Yields and costs of recruitment methods with participant phenotypic characteristics for a diabetes prevention research study in an underrepresented pediatric population

Abstract

Background/aims: Prediabetes and diabetes disproportionately impact Latino youth, yet few diabetes prevention programs have prioritized inclusion of this underrepresented population. This report describes the recruitment process, yields, associated costs, and phenotypic characteristics of Latino youth with obesity and prediabetes enrolled in a randomized controlled diabetes prevention study in the USA. Methods: Recruitment efforts included referrals from clinics, community outlets, local media, and word of mouth with the goal of enrolling 120 Latino adolescents aged 12-16 with obesity (BMI > 95th percentile) and prediabetes. Prediabetes eligibility was determined by any of the following: HbA1c between 5.7 and 6.5%, fasting glucose between 100 and 125 mg/dL, or a 2-h glucose between 120 and 199 mg/dL following a 75-g oral glucose tolerance test (OGTT), but not meeting any of the diagnostic criteria for diabetes. Eligible participants were randomized 2:1 to either a 6-month community-based lifestyle intervention that included group nutrition and health education classes (1 day/week) and group exercise classes (2 days/week) or usual care control arm. Recruitment yields were determined by review of referral source in the study screening database. Recruitment costs were determined by an after-the-fact financial review of actual and in-kind costs. Participant phenotypic characteristics (i.e., demographics, anthropometrics, and biochemical data) were compared by recruitment strategy using a one-way ANOVA.

Barriers to and solutions for representative inclusion across the lifespan and in life course research: The need for structural competency highlighted by the COVID-19 pandemic

“…Use of technology (e.g., social networking sites and study websites) and multimedia materials have been successful for recruiting adolescents, including reaching those who otherwise may have been overlooked [49][50][51][52][53]. However, the enhanced efficiency of recruitment based on informatics and related approaches (e.g., through EHR screening) may be outweighed by the benefits of personal, individualized strategies with research staff or providers [51] or referrals through word-of-mouth or friends/family [45,52,54].…”

“…monitoring of a child's health and dealing with multiple health issues simultaneously may also be beneficial [59,60]. Like many other populations, incentives for participation, such as transportation reimbursements, may improve research recruitment and retention [41,43,44,48,52,54,56,57,60]. A common theme in successful recruitment and retention of pregnant women and children was that personalized interaction with study personnel helped build relationship and engender trust [44,45,52,55,57,60].…”

Effects of a Diabetes Prevention Program on Type 2 Diabetes Risk Factors and Quality of Life Among Latino Youths With Prediabetes

“…Participants were recruited through local schools, community organizations, churches, and media outlets tailored to the local Latino community. 19 Bilingual, bicultural research personnel conducted an initial telephone screening with interested individuals to confirm age, Latino descent, and BMI estimates and to provide a description of the study. Interested individuals were scheduled for a screening visit to determine eligibility.…”

Communicating incidental and reportable findings from research MRIs: considering factors beyond the findings in an underrepresented pediatric population

“…Details of the Preventing Diabetes in Latino Youth study design and methodology have been previously published [ 32 ]. Participants were enrolled from a variety of community and clinical settings [ 33 ] and randomized to either six-month lifestyle intervention or a usual care control group. Inclusion criteria were youth aged 12–16 years old at enrollment, who self-identified as Latino, with obesity (BMI ≥95th percentile for age and sex or a BMI ≥30 kg/m 2 ), and prediabetes (hemoglobin A1c between 5.7–6.4%, fasting glucose between 100 and 125 mg/dL, or 2-h glucose between 120 and 199 mg/dL).…”