Psychology Department, The Graduate Center, City University of New York, NY, USA.
Psychology Department, Penn State Lehigh Valley, PA, USA.
Soc Sci Med. 2020 Jun;255:113009. doi: 10.1016/j.socscimed.2020.113009. Epub 2020 Apr 22.
The differential attrition of racial/ethnic minority participants in clinical research is a major threat to advancing medical and behavioral science.
Our aim was to examine the influence of racial/ethnic concordance between participants and research staff on study attrition.
Data were pooled from participants and clinical research coordinators (CRCs) in six longitudinal studies of respiratory illness. Dyads were classified as concordant if the patient and CRC were of the same racial/ethnic group. Multilevel modeling examined the effect of racial/ethnic concordance on attrition at the first and one-year follow-ups.
Spanish language, lower education, and greater depressive symptoms predicted greater attrition, but these effects disappeared in adjusted models. Race/ethnicity, age, gender and health literacy did not predict attrition. Contrary to hypotheses, attrition was greater among concordant than discordant dyads: Attrition was almost five times greater at first follow-up for Black and Hispanic participants in concordant dyads, and almost four times greater at one year.
Racial/ethnic concordance between participant and CRCs was related to greater attrition in a highly diverse sample of adults with respiratory illness. Differential attrition of racial/ethnic minorities is a major threat to advancing public health. Interactions with research staff may be critical to bridging the disparities gap.
临床研究中少数族裔参与者的差异流失是推进医学和行为科学发展的主要威胁。
我们旨在研究参与者和研究人员之间的种族/民族一致性对研究流失的影响。
从六项呼吸道疾病的纵向研究中汇总了参与者和临床研究协调员(CRC)的数据。如果患者和 CRC 属于同一种族/民族群体,则将对偶分类为一致。多层次模型检查了种族/民族一致性对首次和一年随访时流失的影响。
西班牙语、较低的教育程度和更大的抑郁症状预示着更大的流失,但这些影响在调整后的模型中消失了。种族/民族、年龄、性别和健康素养均不能预测流失。与假设相反,一致的对偶比不一致的对偶流失更大:在首次随访时,黑人和西班牙裔参与者在一致的对偶中流失率几乎高出五倍,而在一年时则高出四倍。
在一项具有高度多样性的呼吸道疾病成年参与者中,参与者和 CRC 之间的种族/民族一致性与更高的流失率有关。少数族裔的差异流失是推进公共卫生的主要威胁。与研究人员的互动对于缩小差距至关重要。