Reasons For Non-participation Research Articles

Rationale and design of the TAILOR-PCI digital study: Transitioning a randomized controlled trial to a digital registry

BackgroundTailored Antiplatelet Initiation to Lessen Outcomes Due to Decreased Clopidogrel Response after Percutaneous Coronary Intervention (TAILOR-PCI) is the largest cardiovascular genotype-based randomized pragmatic trial (NCT#01742117) to evaluate the role of genotype-guided selection of oral P2Y12 inhibitor therapy in improving ischemic outcomes after PCI. The trial has been extended from the original 12- to 24-month follow-up, using study coordinator-initiated telephone visits. TAILOR-PCI Digital Study tests the feasibility of extending the trial follow-up in a subset of patients for up to 24 months using state-of-the-art digital solutions. The rationale, design, and approach of extended digital study of patients recruited into a large, international, multi-center clinical trial has not been previously described.MethodsA total of 930 patients from U.S. and Canadian sites previously enrolled in the 5,302 patient TAILOR-PCI trial within 23 months of randomization are invited by mail to the Digital Study website (http://tailorpci.eurekaplatform.org) and by up to 2 recruiting telephone calls. Eureka, a direct-to-participant digital research platform, is used to consent and collect prospective data on patients for the digital study. Patients are asked to answer health-related surveys at fixed intervals using the Eureka mobile app and or desktop platform. The likelihood of patients enrolled in a randomized clinical trial transitioning to a registry using digital technology, the reasons for nonparticipation and engagement rates are evaluated. To capture hospitalizations, patients may optionally enable geofencing, a process that allows background location tracking and triggering of surveys if a hospital visit greater than 4 hours is detected. In addition, patients answer digital hospitalization surveys every month. Hospitalization data received from the Digital Study will be compared to data collected from study coordinator telephone visits during the same time frame.ConclusionsThe TAILOR-PCI Digital Study evaluates the feasibility of transitioning a large multicenter randomized clinical trial to a digital registry. The study could provide evidence for the ability of digital technology to follow clinical trial patients and to ascertain trial-related events thus also building the foundation for conducting digital clinical trials. Such a digital approach may be especially pertinent in the era of COVID-19.

Factors Predicting Participation in the Prospective Genomic Sequencing Study, Total Cancer Care (TCC), in Kentucky.

Large-scale genomic sequencing studies are driving oncology drug development. However, rural populations, like those residing in Appalachian Kentucky, are underrepresented in these efforts. In this study, we determined the frequency of participation, reasons for nonparticipation, and factors predicting the decision to participate in the Total Cancer Care (TCC) prospective genomic cohort study. A total of 1,188 patients were invited to enroll in the TCC prospective cohort from December 2018 to May 2019. Declining patients were queried for their rationale for nonparticipation and their patient data were obtained from the Kentucky Cancer Registry (KCR). Logistic regression was used to assess the association between characteristics and study participation. The association of study participation with survival was modeled with Cox proportional-hazards regression. 90.9% (1,081) patients consented to participate. In multivariate analysis, factors significantly associated with participation were age, gender, treatment status, and race. Though overall more women participated in the study, men were more likely to participate than women when invited (OR 1.57). Younger, Caucasian individuals who had received chemotherapy, but not surgery, were also more likely to participate. Patients in the Kentucky Appalachian cohort were primarily rural, had less educational attainment, and lower socioeconomic status. Kentucky Appalachian patients were no less likely to enroll in TCC than non-Appalachian patients. Consented individuals had higher overall survival compared to those who declined. Though minorities, those with low socioeconomic status, and rural populations are underrepresented in genomic studies, they were no less likely to participate when given the opportunity, and participation was associated with better clinical outcomes.

Prediction of (Non)Participation of Older People in Digital Health Research: Exergame Intervention Study.

