize Site Performance in Randomized Clinical Trials. J Clin Trials. 2015;05(01). https://doi.org/10.4172/2167-0870.1000208.
Ford JG, Howerton MW, Lai GY, et al. Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review. Cancer. 2008;112(2):228–242. https://doi.org/10.1002/cncr.23157.
doi: 10.1002/cncr.23157 pubmed: 18008363

Auteurs

Mike Wambua (M)

Hennepin Healthcare Research Institute (HHRI), 701 Park Avenue, PP4.460, Minneapolis, MN, 55415, USA. mike.wambua@hcmed.org.

Miamoua Vang (M)

Hennepin Healthcare Research Institute (HHRI), 701 Park Avenue, PP4.460, Minneapolis, MN, 55415, USA.

Crystal Audi (C)

Hennepin Healthcare Research Institute (HHRI), 701 Park Avenue, PP4.460, Minneapolis, MN, 55415, USA.

Mark Linzer (M)

Hennepin Healthcare Research Institute (HHRI), 701 Park Avenue, PP4.460, Minneapolis, MN, 55415, USA.
Hennepin Healthcare Department of Medicine, Minneapolis, MN, USA.
University of Minnesota, Minneapolis, MN, USA.

David T Eton (DT)

Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.

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