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Heeren FAN, Himadi M, Flood-Grady E, Xu K, Loop MS, Francois M, Louis-Jacques AF, Thompson L, Cardel MI, Gillespie Y, DeCicco L, Lemas DJ. Recruitment and retention of participants with obesity into a longitudinal birth cohort: the Breastfeeding and Early Child Health (BEACH) study. Int J Obes (Lond) 2024:10.1038/s41366-024-01625-0. [PMID: 39251767 DOI: 10.1038/s41366-024-01625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND The study aimed to evaluate how maternal pre-pregnant body mass index (BMI) impacts participant recruitment and retention. METHODS Participants were enrolled in a longitudinal study between 30 and 36 weeks of pregnancy as having normal weight (pre-pregnant BMI ≥ 18.5 and <25 kg/m2) or obesity (pre-pregnant BMI ≥ 30.0 kg/m2). Recruitment channels included Facebook, email, newspaper, phone calls, radio advertisements, flyers, and word-of-mouth. The stages of recruitment included eligibility, consent, and completion. Pearson's chi-square tests were used to evaluate the relationship between BMI and enrollment outcomes. RESULTS Recruitment yielded 2770 total prospective participants. After screening, 141 individuals were eligible, 83 consented, and 60 completed the study. Facebook was the most successful method for identifying eligible pregnant patients with obesity, while a higher percentage of participants recruited through word-of-mouth and flyers consented to the study. Pre-pregnant BMI was significantly associated with the stage of recruitment completed by the participant (p = 0.04), whereby individuals eligible for the study with obesity were less likely to consent and complete study visits. CONCLUSION We demonstrated that maternal obesity was significantly associated with enrollment outcomes in a longitudinal birth cohort study. This study showed that pre-pregnancy BMI influenced study participation. Therefore, tailored recruitment strategies to enhance the recruitment and enrollment of individuals with obesity in maternal-infant health research may be necessary.
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Affiliation(s)
- Faith Anne N Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Michele Himadi
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Elizabeth Flood-Grady
- STEM Translational Communication Center, University of Florida, Gainesville, FL, USA
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA
| | - Ke Xu
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Matthew Shane Loop
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Magda Francois
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Adetola F Louis-Jacques
- Department of Obstetrics & Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Research in Perinatal Outcomes, University of Florida, Gainesville, FL, USA
| | - Lindsay Thompson
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
- WW International Inc., New York, NY, USA
| | - Yasmine Gillespie
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Lewis DeCicco
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Dominick J Lemas
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA.
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
- Department of Obstetrics & Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA.
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Tsaltskan V, Sanchez Baez R, Firestein GS. Cost-effectiveness of social media advertising as a recruitment tool: A systematic review and meta-analysis. J Clin Transl Sci 2023; 7:e180. [PMID: 37745929 PMCID: PMC10514690 DOI: 10.1017/cts.2023.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 09/26/2023] Open
Abstract
Background Recruitment of study participants is challenging and can incur significant costs. Social media advertising is a promising method for recruiting clinical studies and may improve cost efficiency by targeting populations likely to match a study's qualifications. Prior systematic reviews of social media as a recruitment tool have been favourable, however, there are no meta-analyses of its cost-effectiveness. Methods Studies evaluating recruitment costs through social media and non-social media methods were identified on MEDLINE and EMBASE. Articles were screened through a two-step process in accordance with PRISMA guidelines. Cost data were extracted from selected articles and meta-analyzed using the Mantel-Haenszel method. The primary outcome was the relative cost-effectiveness of social media compared to non-social media recruitment, defined as the odds ratio of recruiting a participant per US dollar spent. The secondary outcome was the cost-effectiveness of social media recruitment compared to other online recruitment methods only. Results In total, 23 studies were included in the meta-analysis. The odds ratio of recruiting a participant through social media advertising compared to non-social media methods per dollar spent was 1.97 [95% CI 1.24-3.00, P = 0.004]. The odds ratio of recruiting a participant through social media compared to other online methods only was 1.66 [95% CI 1.02-2.72, P = 0.04]. Conclusions Social media advertising may be more cost-effective than other methods of recruitment, however, the magnitude of cost-effectiveness is highly variable between studies. There are limited data on newer social media platforms and on difficult-to-reach populations such as non-English speakers or older individuals.