BackgroundThe use of digital technologies is increasing in health care. However, studies evaluating digital health technologies can be characterized by selective nonparticipation of older people, although older people represent one of the main user groups of health care.ObjectiveWe examined whether and how participation in an exergame intervention study was associated with age, gender, and heart failure (HF) symptom severity.MethodsA subset of data from the HF-Wii study was used. The data came from patients with HF in institutional settings in Germany, Italy, the Netherlands, and Sweden. Selective nonparticipation was examined as resulting from two processes: (non)recruitment and self-selection. Baseline information on age, gender, and New York Heart Association Functional Classification of 1632 patients with HF were the predictor variables. These patients were screened for HF-Wii study participation. Reasons for nonparticipation were evaluated.ResultsOf the 1632 screened patients, 71% did not participate. The nonrecruitment rate was 21%, and based on the eligible sample, the refusal rate was 61%. Higher age was associated with lower probability of participation; it increased both the probabilities of not being recruited and declining to participate. More severe symptoms increased the likelihood of nonrecruitment. Gender had no effect. The most common reasons for nonrecruitment and self-selection were related to physical limitations and lack of time, respectively.ConclusionsResults indicate that selective nonparticipation takes place in digital health research and that it is associated with age and symptom severity. Gender effects cannot be proven. Such systematic selection can lead to biased research results that inappropriately inform research, policy, and practice.Trial RegistrationClinicalTrial.gov NCT01785121, https://clinicaltrials.gov/ct2/show/NCT01785121

Психологическая природа причин неучастия молодежи в выборах

Психологическая природа причин неучастия молодежи в выборах

Institutional Based Reasons for Students Non-participation in Physical Activity and Sport Programs in the Kenyan Public Universities

University environment offers numerous advantages and easy opportunities for improving students' participation in physical activity and sport. However, there are paucity of researches on the reasons for non-participation in the university physical activity and sport programs in Kenya. The purpose of this study was to establish the institutional based reasons for the students' non-participation in the universities' physical activity and sport programs. Cross-sectional survey design was used and data was collected through questionnaires from Sixty-three (33 males, and 30 females) students. Mean standard deviation and graphs respectively, were used to describe and present data. Findings showed that key reasons for non-participation in physical activity and sport programs in the university were inadequate sport facility 74.6%, overcrowded facility 73%, unorganized sport program 63.5%, lack of sport facility 58.7%, lack of sport variety 57.1%, inaccessible facility 49.2%, no coaches 47.6%, unfriendly time for sport 39.7%, unsafe sport equipment 38.1%, inappropriate behaviour of sport personnel 36.5% and 34.9% was due to unskilled sport personnel. Students' age, year and course of the study influenced non-participation of students in the universities' sport programs. Also, students' previous and current participation status confirmed students avoid universities' sport programs although they participate in the same elsewhere. Diversifying and professionalizing sport and aligning programs with academic schedules would attract students. TRA can be useful in sensitizing students on the benefits of sports. Similar studies with larger student population are necessary.

Reasons for nonparticipation in the Valuing Active Life in Dementia randomised controlled trial of a dyadic occupational therapy intervention: An interview study.

Objectives:There is currently little known about why people decline to participate in dyadic, psychosocial dementia research. This interview study aims to explore the reasons why people declined to participate in the Valuing Active Life in Dementia research trial.Methods:Ten family carers of people with dementia, who were part of a dyad that had declined to take part in the randomised controlled trial, participated in qualitative telephone interviews to explore their reasons for declining. Inductive thematic analysis was used to identify themes.Findings:Two themes with related sub-themes were identified: (1) Protectiveness – protecting the person with dementia, themselves as carers and their current lifestyle; (2) ‘It’s not for us’ – the time commitment, and the possible unsuitability of the intervention, was seen to outweigh the perceived benefit of taking part. People with dementia were not always involved in the decision-making process, with carers stating the decision not to participate was made in the usual way as all their decisions. No apparent differences between the spousal and the child carers were apparent in the small sample.Conclusion:Recruitment to randomised controlled trials can be considered difficult or unfair because some participants will miss out on the desired intervention. However, this study shows that concern about the time and inconvenience of being involved in the trial can put people off research participation. Identifying possible reasons for declining research participation contributes to the design of future trials and recruitment strategies, so that the potential benefit is considered relative to the time and effort involved. Offering research opportunities to people with dementia and their families at the right stage of the dementia trajectory for their needs, facilitating personalised recruitment strategies with finely tailored researcher communication skills should help maximise recruitment, reduce attrition and deliver a more successful trial.

