Children in rural settings are under‐represented in clinical trials, potentially contributing to rural health disparities. We performed a scoping review describing available literature on barriers and facilitators impacting participation in pediatric clinical trials in rural and community‐based (nonclinical) settings. Articles identified via PubMed, CINAHL, Embase, and Web of Science were independently double‐screened at title/abstract and full‐text levels to identify articles meeting eligibility criteria. Included articles reported on recruitment or retention activities for US‐based pediatric clinical studies conducted in rural or community‐based settings and were published in English through January 2021. Twenty‐seven articles describing 31 studies met inclusion criteria. Most articles reported on at least one study conducted in an urban or suburban or unspecified community setting ( n = 23 articles; 85%); fewer ( n = 10; 37%) reported on studies that spanned urban and rural settings or were set in rural areas. More studies discussed recruitment facilitators ( n = 25 studies; 81%) and barriers ( n = 19; 61%) versus retention facilitators ( n = 15; 48%) and barriers ( n = 8; 26%). Descriptions of recruitment and retention barriers and facilitators were primarily experiential or subjective. Recruitment and retention facilitators were similar across settings and included contacts/reminders, community engagement, and relationship‐building, consideration of participant logistics, and incentives. Inadequate staff and resources were commonly cited recruitment and retention barriers. Few studies have rigorously examined optimal ways to recruit and retain rural participants in pediatric clinical trials. To expand the evidence base, future studies examining recruitment and retention strategies should systematically assess and report rurality and objectively compare relative impact of different strategies.
Foreign trade offices (FTOs) are an important, little-understood element in the export promotion portfolio of U.S. state export promotion organizations. The value of these organizations is in dispute. In recent years California closed its FTOs in response to budgetary pressures, claiming that these organizations exist primarily to enhance the political standing of politicians rather than to act as effective export development tools. During the same period Washington State opened several new FTOs. Clearly the value of these organizations is in dispute. Another consideration in the effectiveness of U.S. exporters is the subnational contour of the American economic system. State business climates vary considerably, thereby influencing exporter success as well as those programs (such as FTOs) intended to improve firm performance. We hypothesize and find that (a) state entrepreneurial climate is positively related to state exports and (b) FTO network entry activities amplify the impact of state entrepreneurial climate on state exports. Implications for firms and policy makers are explored.
Purpose The purpose of this research project was to improve public awareness to improve public awareness of the importance of energy conservation and to improve the use of simple conservation strategies. A thorough evaluation of the net gain from the numerous energy campaigns rolled out to the public every year is lacking. This study conducted pre- and post-campaign surveys and focus groups to evaluate one campaign’s impact on self-reported energy behaviors. Design/methodology/approach The campaign used television public service announcements and a website to improve awareness of the city’s efforts to conserve energy and to increase individual energy conservation practices. Focus groups (n = 40) were used to identify common barriers to conservation, and pre- and post-surveys (n = 533, 479) were conducted to evaluate the campaign’s effectiveness. Findings Results indicated that the campaign increased positive changes in changing light bulbs and confidence in taking action to turn down thermostats, unplug devices and turn off lights. While follow-up research is needed on the precise mechanism of the psychological process at work, the findings are consistent with the concepts of self and response efficacy as needed components of any behavior change. The authors advocate the adoption of research-informed message design to maximize communication campaign effects. Originality/value This paper demonstrates how the combination of three prominent persuasion theories can be used to develop behavior change campaigns. Also, it is one of the few studies to evaluate the effectiveness of the Energy Star campaign.
Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN.Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research capacity for pediatrician scientists and team members. The inventory findings were utilized by the ISPCTN Data Coordinating and Operations Center to construct training modules covering 3 broad domains: Faculty/coordinator development; Infrastructure; Trials/Research concept development.Results: Key lessons learned reveal substantial participation in the training modules, the importance of an inventory to guide the development of trainings, and recognizing local barriers to clinical trials research.Conclusions: Research networks that seek to implement successfully completed trials need to build capacity across and within the sites engaged. Our findings indicate that building research capacity is a multi-faceted endeavor, but likely necessary for sustainability of a unique network addressing high impact pediatric health problems. The ISPCTN emphasis on building and enhancing site capacity, including pediatrician scientists and team members, is critical to successful trial implementation/completion and the production of findings that enhance the lives of children and families.
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