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Affiliation(s)
- Vladislav Tsaltskan
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Roel Sanchez Baez
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Gary S. Firestein
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
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3
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Xi Q, Jin S, Morris S. Economic evaluations of predictive genetic testing: A scoping review. PLoS One 2023; 18:e0276572. [PMID: 37531363 PMCID: PMC10395838 DOI: 10.1371/journal.pone.0276572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/03/2023] [Indexed: 08/04/2023] Open
Abstract
Predictive genetic testing can provide information about whether or not someone will develop or is likely to develop a specific condition at a later stage in life. Economic evaluation can assess the value of money for such testing. Studies on the economic evaluation of predictive genetic testing have been carried out in a variety of settings, and this research aims to conduct a scoping review of findings from these studies. We searched the PubMed, Web of Science, Embase, and Cochrane databases with combined search terms, from 2019 to 2022. Relevant studies from 2013 to 2019 in a previous systematic review were also included. The study followed the recommended stages for undertaking a scoping review. A total of 53 studies were included, including 33 studies from the previous review and 20 studies from the search of databases. A significant number of studies focused on the US, UK, and Australia (34%, 23%, and 11%). The most frequently included health conditions were cancer and cardiovascular diseases (68% and 19%). Over half of the studies compared predictive genetic testing with no genetic testing, and the majority of them concluded that at least some type of genetic testing was cost-effective compared to no testing (94%). Some studies stated that predictive genetic testing is becoming more cost-effective with the trend of lowering genetic testing costs. Studies on predictive genetic testing covered various health conditions, particularly cancer and cardiovascular diseases. Most studies indicated that predictive genetic testing is cost-effective compared to no testing.
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Affiliation(s)
- Qin Xi
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Shihan Jin
- Department of Pharmaceutical and Health Economics, Leonard D. Schaeffer Center for Health Policy and Economics, School of Pharmacy, University of Southern California, Los Angeles, California, United States of America
| | - Stephen Morris
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Carter CR, Maki J, Ackermann N, Waters EA. Inclusive Recruitment Strategies to Maximize Sociodemographic Diversity among Participants: A St. Louis Case Study. MDM Policy Pract 2023; 8:23814683231183646. [PMID: 37440792 PMCID: PMC10334001 DOI: 10.1177/23814683231183646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 05/19/2023] [Indexed: 07/15/2023] Open
Abstract
Background. Sociodemographically diverse study samples are critical for research related to health decision making. However, not all researchers have the training, capacity, and funding to engage research methods that recruit the most diverse populations. Objective and Methods. We used participant-generated data, staff salary data, and participant observation to examine the effectiveness and cost of strategies that we used for screening, enrolling, and retaining a sociodemographically diverse sample for a risk communication and behavior change randomized controlled trial. Results. It took approximately 646 hours to contact 1,626 individuals and enroll 554 participants (505 of whom completed the baseline survey; 45.2% were members of a underrepresented racial/ethnic group, 19.4% had no college education, 49.5% were age 30-49 y). Retention at 90-d follow-up was 93%. The total cost was USD$19,898.50. The average cost was $35.92 per participant enrolled. In-person recruitment was most successful in identifying the largest proportion of screened and eligible participants who were members of underrepresented racial/ethnic populations (32.8% and 27.8%, respectively) and with no college experience (39.7% and 33.5%, respectively); it also had the highest total cost ($8,079.17). Existing research pools identified the largest proportion of younger participants (ages 30-49 y; 39.3% and 43.4% for screened and eligible, respectively). Existing listservs yielded the smallest proportion of individuals with no college experience and the fewest members of underrepresented racial/ethnic populations but had the lowest total cost ($290.33). Newspaper ads identified the fewest younger individuals and also had the highest cost per participant enrolled ($166.21). Word of mouth had the lowest cost per participant enrolled ($10.47). Conclusion. Results help medical decision-making researchers formulate recruitment plans that increase sociodemographic diversity in study samples. We also ask funders to accommodate increased costs required to maximize sociodemographic diversity in medical decision-making research. Highlights We provide concrete strategies for recruiting, enrolling, and retaining a sociodemographically diverse study sample.We offer cost estimates for all stages of study recruitment and found that in-person recruitment was the most effective, but also the most expensive, way to identify Black participants and participants with no college experience.It is critical for investigators to have access to institutional infrastructure and resources to support conducting research that is inclusive of diverse sociodemographic groups.An intentionally diverse recruitment staff supports a diverse study sample.
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Affiliation(s)
- Chelsey R. Carter
- Department of Social and Behavioral Sciences,
Yale School of Public Health, New Haven, CT
| | - Julia Maki
- Washington University in St. Louis, School of
Medicine, Department of Surgery, Division of Public Health Sciences, St.
Louis, MO, USA
| | - Nicole Ackermann
- Washington University in St. Louis, School of
Medicine, Department of Surgery, Division of Public Health Sciences, St.
