Background
The Community Health Advisor (CHA) model has been widely used to recruit rural and low-income, mostly African American women into clinical and behavioral research studies. However, little is known about its effectiveness in promoting retention and adherence of such women in clinical trials.
Methods
The Community-based Retention Intervention Study (CRIS) evaluated the effectiveness of a community-based intervention strategy using the CHA model and the empowerment theory to improve the retention and adherence of minority and low-income women in clinical trials. The research strategy included the training and use of the volunteer CHAs as research partners. The target population included women participating in the University of Alabama at Birmingham (UAB) clinical site of the ASCUS-LSIL Triage Study (ALTS), a multicenter, randomized clinical trial. Two communities in Jefferson County, Alabama, matched according to population demographics, were identified and randomly assigned to either intervention or control group. Thirty community volunteers were recruited to be CHAs and to implement the intervention with the ALTS trial participants. A total of 632 ALTS participants agreed to participate in the project: 359 in the intervention group with CHA care, and 273 in the control group with standard care.
Results
Adherence rates for scheduled clinic visits were significantly higher in the intervention group (80%) compared to the control group (65%; p < 0.0001).
Conclusion
Results indicate that volunteer CHAs can be trained to serve as research partners and be effective in improving the retention and adherence of minority and low-income women in clinical trials.
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