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确定为服务低收入人群的社区诊所开展的临床研究的参与率和招募障碍:一项队列研究。

Determining call-to-entry rate and recruitment barriers in clinical studies for community clinics serving low-income populations: a cohort study.

机构信息

Department of Internal Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA

Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

出版信息

BMJ Open. 2023 Oct 28;13(10):e077819. doi: 10.1136/bmjopen-2023-077819.

Abstract

BACKGROUND

Recruitment for clinical studies is challenging. To overcome barriers, investigators have previously established call-to-entry rates to assist in planning. However, rates specific to low-income minority populations are needed to account for additional barriers to enrolment these individuals face.

OBJECTIVE

To obtain a call-to-entry rate in a low-income uninsured Hispanic population with chronic disease.

METHODS

We used data from four of our randomised clinical studies to determine the call-to-entry rate for individuals (n=1075) with or at risk for type 2 diabetes: participants needed/potential participants contacted=recruitment rate (yield). Research staff contacted potential participants to enrol in a study that evaluated 6 month diabetes programmes at community clinics from 2015 to 2020. We recorded call-to-entry rates, reasons for declining the study, show rates, and attrition.

RESULTS

The call-to-entry rate was 14.5%. Forty per cent of potential participants could not be contacted, and 30.6%, 19.1%, and 5.4% responded , , and , respectively. No show percentages were 54% for and 91.4% for responders. The majority (61.6%) declined due to inability to attend; reasons to decline included work (43%), eligibility (18%), transportation (10%), out of town (9%), did not think they needed the programme (7%) and other/unknown (14%). Being a physician predicted inability to reach participants (adjusted OR 2.91, 95% CI 1.73 to 4.90). Attrition was 6.8%.

CONCLUSIONS

We described a call-to-entry rate and detailed recruitment data, including reasons to decline the study. This valuable information can assist investigators in study planning and overcoming enrolment barriers in low-income populations. Telehealth-based or strategies that limit transportation needs may increase participant involvement.

TRIAL REGISTRATION NUMBER

NCT03394456.

摘要

背景

临床研究的招募具有挑战性。为了克服障碍,研究人员之前已经建立了进入率来协助计划。然而,需要针对低收入少数族裔群体制定特定的进入率,以说明这些人在入组方面面临的额外障碍。

目的

在患有慢性病的低收入、未参保的西班牙裔人群中获得进入率。

方法

我们使用了来自我们四项随机临床试验的数据,以确定患有或有患 2 型糖尿病风险的个体(n=1075)的进入率:参与者需要/潜在参与者联系=招募率(收益率)。研究人员联系潜在参与者,邀请他们参加一项评估社区诊所 6 个月糖尿病项目的研究,研究时间为 2015 年至 2020 年。我们记录了进入率、拒绝研究的原因、展示率和流失率。

结果

进入率为 14.5%。40%的潜在参与者无法联系,30.6%、19.1%和 5.4%分别回应了 、 、 。失访率分别为 54%和 91.4%。大多数(61.6%)拒绝是因为无法参加;拒绝的原因包括工作(43%)、资格(18%)、交通(10%)、不在当地(9%)、认为自己不需要该项目(7%)和其他/未知(14%)。是否为医生预测了无法联系到参与者(调整后的 OR 2.91,95%CI 1.73 至 4.90)。流失率为 6.8%。

结论

我们描述了进入率和详细的招募数据,包括拒绝研究的原因。这些有价值的信息可以帮助研究人员进行研究计划,并克服低收入人群的入组障碍。基于远程医疗的或限制交通需求的策略可能会增加参与者的参与度。

试验注册号

NCT03394456。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf3e/10619090/a4b05fc2e870/bmjopen-2023-077819f01.jpg

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