Louis, MO, USA
| | - Erika A. Waters
- Washington University in St. Louis, School of
Medicine, Department of Surgery, Division of Public Health Sciences, St.
Louis, MO, USA
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Tsaltskan V, Nguyen K, Eaglin C, Holers VM, Deane KD, Firestein GS. Comparison of Web-Based Advertising and a Social Media Platform as Recruitment Tools for Underserved and Hard-to-Reach Populations in Rheumatology Clinical Research. ACR Open Rheumatol 2022; 4:623-630. [PMID: 35536990 PMCID: PMC9274346 DOI: 10.1002/acr2.11448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/12/2022] [Accepted: 04/22/2022] [Indexed: 01/03/2023] Open
Abstract
Objective Traditional nondigital methods of participant recruitment for clinical research studies in rheumatology can be costly and inefficient, particularly for recruitment of underserved populations. We aimed to address this need by evaluating two methods of online recruitment to an observational cohort of individuals at risk for rheumatoid arthritis, namely web and Facebook advertisements. Methods A 3‐month countywide web‐based recruitment campaign was conducted consisting of text and image‐based advertisements. Similar advertisements were subsequently displayed on Facebook, initially in English for 5 months and later in Spanish for an additional 3 months. Individuals who clicked on advertisements were directed to a website landing page containing study information and could contact study personnel to schedule testing for anti‐cyclic citrullinated peptide‐3 (CCP3). The primary outcome measure for each campaign was the click‐through rate. Results During the web campaign, 413,289 advertisement impressions were displayed, resulting in 428 clicks (click‐through rate 0.10%) and only one screened participant. During the English Facebook campaign, 724,815 advertisements were displayed with 6765 clicks (click‐through rate 0.93%) and 43 screened participants, significantly greater than the web campaign (P < 0.001). During the Spanish advertisement campaign, 255,730 Spanish advertisements were displayed, resulting in a click‐through rate of 2.09% and 24 screened participants, a significantly higher rate than English advertisements. Of participants recruited through social media, 94% were female and 29.8% were Spanish speakers. Conclusion Facebook advertisements were superior to web advertisements for participant recruitment. Spanish Facebook advertisements had a greater click‐through rate than English Facebook advertisements. Facebook was an effective recruitment method, particularly for Spanish speakers.
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Massett HA, Mitchell AK, Alley L, Simoneau E, Burke P, Han SH, Gallop-Goodman G, McGowan M. Facilitators, Challenges, and Messaging Strategies for Hispanic/Latino Populations Participating in Alzheimer's Disease and Related Dementias Clinical Research: A Literature Review. J Alzheimers Dis 2021; 82:107-127. [PMID: 33998537 DOI: 10.3233/jad-201463] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) disproportionally affect Hispanic and Latino populations, yet Hispanics/Latinos are substantially underrepresented in AD/ADRD clinical research. Diverse inclusion in trials is an ethical and scientific imperative, as underrepresentation reduces the ability to generalize study findings and treatments across populations most affected by a disease. This paper presents findings from a narrative literature review (N = 210) of the current landscape of Hispanic/Latino participation in clinical research, including the challenges, facilitators, and communication channels to conduct culturally appropriate outreach efforts to increase awareness and participation of Hispanics/Latinos in AD/ADRD clinical research studies. Many challenges identified were systemic in nature: lack of culturally relevant resources; staffing that does not represent participants' cultures/language; eligibility criteria that disproportionately excludes Hispanics/Latinos; and too few studies available in Hispanic/Latino communities. The paper also details facilitators and messaging strategies to improve engagement and interest among Hispanics/Latinos in AD/ADRD research, starting with approaches that recognize and address the heterogeneity of the Hispanic/Latino ethnicity, and then, tailor outreach activities and programs to address their diverse needs and circumstances. The needs identified in this article represent longstanding failures to improve engagement and interest among Hispanics/Latinos in AD/ADRD research; we discuss how the field can move forward learning from the experiences of the COVID-19 pandemic.