Psychological reasons for non-participation of youth in political life

Introduction.The article discusses comparative psychograms of groups of respondents. They are formed on the basis of 9 their reasons for non-participation in political life.Materials and Methods.For analysis (120 respondents, 2 sociological questionnaires, 6 personality tests), we use the author's method of multiple comparison (generalized version). As a result, the summ extremeness of these 9 groups were determined within the framework of a problem in which 89 groups were compared.Results.Based on the summ extremeness of personal qualities for three groups of high extremeness, full psychograms are given. These are groups whose respondents: 1) were at a loss to answer why they are not taking part in political life; 2) due to personal employment do not participate in political life; 3) do not take part in political life because they trust the president and believe that he will solve all problems. For next gruops on the extremeness (3 groups), abbreviated psychograms are considered, in which only pronounced personal qualities are indicated. These are groups whose respondents: 1) do not participate in political life because politics is a “dirty business” and decent people have nothing to do there; 2) they do not see leaders whom they could follow, and therefore do not take part in political life; 3) do not participate in political life because, in their opinion, professionals should deal with politics. For the remaining three groups, in which no pronounced personal qualities were revealed (the picture quite averaged over the whole of 89 groups), only their names are listed for reasons of non-participation of their representatives in political life.Discussion and Conclusions.As a result, we can conclude that the reasons for the non-participation of respondents in political life are largely determined by their psychological identity.

Patient/Provider Discussions About Clinical Trial Participation and Reasons for Nonparticipation Among Adolescent and Young Adult Women with Cancer.

Purpose: Clinical trial enrollment is low among adolescents and young adults (AYAs) with cancer and may contribute to inferior survival gains in recent years in this population compared with other age groups. We investigated clinical trial participation among AYA women with cancer, and examined whether patients discussed clinical trial participation with their doctor and reasons for nonparticipation. Methods: Women with a diagnosis of breast cancer, thyroid cancer, melanoma, lymphoma, or gynecologic cancer at ages 15-39 years during 2004-2016 were identified from the North Carolina Central Cancer Registry and the Kaiser Permanente Southern California health system. During 2018-2019, a total of 1264 eligible women completed an online survey (response = 13%), which examined survivorship issues among AYAs. Results: Overall, 5% of participants reported that they had participated in a clinical trial. Most women reported that they had not discussed clinical trial participation with a medical provider (76%) and that they did not know whether a relevant trial was available for their cancer (73%). Among those who knew that a trial was available but did not participate, the most commonly reported reasons for nonparticipation included concerns about side effects of the treatment in the trial and concerns that the treatment had not been sufficiently tested. Conclusion: Only a small proportion of AYA women with cancer in our cohort reported discussing a clinical trial with a provider or knowing whether a relevant trial was available. Our findings point to opportunities to improve patient/provider communication to increase clinical trial enrollment among AYAs with cancer.

A qualitative approach to understanding reasons for nonparticipation in school-based vision programs

A qualitative approach to understanding reasons for nonparticipation in school-based vision programs

"I'm not doing that." An in-depth examination of nonparticipation in mail-out bowel cancer screening programs.

Despite a clear association between the early detection of bowel cancer and increased survival, participation in mail-out screening programs is poor. Several key barriers to participation have been identified, yet research has failed to examine the specific cognitions, actions, and individual contexts from which barriers emerge. The purpose of the current study was to gain a detailed understanding of the actual experience of kit receipt from the perspective of nonparticipants including their opinion on interventions that may be effective in promoting participation. Demographic differences in reasons for nonparticipation are also examined. Opt-out data from a national program was analyzed to detect demographic differences in reasons for nonparticipation. Qualitative interviews were conducted in a sample of "at risk" nonparticipants. Thematic analysis was conducted using an inductive phenomenological approach. Older, higher SES, male and previously screened participants were more likely to provide a medical reason for opting out of participation. Four key themes emerged from interview data. The first reflected intention; whereby participants were either intenders (i.e., they planned to participate) or refusers. Subsequent themes reflected practicalities, emotional reactions, and necessity. Differences between intenders and refusers within these themes as well as opinions regarding interventions were identified. Interventions involving interactions with health professionals, autonomous decision making, and those which emphasize the positive outcomes of screening may encourage refusers to participate in mail-out bowel cancer screening programs. Messages that reinforce the importance of screening or provide a practical reminder may be more useful for intenders.

