Tosur Mustafa, Gandolfo Laura, Balasubramanyam Ashok, Naylor Rochelle N, Pollin Toni I, Rasouli Neda, Cromer Sara J, Buse John B, Redondo Maria J
Department of Pediatrics, The Division of Diabetes and Endocrinology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Children's Nutrition Research Center, USDA/ARS, Houston, TX, USA.
J Clin Transl Sci. 2023 Jan 23;7(1):e47. doi: 10.1017/cts.2022.529. eCollection 2023.
Diabetes mellitus in underrepresented racial and ethnic groups (URG) is rapidly increasing in incidence and has worse outcomes than diabetes in non-Hispanic White individuals. Rare and Atypical Diabetes Network (RADIANT) established recruitment targets based on the racial and ethnic distribution of the USA to enroll a diverse study population. We examined participation of URG across RADIANT study stages and described strategies to enhance recruitment and retention of URG.
RADIANT is a multicenter NIH-funded study of people with uncharacterized forms of atypical diabetes. RADIANT participants consent online and progress through three sequential study stages, as eligible.
We enrolled 601 participants with mean age 44 ± 16.8 years, 64.4% female. At Stage 1, 80.6% were White, 7.2% African American (AA), 12.2% other/more than one race, and 8.4% Hispanic. Enrollment of URG was significantly below preset targets across most stages. Referral sources differed by race ( < 0.001) but not ethnicity ( = 0.15). Most AA participants were referred by RADIANT investigators (58.5% vs. 24.5% in Whites), whereas flyers, news, social media, and family or friends were more frequent referral sources for White individuals (26.4% vs. 12.2% in AA). Ongoing initiatives to increase enrollment of URG in RADIANT include engaging with clinics/hospitals serving URG, screening electronic medical records, and providing culturally competent study coordination and targeted advertisement.
There is low participation of URG in RADIANT, potentially limiting the generalizability of its discoveries. Investigations into barriers and facilitators for recruitment and retention of URG in RADIANT, with implications for other studies, are ongoing.
在未得到充分代表的种族和族裔群体（URG）中，糖尿病的发病率正在迅速上升，且其预后比非西班牙裔白人的糖尿病更差。罕见和非典型糖尿病网络（RADIANT）根据美国的种族和族裔分布确定了招募目标，以纳入多样化的研究人群。我们研究了URG在RADIANT研究各阶段的参与情况，并描述了提高URG招募和保留率的策略。
RADIANT是一项由美国国立卫生研究院资助的多中心研究，研究对象为患有未明确类型的非典型糖尿病患者。RADIANT参与者通过在线方式同意参与研究，并根据 eligibility 依次进入三个连续的研究阶段。
我们招募了601名参与者，平均年龄为44±16.8岁，女性占64.4%。在第一阶段，80.6%为白人，7.2%为非裔美国人（AA），12.2%为其他/多种族，8.4%为西班牙裔。在大多数阶段，URG的招募人数显著低于预设目标。推荐来源因种族而异（<0.001），但不因族裔而异（=0.15）。大多数AA参与者是由RADIANT研究人员推荐的（58.5%，而白人中这一比例为24.5%），而传单、新闻、社交媒体以及家人或朋友是白人更常见的推荐来源（26.4%，而AA中这一比例为12.2%）。RADIANT正在开展的增加URG招募人数的举措包括与服务URG的诊所/医院合作、筛查电子病历，以及提供具有文化胜任力的研究协调和针对性广告。
URG在RADIANT中的参与度较低，这可能会限制其研究结果的普遍性。目前正在对RADIANT中URG招募和保留的障碍及促进因素进行调查，这对其他研究也有启示意义
