Housing-Based Socioeconomic Status (HOUSES) Index as a Recruitment Tool for Integrating Under-represented Populations in Clinical Research

Abstract

While minority children are in general under-represented in clinical research, the role of socioeconomic status (SES) on recruitment for research is poorly understood. This cross-sectional study utilized a large pediatric birth cohort (n=8,196), who participated in a prospective study for childhood asthma between 2016-2017 (n=300). SES was based on the HOUSES index, an individual-level housing-based SES, with a higher HOUSES score indicating a higher SES. HOUSES as a standardized z-score from the entire Olmsted county MN population was assigned to the study cohort. The distribution of the HOUSES index (in quartiles) and race/ethnicity was compared between invited children (IC) and accrued children (AC). We invited 793 eligible children (mean [SD] age: 13.4 years [2.7], 55% males) of which 300 (AC) were enrolled (13.1 years [2.5], 53% males). Compared to the all invited children (IC), those from racial/ethnic minorities were under-represented in the final study cohort (e.g., frequency of Blacks in IC was 6%, while 3% in AC vs. 78% and 81% for Whites), as were low SES families (e.g., 23% in IC vs 21% in AC for HOUSES Q1 vs. 27% vs 31% for Q4). In Caucasian children, a higher HOUSES was associated with a higher participation whereas African American children with lower HOUSES tended to participate in the study. HOUSES may add to race and ethnicity information for predicting research participation in childhood asthma studies. HOUSES could be a useful tool for recruitment planning and community engagement to integrate minority children in clinical research.