Greene Adina, Yost Kathleen J, Daniels Wendlyn, Butterfield Richard, Zhang Nan, Branch Emily, Costello Collin M
University of Arizona College of Medicine, Phoenix, AZ, USA.
Department of Dermatology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA.
J Racial Ethn Health Disparities. 2025 May 30. doi: 10.1007/s40615-025-02481-y.
In the USA, the Hispanic/Latino population is the largest minority racial/ethnic group; yet, data have shown that they are underrepresented in trials. We conducted an experiment to assess the effect on response rate and cost of three email formats to engage Hispanic/Latino patients.
Patients were randomly allocated to either Arm 1 ("Survey Research Center (SRC) Plain"), which was a plain email script with text only; Arm 2 ("SRC Formatted"), which included photos of Latino individuals; or Arm 3 ("Vendor Formatted"), which had a visual layout like Arm 2, but the email distribution was routed through a third-party's software. The overall response rate (RR1) was defined as the number of respondents who engaged with the survey (partial or complete response). The completed response rate (RR2) is the number of complete responses compared to patients invited to complete the survey. RR1 and RR2 were compared between arms using the Chi-Sq test. Analyses were performed in SAS v9.4 (SAS Institute; Cary, North Carolina).
In total, 89,778 participants were emailed. The mean age of respondents was 54.2 years (SD 14.5 years), and most respondents, 65.7%, were female, with no significant differences across all three arms. The overall response rate (RR1) for all 89,778 individuals was 2.3% (2004 responses). The overall completion rate was not significantly different across the three arms (69.6%, 66.9%, 68.4%, respectively, p = 0.589). Actual costs for implementing the three arms are proprietary. Using Arm 1 (Plain Text) as the reference, Arm 2 (SRC Formatted) costs were 1.5 times higher than Arm 1, and Arm 3 (Vendor formatted) costs were 30 times higher than Arm 1.
Although the costs differed substantially between Arms 1, 2, and 3 in this study, we found no statistically significant differences in response rate between arms amongst English and Spanish speakers. These findings suggest that investigators should avoid spending additional resources on email campaigns incorporating images or outsourcing to third-party vendors when contacting Hispanics/Latinos in English or Spanish for research-related studies and focus on other ways to help foster engagement amongst this population, including incorporating community partners and incorporating Hispanic/Latino cultural values.
在美国，西班牙裔/拉丁裔人口是最大的少数族裔种族/族群；然而，数据表明他们在试验中的代表性不足。我们进行了一项实验，以评估三种电子邮件格式对吸引西班牙裔/拉丁裔患者的响应率和成本的影响。
患者被随机分配到第1组（“调查研究中心（SRC）普通格式”），这是一个只有文本的普通电子邮件脚本；第2组（“SRC格式化格式”），其中包括拉丁裔个体的照片；或第3组（“供应商格式化格式”），其视觉布局与第2组类似，但电子邮件分发通过第三方软件进行。总体响应率（RR1）定义为参与调查的受访者数量（部分或完整回复）。完整回复率（RR2）是与受邀完成调查的患者相比的完整回复数量。使用卡方检验比较各组之间的RR1和RR2。分析在SAS v9.4（SAS研究所；北卡罗来纳州卡里）中进行。
总共向89778名参与者发送了电子邮件。受访者的平均年龄为54.2岁（标准差14.5岁），大多数受访者（65.）为女性，三组之间无显著差异。所有89778人的总体响应率（RR1）为2.3%（2004份回复）。三组的总体完成率无显著差异（分别为69.6%、66.9%、68.4%，p = 0.589）。实施三组的实际成本是保密的。以第1组（纯文本）为参考，第2组（SRC格式化格式）的成本比第1组高1.5倍，第3组（供应商格式化格式）的成本比第1组高30倍。
尽管本研究中第1组、第2组和第3组的成本差异很大，但我们发现英语和西班牙语使用者在各组之间的响应率没有统计学上的显著差异。这些发现表明，在针对西班牙裔/拉丁裔进行与研究相关的联系时，研究人员应避免在包含图像的电子邮件活动或外包给第三方供应商方面花费额外资源，而应专注于其他有助于促进该人群参与的方法，包括纳入社区合作伙伴和融入西班牙裔/拉丁裔文化价值观。