Sample selection and reasons for non-participation in the PRedictors and Outcomes of incident FRACtures (PROFRAC) study.

Background. Fragility fractures, associated with osteoporosis, are an escalating public health problem. We aim to describe sample selection, recruitment methods and reasons for non-participation in The PRedictors and Outcomes of incident FRACtures (PROFRAC) study.Design and Methods. Barwon Statistical Division residents aged 20+ years, with a radiologically-confirmed fracture between June 1st 2012 and May 31st 2013, were eligible. Individuals identified as fracture cases were invited by mail to complete a questionnaire. Reasons for non-participation were documented. Logistic regression techniques were used to determine odds ratios for participation and non-participation reasons.Results. A total of 1,458 of 2,155 (67.7%) adults with fracture (48.7% men) participated. Individuals were excluded due to inability to give informed consent, death, no knowledge of fracture, or inability to be contacted. The odds of participation decreased with age (OR 0.99, 95%CI 0.99-0.99, P=0.011) and increased among specific fracture groups [clavicle/scapula (OR 2.50, 1.30-4.68, P=0.006), forearm/humerus (OR 2.00, 1.22-3.27, P=0.006), wrist (OR 2.08, 1.31-3.32, P=0.002), hip (OR 2.12, 1.20-3.75, P=0.009), ankle (OR 1.85, 1.20-2.87, P=0.001), compared to face/skull fractures]. The odds of reporting disinterest, time constraints or personal reasons as the reason for non-participation decreased with age, whereas the odds of reporting frailty, language-related issues or illness as the reason for non-participation increased with of age [disinterest (OR 0.98, 0.97-0.98, P<0.001), time constraints (OR 0.97, 0.96-0.98, P<0.001), personal reasons (OR 0.98, 0.97-0.99, P=0.007), frailty (OR 1.12, 1.09-1.15, P<0.001), language-related issues (OR 1.02, 1.01-1.04, P<0.001), illness (OR 1.03, 1.02-1.05, P<0.001)].Conclusions. Understanding drivers of research participation can inform study design to achieve optimal participation in health research.Significance for public healthFragility fractures associated with osteoporosis are a major public health concern for our aging population. Identifying predictors and consequences of incident fracture is thus imperative if we are to target modifiable risk factors and reduce the burden of disease. This manuscript describes sample selection, cost-effective recruitment methods and reasons for non-participation for the PRedictors and Outcomes of incident FRACtures (PROFRAC) study. Understanding drivers of research participation and barriers to participation is necessary to inform study design to achieve optimal participation in comprehensive samples.

Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms

ObjectiveIn line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set‐up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines.MethodsTwo thousand six hundred eight medium‐ to long‐term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire‐9 (PHQ‐9). Those with moderate depressive symptoms (PHQ‐9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored.ResultsOne thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial.ConclusionOf the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho‐oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.

Male Participation in Maternal and Child Health Care among Husbands of women Consulting the Gynecological Department

A Quantitative approach, non experimental descriptive exploratory research design was used for this study. 30 samples from Almas hospitals were selected by probability simple random sampling technique. Socio demographic data were assessed using socio demographic performa, the extent of male participation in maternal and child health care and reason for non participation were assessed by Structured questionnaire and Various care provided by the male participants were assessed by using a Checklist. The data were analyzed and interpreted by using descriptive and inferential statistics. Data collection tools included were socio demographic performa, Structured questionnaire and Checklist.

Türkiye’de Okuma-Yazma Bilmeyen Kadınlar ve Okuma-Yazma Kurslarına Katılmama Nedenleri: “Ne Edeyim Okumayı, Hayatım mı Değişecek?”

