Abstract P387: Research Participation Rates and Characteristics in Underrepresented Groups in a West Virginia-Based Pregnancy Cohort Study

Abstract

Introduction: Individuals living in rural areas, identifying as underrepresented racial minorities, and with low socioeconomic status tend to be poorly represented in research. Each underrepresented group experiences unique barriers that may prevent them from participating in research. Objectives and Hypothesis: This study aimed to test the hypotheses that 1) in a West Virginia-based pregnancy cohort study, individuals identifying as rural, an underrepresented racial minority, or receiving Medicaid/Medicare (as a surrogate for socioeconomic status) would have lower participation rates than typically better represented populations; and 2) that people from each underrepresented group would have different characteristics associated with screening for and consenting to participate in the pregnancy cohort study. Methods: Potentially eligible participants were sent recruitment messages via MyChart, a patient facing app linked to their electronic medical record. Upon receiving the message, participants could express their interest to participate in the study by filling out an eligibility screening form and, eventually, consent to participate at a study visit. Screening and consenting rates were calculated, stratified by rurality (i.e., urban, micropolitan rural, small town rural), race (i.e., white, underrepresented racial minority), and insurance status (i.e., Medicaid/Medicare, private). Logistic regression was used to test which characteristics were associated with screening for and participating in the study in each group. Results: Between October 2022 - April 2023, 1024 potential participants were sent recruitment messages. Screening rates (7.3% urban, 7.6% micropolitan rural, 8.8% small town rural; 7.3% White, 10.1% underrepresented racial minorities; 7.9% private insurance, 7.1% Medicaid/Medicare) and consenting rates (2.5% urban, 2.1% micropolitan rural, 4.6% small town rural; 2.8% White, 1.4% underrepresented racial minorities; 3.6% private insurance, 1.9% Medicaid/Medicare) were similar between different underrepresented groups and their better represented counterparts. For small town rural participants, preterm births (OR 6.85 [2.04 - 33.7]) and number of children (OR .24 [.05 - .71]) were associated with participating in the study. Those who identified as an underrepresented racial minority were more likely to screen for the study if they had private health insurance (OR 16.81 [1.53 - 500]). People with Medicaid/Medicare were more likely to participate in the study if they lived in a small town rural area (OR 7.71 [1.57 - 58.97]). Conclusion: Differences in characteristics associated with research participation suggest that researchers may need to tailor recruitment strategies to better consider characteristics of different underserved groups.