Enrolling African-American and Latino Patients with Asthma in Comparative Effectiveness Research: Lessons Learned From Eight Patient-Centered Studies

Publication date: Available online 24 October 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): C. Bradley Kramer, Lisa LeRoy, Sara Donahue, Andrea J. Apter, Tyra Bryant-Stephens, John Elder, Winifred Hamilton, Jerry A. Krishnan, Deborah Q. Shelef, James W. Stout, Kaharu Sumino, Stephen Teach, Alex D. Federman
BackgroundAfrican-American and Latino patients are often difficult to recruit for asthma studies. This challenge is a barrier to improving asthma care and outcomes for these populations.ObjectiveTo examine the recruitment experiences of 8 asthma comparative effectiveness studies that specifically targeted African-American and Latino patients, and identify the solutions they developed to improve recruitment.MethodsCase report methodology was used to gather and evaluate information on study design, recruitment procedures and outcomes from study protocols and annual reports, and in-depth interviews with each research team. Data were analyzed for themes, commonalities and differences.ResultsThere were 4 domains of recruitment challenges: individual participant, institutional, research team and study intervention. Participants had competing demands for time and some did not believe they had asthma. Institutional challenges included organizational policies governing monetary incentives and staff hiring. Research team challenges included ongoing training needs of recruitment staff, and intervention designs often were unappealing to participants because of inconveniences. Teams identified a host of strategies to address these challenges, most importantly engagement of patient and other stakeholders in study design and trouble-shooting, and flexibility in data collection and intervention application to meet the varied needs of patients.ConclusionAsthma researchers may have greater success with recruitment by addressing uncertainty among patients about asthma diagnosis, engaging stakeholders in all aspects of study design and implementation, and maximizing flexibility of study and intervention protocols. However, even with such efforts, engagement of African-American and Latino patients in asthma research may remain low. Greater investment in research on engaging these populations in asthma research may ultimately be needed to improve their asthma care and outcomes.

Teaser

Recruitment of low income, minority asthma patients into eight PCORI funded studies required time, extensive effort and resources. Researchers carefully addressed each barrier and engaged stakeholders in recruitment efforts beginning in the early stages of the studies.


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