Bu çalışmanın amacı okuma-yazma bilmeyen kadınların okuma-yazma kurslarına katılmama nedenlerini ve bu nedenlere temel oluşturan etmenlerin (sosyal ve kültürel arkaplanın) saptanmasıdır. Bu çerçevede araştırmanın alt problemleri şöyledir: (1) Türkiye’de okuma-yazma bilmeyen kadınların demografik özelliklerini nelerdir? (2) Bu kadınların okuma- yazma kurslarına katılmama nedenleri nelerdir ve bu nedenlere temel oluştıran etmenler nelerdir? (3) Okuma-yazma becerisine ihtiyaç yerleşim yerine göre farklılaşmakta mıdır? Çalışmada nicel ve nitel yöntem bir arada kullanılmıştır. İstatistiki veriler okuma-yazma bilmeme durumunun cinsiyet açısından kadın nüfusta; yaş açısından yaşlı nüfusta ve yerleşim yeri açısından kırsal kesimde yoğunlaştığını göstermektedir. Ayrıca kadınlar, ev işleri ve çocuk bakımı, yaşlanma ve yaşlılığa bağlı nedenler, başarısız olma korkusu, iş kaynaklı nedenler, yakın çevrenin hoş karşılamaması gibi etmenleri okuma-yazma kurslarına katılmama nedenleri olarak belirtmişlerdir. Kadınlar tarafından belirtilen bu nedenler tabi ki önemlidir; ancak bu nedenlerin temellendiği arka plana bakıldığında ataerkil toplumsal yapı, gündelik yaşamı çevreleyen sözlü kültürün doğası ve yazıyı talep etmeyen akış öne çıkmaktadır. Yerleşim yeri açısından bakıldığında, ev içi sorumluluklar daha çok köydeki kadınlar; çocuk bakımı ise gecekondu ve kent merkezindeki kadınlar tarafından dile getirilmiştir.

Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark.

Background: Offering human papillomavirus-based self-sampling to nonparticipants in routine cervical cancer screening can increase screening participation. However, little is known about characteristics of women who accept self-sampling. In this population-based study, we investigated determinants for participation in self-sampling among Danish nonattenders to routine cervical cancer screening.Methods: During 2014 to 2015, a random sample of screening nonparticipants ages 27 to 65 years living in the Capital Region of Denmark were invited for self-sampling. Of 21,314 eligible women, 4,743 participated in self-sampling. Information on sociodemographic characteristics and mental and physical health of all the women was obtained from nationwide registries, and 3,707 women completed a questionnaire on lifestyle, sexual behavior, and reasons for nonparticipation in routine screening. We used logistic regression to estimate ORs for participation in self-sampling, crude, and adjusted for sociodemographic characteristics.Results: Basic education [ORadjusted = 0.79; 95% confidence interval (CI), 0.72-0.88], low income (ORadjusted = 0.66; 95% CI, 0.59-0.73), origin from a nonwestern country (ORadjusted = 0.43; 95% CI, 0.38-0.48), and being unmarried (ORadjusted = 0.66; 95% CI, 0.61-0.72) were associated with lower self-sampling participation. Long-term unscreened women (ORadjusted = 0.49; 95% CI, 0.45-0.53), women with prior schizophrenia or other psychoses (ORadjusted = 0.62; 95% CI, 0.48-0.80), women with poor self-perceived health (ORadjusted = 0.42; 95% CI, 0.25-0.69), and women who perceived screening as unnecessary (ORadjusted = 0.54; 95% CI, 0.37-0.80) or irrelevant (ORadjusted = 0.81; 95% CI, 0.78-0.96) were less likely to self-sample.Conclusions: Certain population groups, including women with low socioeconomic position or of nonwestern origin, were less likely to participate in self-sampling.Impact: Targeted approaches may be needed to increase screening participation in these groups. Cancer Epidemiol Biomarkers Prev; 27(11); 1342-51. ©2018 AACR.

Uptake of a colorectal cancer screening blood test in people with elevated risk for cancer who cannot or will not complete a faecal occult blood test.