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Affiliation(s)
- Holly A Massett
- Division of Extramural Activities, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | - Sae H Han
- Kelly Government, Kelly Services, Inc., Rockville, MD, USA
| | - Gerda Gallop-Goodman
- Office of Communications and Public Liaison, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Melissa McGowan
- Office of Communications and Public Liaison, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
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Milo Rasouly H, Cuneo N, Marasa M, DeMaria N, Chatterjee D, Thompson JJ, Fasel DA, Wynn J, Chung WK, Appelbaum P, Weng C, Bakken S, Gharavi AG. GeneLiFT: A novel test to facilitate rapid screening of genetic literacy in a diverse population undergoing genetic testing. J Genet Couns 2021; 30:742-754. [PMID: 33368851 PMCID: PMC8246865 DOI: 10.1002/jgc4.1364] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 11/05/2022]
Abstract
With the broader introduction of genomic medicine in research and clinical care, an increasing number of persons are offered genetic testing. Many factors, including genetic literacy, may impact the utilization of genetic results by patients and their families. We developed a rapid, self-administered measure of genetic literacy, called Genetic Literacy Fast Test (GeneLiFT). We next evaluated the association of GeneLiFT scores with the comprehension of limitations of genomic medicine in participants undergoing genetic testing in the NIH-sponsored eMERGE III study at Columbia University Irving Medical Center, New York. All participants underwent genetic screening for variants in 74 actionable genes associated with adult-onset disorders. A diverse cohort of 724 participants completed the survey (60% women, 45% less than 40 years old, and 53% self-reported White non-Hispanic ancestry). The GeneLiFT was validated using known group differences based on education, health literacy, and numeracy, and with questions assessing genetic knowledge. GeneLiFT identified multiple standard genetics terms, that is, jargon, not recognized by more than 50% of participants (including actionability and pathogenicity). Low genetic literacy, identified in 210 participants (29%), was significantly associated with poor understanding of the limitations of genetic testing (p-values < 10-9 ). This association was independent of education, health literacy, and numeracy levels, highlighting the importance of directly measuring genetic literacy. Low genetic literacy was also associated with low satisfaction with the informed consent process. GeneLiFT is a practical tool for rapid assessment of genetic literacy in large studies or clinical care. GeneLiFT will allow future research to efficiently assess the role of genetic literacy on the clinical impact of genetic testing.
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Affiliation(s)
- Hila Milo Rasouly
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
- Center for Precision Medicine and Genomics, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Nicole Cuneo
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Maddalena Marasa
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
- Center for Precision Medicine and Genomics, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Natalia DeMaria
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Debanjana Chatterjee
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
- Center for Precision Medicine and Genomics, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Jacqueline J. Thompson
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - David A. Fasel
- Center for Precision Medicine and Genomics, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Julia Wynn
- Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Wendy K. Chung
- Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
- Department of PediatricsColumbia University Irving Medical CenterNew YorkNYUSA
| | - Paul Appelbaum
- Department of PsychiatryColumbia University Irving Medical CenterNew YorkNYUSA
| | - Chunhua Weng
- Department of Biomedical informaticsColumbia University Irving Medical CenterNew YorkNYUSA
| | - Suzanne Bakken
- School of Nursing and Department of Biomedical InformaticsColumbia University Irving Medical CenterNew YorkNYUSA
| | - Ali G. Gharavi
- Division of Nephrology, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
- Center for Precision Medicine and Genomics, Department of MedicineColumbia University Irving Medical CenterNew YorkNYUSA
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Nestor JG, Fedotov A, Fasel D, Marasa M, Milo-Rasouly H, Wynn J, Chung WK, Gharavi A, Hripcsak G, Bakken S, Sengupta S, Weng C. An electronic health record (EHR) log analysis shows limited clinician engagement with unsolicited genetic test results. JAMIA Open 2021; 4:ooab014. [PMID: 33709066 PMCID: PMC7935499 DOI: 10.1093/jamiaopen/ooab014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/21/2021] [Accepted: 02/12/2021] [Indexed: 11/14/2022] Open
Abstract
How clinicians utilize medically actionable genomic information, displayed in the electronic health record (EHR), in medical decision-making remains unknown. Participating sites of the Electronic Medical Records and Genomics (eMERGE) Network have invested resources into EHR integration efforts to enable the display of genetic testing data across heterogeneous EHR systems. To assess clinicians’ engagement with unsolicited EHR-integrated genetic test results of eMERGE participants within a large tertiary care academic medical center, we analyzed automatically generated EHR access log data. We found that clinicians viewed only 1% of all the eMERGE genetic test results integrated in the EHR. Using a cluster analysis, we also identified different user traits associated with varying degrees of engagement with the EHR-integrated genomic data. These data contribute important empirical knowledge about clinicians limited and brief engagements with unsolicited EHR-integrated genetic test results of eMERGE participants. Appreciation for user-specific roles provide additional context for why certain users were more or less engaged with the unsolicited results. This study highlights opportunities to use EHR log data as a performance metric to more precisely inform ongoing EHR-integration efforts and decisions about the allocation of informatics resources in genomic research.
