UyBico Stacy J, Pavel Shani, Gross Cary P
Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
J Gen Intern Med. 2007 Jun;22(6):852-63. doi: 10.1007/s11606-007-0126-3. Epub 2007 Mar 21.
Members of vulnerable populations are underrepresented in research studies.
To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies.
Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study.
African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35-45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms.
Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies.
弱势群体成员在研究中所占比例不足。
评估并综合有关干预措施的证据，以提高弱势群体参与健康研究的比例。
通过检索MEDLINE、科学引文索引数据库、个人资源、手工检索相关期刊及文章参考文献来确定研究。纳入的研究需包含针对弱势群体（少数族裔、服务不足群体、贫困群体、农村群体、城市群体或市中心群体）的招募干预措施数据，且其母研究（正在进行招募的研究）为干预性研究。共筛选了2648个研究标题，48篇文章符合纳入标准，代表56项母研究。两名研究人员从每项研究中提取数据。
非裔美国人是最常被作为目标的群体（82%的研究），而46%的研究针对西班牙裔/拉丁裔。许多研究评估了两种或更多干预措施，包括社会营销（82%的研究）、社区外展（80%）、卫生系统招募（52%）和转诊（28%）。方法学的严谨程度差异很大。只有40项研究（71%）纳入了对照组，21%使用统计分析来比较干预措施。在尝试社会营销、卫生系统和转诊招募的研究中，分别约有35% - 45%的研究发现这些是最成功的干预措施，而社区外展在其实施的16项研究中仅有2项（13%）是最成功的干预措施。因社会营销而被联系的人参与研究的可能性并不低于通过其他机制被联系的人。
需要开展方法学更严谨的进一步工作，以确定增加少数族裔参与研究的循证策略；作为一种孤立的策略，社区外展可能不如其他策略成功。
