Recruitment and retention of participants from socioeconomically deprived communities: lessons from the Awareness and Beliefs About Cancer (ABACus3) Randomised Controlled Trial

Kolovou, Vasiliki; Moriarty, Yvonne; Gilbert, Stephanie; Quinn-Scoggins, Harriet; Townson, Julia; Padgett, Louise; Owen, Sioned; Buckle, Peter; Edwards, Adrian; Hepburn, Julie; Lau, Mark A.; Matthews, Maura; Mitchell, Caroline; Neal, Richard D; Playle, Rebecca; Robling, Michael; Smits, Stephanie; Trubey, Rob; Wood, Fiona; Brain, Kate

doi:10.1186/s12874-020-01149-x

Cited by 9 publications

(18 citation statements)

References 19 publications

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“…Uptake of the community pharmacy referral service was hindered by lack of awareness and limited promotion. Consistent with other studies, we found that targeted, multifaceted 43 44 approaches using community-focused strategies to promote the pharmacy referral service 45 46 were preferred. Information to raise awareness of cancer symptoms 47 alongside clear, positive messages 48 emphasising the benefits of earlier diagnosis 49 and the fast-track nature of the service were considered important.…”

Section: Discussionsupporting

confidence: 86%

Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms

et al. 2021

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BackgroundLung cancer survival rates in the UK are among the lowest in Europe, principally due to late-stage diagnosis. Alternative routes to earlier diagnosis of lung cancer are needed in socioeconomically deprived communities that are disproportionately affected by poor lung cancer outcomes. We assessed the feasibility and acceptability of a community-based pharmacy referral service to encourage earlier symptomatic referral for chest X-rays.MethodsSeventeen community pharmacies located in a deprived area of Wales participated between March 2019 and March 2020. Stakeholder interviews were conducted with four patients, seven pharmacy professionals and one general practitioner. Four focus groups were conducted, including one with healthcare professionals (n=6) and three with members of the public who were current and former smokers (n=13). Quantitative data regarding patient characteristics and clinical outcomes were collected from hospital records and patient referral questionnaires completed by pharmacists and analysed using descriptive statistics. Qualitative data sets were analysed thematically and triangulated.ResultsTwelve patients used the pharmacy referral service, all of whom were male. Average length of the pharmacy consultation was 13 min, with a mean 3 days to accessing chest X-rays in secondary care. Patients experienced a mean 46-day wait for results, with no lung cancer detected. Participants found the service to be acceptable and considered the pharmacy element to be broadly feasible. Perceived barriers included low awareness of the service and concerns about the role and capacity of pharmacists to deliver the service. Facilitators included perceived approachability and accessibility of pharmacists. A well-publicised, multifaceted awareness campaign was recommended.ConclusionsA community pharmacy referral service for lung symptoms was considered an acceptable alternative pathway to symptomatic diagnosis of lung cancer in deprived communities. Wider implementation of the service would require workforce capacity and training to be addressed to ensure optimum utilisation and promotion of the service.

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Section: Discussionsupporting

confidence: 86%

Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms

et al. 2021

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“…The attrition of non-White participants and those with lower socioeconomic status has been well documented as an important problem in longitudinal research. 49,50 These participants also may be at a higher risk of low self-efficacy. Likewise, our decision to exclude those in a nursing home setting may have also led to a lower estimation of how self-efficacy influences frailty incidence.…”

Section: Discussionmentioning

confidence: 99%

“…Lastly, those excluded from the study analysis due to death or lack of follow‐up were more likely to have low self‐efficacy, identify as non‐White with lower education and income parameters (Table S1). The attrition of non‐White participants and those with lower socioeconomic status has been well documented as an important problem in longitudinal research 49,50 . These participants also may be at a higher risk of low self‐efficacy.…”

Section: Discussionmentioning

confidence: 99%

Self‐efficacy proxy predicts frailty incidence over time in non‐institutionalized older adults

