Recruitment of Older African American Males for Depression Research: Lessons Learned

Bryant, Keneshia; Wicks, Mona; Willis, Nathaniel

doi:10.1016/j.apnu.2013.09.006

Cited by 11 publications

(13 citation statements)

References 30 publications

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“…The NIH has acknowledged the need for increased enrollment of ethnic minorities in biomedical research, yet minority enrollment into clinical and translational research remains low. 10 Notable contributing factors include negative experiences with the health care system, misunderstandings caused by poor communication, and problems interpreting medical terminology. 1 – 3 , 7 …”

Section: Introductionmentioning

confidence: 99%

“…Recent data suggest that successful recruitment and enrollment rates have fallen to levels that could endanger the successful completion of some categories of research. 10 Though overall enrollment into clinical and biomedical research in general continues to be a challenge across multiple studies, minority enrollment poses an even greater challenge. In addition, the elderly, are generally underrepresented.…”

Section: Introductionmentioning

confidence: 99%

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Best strategies to recruit and enroll elderly Blacks into clinical and biomedical research

Graham¹,

Ngwa²,

Ntekim³

et al. 2017

CIA

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BackgroundHistorically, Blacks have been disproportionately underrepresented in clinical trials. Outcomes associated with low Blacks’ participation in research include poor understanding of the predictors and treatment of the disease, increasing health disparities, poor health equity, and suboptimal wellness of the nation as a whole. To address this gap in research participation, we analyzed our recruitment data to identify the most effective strategies for enrolling older Blacks in clinical trials.MethodsData used in these analyses were obtained from 3,266 potential volunteers, ages 50 or older, who completed a Mini-Mental State Exam as part of recruitment and screening for various clinical studies on Alzheimer’s disease. In order to determine the most effective strategies for engaging Blacks in clinical research, we used tests of proportion to assess significant differences in recruitment sources, counts, and percentages for optimal recruitment strategies by gender. Finally, we employed regression analyses to confirm our findings.ResultsOf the total 3,266 screened, 2,830 Black volunteers were identified for further analysis. Overall, more women than men (73.8% vs 26.2%) participated in our recruitment activities. However, a significantly higher proportion of men than women were engaged through family (3.86% vs 1.30%, p=0.0004) and referral sources (5.89% vs 2.59%, p=0.0005). Compared to other sources for recruitment, we encountered a higher proportion of volunteers at health fairs (42.95%), and through advertisements (14.97%). In our sample, years of education and age did not appear to influence the likelihood of an encounter, screening, and potential participation.ConclusionOur findings indicate Black men and women in our sample were predominantly recruited from health fairs and through advertisements tailored to their health needs and interests. Conversely, we mostly engaged Black men through family referrals and persons known to them, indicating a need for trust in their decision to engage study personnel and/or participate in clinical trials.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Best strategies to recruit and enroll elderly Blacks into clinical and biomedical research

Graham¹,

Ngwa²,

Ntekim³

et al. 2017

CIA

View full text Add to dashboard Cite

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“…Recent reports in the United Kingdom (UK) suggest that more people than ever are being approached to participate in trials [ 6 ]; however the proportion of people who enrol is small and recruitment remains a problem, with between 45 % and 80 % of trials failing to meet recruitment targets [ 2 , 7 ]. The difficulties may be even more pronounced when enrolling patients with depression, with many examples of trial failure due to poor recruitment [ 8 , 9 ]. The challenges stem from sources including: the stigma of mental illness; poor identification of mental disorders by clinicians; diagnoses which adversely affect patients’ ability and motivation to participate in research; and mistrust [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

What can we learn from trial decliners about improving recruitment? Qualitative study