Participation rates in colorectal cancer (CRC) screening programmes using faecal occult blood tests (FOBTs) are low. Nonparticipation is commonly attributed to psychosocial factors, but some medical conditions also prevent screening. These barriers might be partially overcome if a blood test for CRC screening was available. This study determined whether people who had always declined screening by FOBT would participate if offered a blood test. An audit of registrants within a personalized CRC screening programme was undertaken to determine the reasons for regular nonparticipation in FOBT. Consistent nonparticipants (n=240) were randomly selected and invited for CRC screening with a blood test. Demographic characteristics and the reasons for prior FOBT nonparticipation were collected by means of a questionnaire. Nonparticipation in the screening programme could be classified as either behavioural (8.6%), with consistent noncompliance, or due to medical contraindications (8.5%), which included chronic rectal bleeding, being deemed unsuitable by a health professional, and needing personal assistance. Blood test uptake was 25%, with participation in the medical contraindications group greater than that in the behavioural group (43 vs. 12%, P<0.001). Reported behavioural reasons for nonparticipation in faecal immunochemical test included procrastination and dislike of the test, but these were not associated with blood test uptake (P>0.05). There is a subgroup of the community who have medical reasons for nonparticipation in CRC screening with FOBT but will participate if offered a blood test. The option of a blood test does not, however, improve uptake in those who admit to behavioural reasons for noncompliance with screening.

What Patients Know About Services to Help Manage Chronic Diseases and Medications: Findings from Focus Groups on Medication Therapy Management.

Managing and treating patients with multiple chronic conditions presents challenges on many levels. Pharmacist-delivered medication therapy management (MTM) services, mandated as part of the Medicare Part D drug benefit, are designed to help patients manage their chronic conditions and medications. To identify factors that influence patient understanding and use of MTM services and potential strategies to educate individuals about MTM. Participants who had at least 2 chronic conditions, were taking 2 or more prescription medications, and were aged 18 years or older were recruited from community-based settings to participate in focus groups. The focus groups aimed to identify participants' perceptions and use of MTM services, barriers and facilitators to utilization, and medication problems. Participants were asked to complete a 14-item health care questionnaire and view a brief, 3-minute video introducing the topic of MTM before the group discussion. The health care questionnaire data were analyzed in Microsoft Excel. The focus group responses were transcribed and entered into the computer program ATLAS.ti for thematic analysis. Two independent reviewers qualitatively coded the discussion question responses; a third reviewer investigated discrepancies and facilitated consensus among the reviewers. Participants (N = 27) were mostly female (70.4%), college educated (62.9%), and had Medicare insurance (81.5%). Seven themes were identified: (1) new proposed names for MTM, (2) mechanisms to gain interest in and to promote the value of MTM, (3) familiarity with MTM, (4) pharmacists' training and expertise in MTM, (5) experience with MTM, (6) reasons for nonparticipation in MTM, and (7) preferred method to learn about MTM. Participants did not understand the term "medication therapy management" and felt the interpretation of "therapy"' differed between health care professionals and the public. Some participants used MTM services to learn about appropriate use of their medications, while others were unsure about their eligibility, associated costs, and how to access the services. Participants had limited pharmaceutical knowledge but felt pharmacist-provided MTM services were helpful. Participants were unfamiliar with pharmacists' skills and training. Participants' experiences with MTM services ranged from disregarding the invitation to participate to having pharmacists identify drug-drug interactions. Reasons for nonparticipation in MTM services included being unaware of their eligibility, failing to read excessive information from insurance companies, and being uncertain of the identity of the telephone caller. Preferred methods for learning more about MTM services included the Internet, e-mail, information availability at physician's office, and television advertisements. These results suggest that the lay public remains largely unaware of MTM services and that the term "MTM" is not well understood. Clearly, tailored public health campaigns and patient engagement strategies are needed to promote MTM in chronic disease management, pharmacists as respected providers, and the importance of the prescriber-MTM pharmacist collaborative relationship in managing medications for patients with multiple chronic conditions. Grant funding from SinfoniaRx to Taylor, Axon, Campbell, Fair, and Warholak was used to help conduct this project. Boesen is employed by SinfoniaRx. The other authors have nothing to disclose. This original research was presented as a poster at the Academy of Managed Care Pharmacy 27th Annual Meeting and Expo; April 7-10, 2015; San Diego, CA.