Hladek

Zhu

Buta

et al. 2021

J American Geriatrics Society

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Background: Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality, and other adverse outcomes upon experiencing stressors. Self-efficacy, which is confidence in one's ability to perform well in a domain of life, is modifiable.Self-efficacy is associated with improved health behavior and decreased chronic disease burden. Its relationship to frailty is unknown. The purpose of this study was to evaluate whether a general self-efficacy proxy predicts incident frailty. Methods: A nationally representative sample of 4825 U.S. older adults aged 65 and older living in the community or non-nursing home care setting enrolled in the National Health and Aging Trends Study from 2011 to 2018 was used. Self-efficacy was dichotomized into low and high groups using the one-item self-efficacy proxy measure. The Physical Frailty Phenotype was used to categorize participants as frail and non-frail. A discrete time hazard model using data from eight rounds was used to obtain incident hazard ratios of frailty in two models. Model 1 was adjusted for age, race, sex, education, and income. Model 2 contained Model 1 covariates and added disability and comorbidities. Results: Among people without frailty at baseline, risk of developing frailty over 7 years was increased by 41% among those with low versus high selfefficacy after adjustment for sociodemographics (P = 0.002), and by 27% after further adjustment for disability and comorbidities (P = 0.032). Conclusion:This study generates a rationale to further explore self-efficacy in frailty research. Self-efficacy may be a key modifiable element to incorporate into multimodal physical frailty interventions.

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“…7 ), and this is likely to have contributed to the lower rate of H. pylori infection observed in the trial. Strategies for encouraging trial participation in more socially deprived areas have been considered in other studies, including community-based recruitment [ 23 ]. Jennings et.…”

Section: Discussionmentioning

confidence: 99%

Recruitment to a large scale randomised controlled clinical trial in primary care: the Helicobacter Eradication Aspirin Trial (HEAT)

Stevenson

Avery

Coupland

et al. 2022

Trials

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Background The Helicobacter Eradication Aspirin Trial (HEAT) is a multicentre, double blind, randomised controlled trial investigating whether Helicobacter (H.) pylori eradication reduces hospitalisation for peptic ulcer bleeding. Recruited participants were aged 60 and over and taking aspirin (≤325 mg daily) for at least four months prior to consent. Based on results of a pilot study, a sample size calculation predicted 6600 H. pylori-positive randomised participants would be required, from 33,000 volunteers, recruited from 170,000 invited patients. Methodology was therefore designed for recruitment of large numbers of patients from primary care using a novel electronic search tool, automated mail-out and electronic follow-up. Recruitment started in 2012 and completed in 2017. Methods All participants were recruited from GP practices, with assistance from the UK Clinical Research Network (UKCRN). H. pylori-positive participants were randomised to one week of eradication treatment or placebo. Recruitment was managed using a bespoke web-based database that communicated directly with a programmed search tool downloaded at participating practices. The primary endpoint is hospitalisation due to peptic ulcer bleeding. The trial will end when 87 adjudicated events have occurred, identified from searches of GP databases, review of secondary care admission data and mortality data, and reported events from randomised participants and GPs. Results HEAT has recruited participants from 1208 GP practices across the UK. Of the 188,875 invitation letters sent, 38,771 returned expressions of interest. Of these, 30,166 patients were consented to the trial, of whom 5355 H. pylori-positive participants (17.8% of those consented) were randomised. Mean age at consent was 73.1 ± 6.9 (SD) years and 72.2% of participants were male. Of the randomised (H. pylori-positive) participants, 531 have died (as of 17 Sep 2020); none of the deaths was due to trial treatment. Conclusion The HEAT trial methodology has demonstrated that recruitment of large numbers of patients from primary care is attainable, with the assistance of the UKCRN, and could be applied to other clinical outcomes studies. Trial registration ClinicalTrials.gov; registration number NCT01506986. Registered on 10 Jan 2012.

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Recruitment and retention of participants from socioeconomically deprived communities: lessons from the Awareness and Beliefs About Cancer (ABACus3) Randomised Controlled Trial

Cited by 9 publications

References 19 publications

Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms

Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms

Self‐efficacy proxy predicts frailty incidence over time in non‐institutionalized older adults

Recruitment to a large scale randomised controlled clinical trial in primary care: the Helicobacter Eradication Aspirin Trial (HEAT)

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