Abstract
BackgroundTo improve equity in access to medical research, successful strategies are needed to recruit diverse populations. Here, we examine experiences of community health center (CHC) staff who guided an informed consent process to overcome recruitment barriers in a medical record review study.MethodsWe conducted ten semi-structured interviews with CHC staff members. Interviews were audiotaped, transcribed, and structurally and thematically coded. We used NVivo, an ethnographic data management software program, to analyze themes related to recruitment challenges.ResultsCHC interviewees reported that a key challenge to recruitment included the difficult balance between institutional review board (IRB) requirements for informed consent, and conveying an appropriate level of risk to patients. CHC staff perceived that the requirements of IRB certification itself posed a barrier to allowing diverse staff to participate in recruitment efforts. A key barrier to recruitment also included the lack of updated contact information on CHC patients. CHC interviewees reported that the successes they experienced reflected an alignment between study aims and CHC goals, and trusted relationships between CHCs and staff and the patients they recruited.ConclusionsMaking IRB training more accessible to CHC-based staff, improving consent form clarity for participants, and developing processes for routinely updating patient information would greatly lower recruitment barriers for diverse populations in health services research.
Highlights
To improve equity in access to medical research, successful strategies are needed to recruit diverse populations
The objective of the present study is to describe themes related to the barriers in the recruitment of diverse populations in medical and health services research, and to describe specific details on the facilitating factors and strategies used to address these challenges from the perspective of community health center (CHC) staff
CHC staff indicated that difficulty locating potential participants due to participants’ residential mobility and/or lack of up to date contact information was the greatest barrier to recruitment
Summary
To improve equity in access to medical research, successful strategies are needed to recruit diverse populations. Known barriers from the perspective of potential participants include: distrust of the research community [2,3,4,5,6,7,8,9,10,11,12,13,14]; lack of knowledge or awareness of medical research [3,6,8,12,14,15,16]; concerns over confidentiality and privacy [10,11,14,17,18]; fear that participation in a research study could result in a loss of health services or deportation due to immigration status [10,11]; and an ineffective informed consent process [3,11,19,20]. Context of the current study To overcome recruitment barriers, increasingly, there are opportunities for community health centers (CHCs) and academic medical centers to partner to improve recruitment of minority or vulnerable populations into biomedical, health services, and community participatory research [22]. While academic medical institutions can provide expertise in study design and research processes, CHCs can offer important knowledge and cultural contexts of their patient populations that may enhance recruitment
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