Knowledge of Clinical Trial Availability and Reasons for Nonparticipation Among Adolescent and Young Adult Cancer Patients: A Population-based Study.

Adolescent and young adult (AYA) cancer patients are underrepresented in clinical trials, but the reasons for this phenomenon are unknown. Questionnaire and medical record data from 515 AYA cancer patients (21 acute lymphocytic leukemia [ALL], 201 germ cell tumor, 141 Hodgkin lymphoma, 128 non-Hodgkin lymphoma, 24 sarcoma) from a population-based study were analyzed. We used multivariable models to determine characteristics associated with patient knowledge of the availability of clinical trials for their cancer. Reasons for not participating in a trial were tabulated. In total, 63% of patients reported not knowing whether a relevant clinical trial was available, 20% reported knowing that a clinical trial was not available, and 17% reported that a trial was available. Among patients reporting an available trial, 67% were recommended for enrollment. Knowing about the availability of clinical trials was associated with having ALL (odds ratio=2.9, 95% confidence interval=1.1, 7.8). Reporting that a clinical trial was available was positively associated with having ALL, Hodgkin lymphoma, non-Hodgkin lymphoma and sarcoma (relative to germ cell tumor) and working full-time or in school full-time (odds ratio=2.6, 95% confidence interval=1.0, 6.7). Concerns about involvement in research (57%) and problems accessing trials (21%) were the primary reasons cited for not enrolling among patients who knew that a trial was available. Improvement in AYA cancer patient clinical trial enrollment will require enhancing knowledge about trial availability and addressing this population's concerns about participating in medical research.

Challenges in recruitment of persons with peripheral artery disease for exercise studies

This article describes feasibility of direct and indirect recruitment methods for exercise studies designed for older adults with peripheral artery disease (PAD). Recruitment of older adults with PAD for participation in exercise studies has been particularly challenging. Age, risk factors, and comorbid conditions affect physical activity in older adults with PAD. Barriers to exercise, such as safety, health, and age-related changes, contribute to lack of participation in exercise studies. Various direct and indirect recruitment approaches and participant responses, along with reasons for nonparticipation, are categorized into participant demographic, community, and research-related barriers. At a cost of $1,330.00, indirect recruitment strategies of social marketing and community outreach resulted in two referrals and no enrollments. Recruitment-site champions and education resulted in no referrals and no enrollments. Direct recruitment approaches such as health system recruitment and referrals paired with flyers resulted in 44 referrals and one enrollment. Only one referral was obtained from a physician practice. Reasons for nonparticipation included lack of follow-up, presence of one or more exclusion criteria, lack of transportation, and comorbid disease burden that limited activity. Community- and research-related barriers included recruitment competition for other studies, budget limitations, lack of recruitment staff, and strict inclusion/exclusion criteria. Successful recruitment of older adults with PAD for participation in exercise clinical trials may require substantial time and budget. Interventions to address identified barriers such as personal attitudes and socioeconomic factors, lack of social support, and lack of transportation, combined with community factors such as rural location, and research study design considerations may facilitate recruitment efforts.

Barriers Non Perform an Pap Smear Test in Women

Background: Implementing Pap smear test is an appropriate method to prevent and/or decrease fatalities of cervical cancer. The aim of this study is the reasons for non-participation of women in implementing screening tests Method: This sectional-descriptive study was performed with consecutive sampling on 230 women who referred to health centers in Jiroft and had health records. Data collecting tool was the questionnaire having personal-social information and some information about the reasons for not doing cervical cancer screening by Pap smear method. The data were analyzed in SPSS software version 18. Findings: Among the reasons for non-participation of women in cervical cancer screening program were from the highest cases to lowest respectively: lack of knowledge about Pap smear implementation (85.3%), lack of training medical staff in Pap smear implementation (77%) and the lowest was husband’s opposition. Conclusion: By sensitization of women to the subject and the importance of on-time disease recognition, their operations can be modified.