Department of Health Management, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA.
Division of Cardiovascular Medicine, College of Medicine, Howard University, Washington, DC, USA.
Clin Interv Aging. 2017 Dec 22;13:43-50. doi: 10.2147/CIA.S130112. eCollection 2018.
Historically, 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.
Data 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.
Of 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%, =0.0004) and referral sources (5.89% vs 2.59%, =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.
Our 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.
历史上，黑人在临床试验中所占比例不成比例。黑人参与研究程度低会导致与疾病相关的预测因素和治疗方法理解不足、健康差距扩大、健康公平性下降以及整个国家的健康状况不佳等后果。为了解决这一研究参与差距，我们分析了我们的招募数据，以确定招募老年黑人参与临床试验的最有效策略。
这些分析中使用的数据来自 3266 名年龄在 50 岁或以上的潜在志愿者，他们在参与和筛选各种阿尔茨海默病临床研究时完成了 Mini-Mental State 检查。为了确定招募黑人参与临床研究的最有效策略，我们使用比例检验来评估招募来源、计数和百分比在性别方面的最佳招募策略上的显著差异。最后，我们采用回归分析来证实我们的发现。
在总共筛选的 3266 人中，确定了 2830 名黑人志愿者进行进一步分析。总体而言，女性（73.8%）比男性（26.2%）更多地参与我们的招募活动。然而，男性通过家庭（3.86%）和推荐（5.89%）招募的比例明显高于女性（1.30%），差异具有统计学意义（=0.0004）。与其他招募来源相比，我们在健康博览会上（42.95%）和广告中（14.97%）遇到的志愿者比例更高。在我们的样本中，受教育程度和年龄似乎并没有影响遇到、筛选和潜在参与的可能性。
我们的研究结果表明，在我们的样本中，黑人男女主要通过健康博览会和针对他们健康需求和兴趣的广告招募。相反，我们主要通过家庭推荐和他们认识的人招募黑人男性，这表明他们需要信任招募研究人员和/或参与临床试验的决定。