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Affiliation(s)
- Jordan G Nestor
- Department of Medicine, Division of Nephrology, Columbia University, New York, New York, USA
| | - Alexander Fedotov
- The Irving Institute for Clinical and Translational Research, Columbia University, New York, New York, USA
| | - David Fasel
- Department of Medicine, Center for Precision Medicine and Genomics, Columbia University, New York, New York, USA
| | - Maddalena Marasa
- Department of Medicine, Division of Nephrology, Columbia University, New York, New York, USA.,Department of Medicine, Center for Precision Medicine and Genomics, Columbia University, New York, New York, USA
| | - Hila Milo-Rasouly
- Department of Medicine, Division of Nephrology, Columbia University, New York, New York, USA.,Department of Medicine, Center for Precision Medicine and Genomics, Columbia University, New York, New York, USA
| | - Julia Wynn
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Wendy K Chung
- Departments of Pediatric and Medicine, Columbia University, New York, New York, USA
| | - Ali Gharavi
- Department of Medicine, Division of Nephrology, Columbia University, New York, New York, USA.,Department of Medicine, Center for Precision Medicine and Genomics, Columbia University, New York, New York, USA
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Suzanne Bakken
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Soumitra Sengupta
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
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Indorewalla KK, O’Connor MK, Budson AE, Guess (DiTerlizzi) C, Jackson J. Modifiable Barriers for Recruitment and Retention of Older Adults Participants from Underrepresented Minorities in Alzheimer's Disease Research. J Alzheimers Dis 2021; 80:927-940. [PMID: 33612540 PMCID: PMC8150544 DOI: 10.3233/jad-201081] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 01/05/2023]
Abstract
Clinical Alzheimer's disease (AD) trials currently face a critical shortfall of thousands of eligible participants, which inflates the duration and cost of the clinical study as well as threatens the scientific merit of promising clinical interventions. This recruitment crisis is further compounded by the fact that underrepresented and marginalized populations-particularly those identifying as a racial or ethnic minority, those with low socioeconomic status, or living in rural areas-have been historically underrepresented in ongoing AD clinical trials despite overwhelming evidence that such populations are at increased risk for developing dementia. As a result of various recruitment barriers, current AD clinical studies frequently reflect a decreasingly representative segment of the US population, which threatens the overall generalizability of these findings. The current narrative review provides an updated examination and critique of common recruitment barriers and potential solutions, as well as a discussion of theoretical approaches that may address barriers disproportionately experienced by underrepresented communities. AD clinical researchers are encouraged to take purposive action aimed at increasing diversity of enrolled AD clinical trial cohorts by actively identifying and quantifying barriers to research participation-especially recruitment barriers and health disparities that disproportionately prevent underrepresented and marginalized populations from participating in research. Furthermore, researchers are encouraged to closely track which individuals who express interest in AD research ultimately enroll in research studies to examine whether AD research participation is appropriately representative of the intended population for whom these new and novel AD interventions are being designed.
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Affiliation(s)
| | - Maureen K. O’Connor
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
- Boston University Alzheimer’s Disease Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Andrew E. Budson
- Boston University Alzheimer’s Disease Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Christina Guess (DiTerlizzi)
- Boston University Alzheimer’s Disease Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Jonathan Jackson
- Boston University Alzheimer’s Disease Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- CARE Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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10
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Choices, attitudes, and experiences of genetic screening in Latino/a and Ashkenazi Jewish individuals. J Community Genet 2020; 11:391-403. [PMID: 32382939 DOI: 10.1007/s12687-020-00464-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/21/2020] [Indexed: 12/21/2022] Open
Abstract
Genetic screening to inform personal risk has only recently become an option as the cost of sequencing decreases, and our ability to interpret sequence variants improves. Studies have demonstrated that people want to learn about their genetic information and do well after learning it, but minorities are underrepresented in these studies. We surveyed Ashkenazi Jewish (AJ) and Latino/a participants in a genetic screening study to solicit choices about genetic results to return, as well as their experience with learning these results and attitudes about genetic information secrecy and security. Participants had the option to proceed through the study self-guided, and few elected to have traditional pre-test genetic education and counseling. Despite this, the majority were satisfied with the process of selecting and receiving genetic results and felt that they understood their results. Concerns about privacy and confidentiality of genetic data were minimal, though some participants expressed modest concerns about keeping any potential results secret or the confidentiality of their genetic information. Our results support the feasibility of the option of self-guided genetic screening. Additional care will need to be taken when designing population-based screening studies to meet the needs of participants who come from communities with different experiences with genetics.
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