Hughes-Morley

Young

Hempel

et al. 2016

Trials

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BackgroundTrials increasingly experience problems in recruiting participants. Understanding the causes of poor recruitment is critical to developing solutions. We interviewed people who had declined a trial of an innovative psychological therapy for depression (REFRAMED) about their response to the trial invitation, in order to understand their decision and identify ways to improve recruitment.MethodsOf 214 people who declined the trial, 35 (16 %) gave permission to be contacted about a qualitative study to explore their decision. Analysis of transcripts of semi-structured interviews was informed by grounded theory.ResultsWe interviewed 20 informants: 14 women and six men, aged 18 to 77 years. Many interviewees had prior experience of research participation and positive views of the trial. Interviewees’ decision making resembled a four-stage sequential process; in each stage they either decided not to participate in the trial or progressed to the next stage. In stage 1, interviewees assessed the invitation in the context of their experiences and attitudes; we term those who opted out at this stage ‘prior decliners’ as they had an established position of declining trials. In stage 2, interviewees assessed their own eligibility; those who judged themselves ineligible and opted out at this stage are termed ‘self-excluders’. In stage 3, interviewees assessed their need for the trial therapy and potential to benefit; we term those who decided they did not need the trial therapy and opted out at this stage ‘treatment decliners’. In stage 4, interviewees deliberated the benefits and costs of trial participation; those who opted out after judging that disadvantages outweighed advantages are termed ‘trial decliners’. Across all stages, most individuals declined because they judged themselves ineligible or not in need of the trial therapy. While ‘prior decliners’ are unlikely to respond to any trial recruitment initiative, the factors leading others to decline are amenable to amelioration as they do not arise from a rejection of trials or a personal stance.ConclusionsTo improve recruitment in similar trials, the most successful interventions are likely to address patients’ assessments of their eligibility and their potential to benefit from the trial treatment, rather than reducing trial burden.Trial registrationInternational Standard Randomised Controlled Trial Number: ISRCTN85784627. Registration date 10 August 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1626-4) contains supplementary material, which is available to authorized users.

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“…Mental health disorders are the leading cause of disability among adults worldwide [3]; however, trials enrolling patients with mental health problems experience even greater recruitment challenges [4–7]. These challenges stem from various sources including stigma [8] and issues related to the diagnosis adversely impacting on the patient’s ability and motivation to participate in research [9].…”

Section: Introductionmentioning

confidence: 99%

The impact of advertising patient and public involvement on trial recruitment: embedded cluster randomised recruitment trial

Hughes-Morley

Hann

Fraser

et al. 2016

Trials

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BackgroundPatient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate this clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants.MethodsThis is a cluster trial, embedded within a host trial (‘EQUIP’) recruiting service users diagnosed with severe mental illness. The intervention was informed by a systematic review, a qualitative study, social comparison theory and a stakeholder workshop including service users and carers. Adopting Participatory Design approaches, we co-designed the recruitment intervention with PPIR partners using a leaflet to advertise the PPIR in EQUIP and sent potential participants invitations with the leaflet (intervention group) or not (control group). Primary outcome was the proportion of patients enrolled in EQUIP. Secondary outcomes included the proportions of patients who positively responded to the trial invitation.ResultsThirty-four community mental health teams were randomised and 8182 service users invited. For the primary outcome, 4% of patients in the PPIR group were enrolled versus 5.3% of the control group. The intervention was not effective for improving recruitment rates (adjusted OR = 0.75, 95% CI = 0.53 to 1.07, p = 0.113). For the secondary outcome of positive response, the intervention was not effective, with 7.3% of potential participants in the intervention group responding positively versus 7.9% of the control group (adjusted OR = 0.74, 95% CI = 0.53 to 1.04, p = 0.082). We did not find a positive impact of directly advertising PPIR on any other outcomes.ConclusionTo our knowledge, this is the largest ever embedded trial to evaluate a recruitment or PPIR intervention. Advertising PPIR did not improve enrolment rates or any other outcome. It is possible that rather than advertising PPIR being the means to improve recruitment, PPIR may have an alternative impact on trials by making them more attractive, acceptable and patient-centred. We discuss potential reasons for our findings and implications for recruitment practice and research.Trial registration numbersISRCTN, ISRCTN16488358. Registered on 14 May 2014.Study Within A Trial, SWAT-26. Registered on 21 January 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1718-1) contains supplementary material, which is available to authorized users.

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Recruitment of Older African American Males for Depression Research: Lessons Learned

Cited by 11 publications

References 30 publications

Best strategies to recruit and enroll elderly Blacks into clinical and biomedical research

Best strategies to recruit and enroll elderly Blacks into clinical and biomedical research

What can we learn from trial decliners about improving recruitment? Qualitative study

The impact of advertising patient and public involvement on trial recruitment: embedded cluster randomised recruitment trial

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