Recruitment Materials Research Articles

Development and pilot implementation of guidelines for culturally tailored research recruitment materials for African Americans and Latinos

BackgroundPrevious studies support cultural tailoring of recruitment materials as a strategy to promote the enrollment of minoritized groups in clinical trials. However, there is a lack of guidance for research teams to create culturally tailored materials, potentially contributing to low recruitment rates of minoritized groups. We describe the development and pilot testing of recruitment material guidelines used to culturally tailor clinical trial recruitment materials targeting African Americans and Latinos.MethodsThe guideline development team consisted of investigators, research staff, and community leaders and members experienced in the recruitment and community engagement of minoritized groups. The recruitment material guidelines were developed using the literature, focus groups with African Americans and Latinos, the teams’ research experience, and guidance from a community advisory board. To assess the effectiveness of the guidelines, a pilot study was conducted comparing advertisement click-through rates and enrollment outcomes between two institutions differing in use of culturally tailored versus non-tailored Facebook banner ads for the “Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness” (ADAPTABLE) study.ResultsFive themes emerged from focus groups: (1) employ diversity and inclusion in recruitment efforts; (2) access multiple recruitment channels to increase reach and possible participation; (3) increase your “footwork”; (4) personalize outreach and recruitment to specific groups’ beliefs and values; (5) align recruitment messaging with language preferences and motivations for study participation; and (6) specify incentives for participation. Guidelines were: 1) be inclusive; 2) use all forms of media; 3) take a personalized approach; 4) align recruitment messaging with motivations for study participation; 5) specify incentives; and 6) get out into the community. Additional guidelines were developed addressing specific considerations for images and language when targeting African American and Latino populations. Pilot study results demonstrated that clicks per impression ratio (0.47 clicks per impression vs. 0.03 clicks per impression) and the percentage of African American enrollment were significantly higher when using tailored compared to non-tailored ads (12.8% vs. 8.3%, respectively).ConclusionThe recruitment material guidelines offer practical recommendations to reach diverse populations for clinical trial participation more effectively. Our preliminary data supports use of these guidelines as a strategy to enhance recruitment of minoritized groups into clinical research studies.

Mixed signals: an analysis of diversity value signaling in leading U.S. hospitals

Background: As the United States (U.S.) population continues to diversify, the recruitment and retention of a diverse and culturally competent nursing workforce is paramount to delivering high quality care. To meet this challenge, organizations may use diversity value signaling (DVS) in recruitment materials. DVS, defined as the use of inclusive language and terms in organizational communication, is an extension of Signaling Theory which suggests that the content in a job description provides both instrumental and symbolic signaling of the organization’s values, goals, and expectations. The purpose of this study is to examine the prevalence of DVS in leading U.S. hospitals and to explore whether there is a relationship between DVS and performance.

S06-1 Putting young people at the heart of physical activity research design: The Walking In ScHools (WISH) Study

Abstract Background Young people have the right to be informed and consulted about decisions affecting their lives. Youth Patient and Public Involvement (PPI) should be encouraged to ensure research is carried out ‘with' or ‘by' young people rather than ‘to', ‘about' or ‘for' them. PPI can ensure research is relevant, results are accessible and recruitment rates are improved. Young people have had limited involvement in the design, implementation and dissemination of public health research and there have been calls for a greater focus on youth PPI in research. Methods Following the WISH feasibility study that consulted young people pre and post-intervention, a Youth Advisory Group (YAG) was set up within the main trial. The WISH study is a clustered randomised controlled trial in which a peer-led, school-based, brisk walking intervention is compared to usual physical activity in adolescent females. The YAG was introduced to inform intervention delivery and provide researchers with an understanding of what would encourage/discourage participation. Schools were asked to invite pupils aged 12-14 years (participants) and 15-18 years (walk leaders). Participative methods were used to develop and review study documentation. The YAG completed a short questionnaire and recruitment rates were monitored. Results Fourteen pupils from 3 schools attended the 2019 YAG meeting. The YAG agreed the meeting was a good way of getting young people involved in research (93%) and attendees enjoyed the meeting (100%). As a result, changes were made to study documentation, incentives were purchased and recruitment materials developed. Participant recruitment was higher in schools who participated in the YAG (54%) compared to those who did not (47%). In 2021 the second YAG occurred and 1 teacher, 12 participants and 10 walk leaders from 2 schools provided feedback on the trials COVID-19 contingency plan. The girls felt their feedback was valued (100%) and it was important young people had the chance to contribute to research studies (100%). Conclusions The views of young people have been central to the development of the WISH Study and although youth PPI is not without challenges, there are many benefits for researchers, the study and the young people involved.

Implications of diversity cues in recruitment and assessment materials: Reactions and performance

AbstractCues regarding organizational diversity in recruitment and assessment materials can serve as signals to infer how members of a social group are treated. However, theory on identity–contingency (diversity) cues provides little guidance as to how the interaction of multiple cues impacts performance on selection tools. In an experiment, racial diversity cues in employee testimonials and situational judgment test (SJT) items were manipulated in a simulated selection process to examine implications for individuals' performance and reactions. SJT diversity cues indirectly reduced SJT performance via lower attentiveness. Individuals also evaluated an SJT with diversity cues to be less related to the job than a similar, nondiverse version, whereas perceptions of the assessment's predictive validity and opportunity to perform on it were unaffected. Effects on assessment reactions did not vary as a function of participant race or the presence of diversity cues in employee testimonials. Individuals who watched testimonials with more diverse speakers were subsequently more attracted to the organization if the testimonials were followed by the SJT with more diverse representation in items. Implications for assessment design and recruitment are discussed.

I Fit Here! Social Responsibility Type and Wordings in Recruitment Affect Women’s Pursuit Intentions

While varied efforts at workplaces have helped improve gender equality in recent years, most occupations still suffer from a stark underrepresentation of women in the workforce. In this research, we consider the possibility of the impact of women’s self-stereotyping processes on their own job search, pursuit efforts, and application intentions during the recruitment process. We explore how different kinds of social responsibility activities of an employer can impact women's job pursuit intentions with the employer where self-stereotyping processes can kick in. Drawing on the lack of fit theory, we argue that the people and nature-oriented social responsibility efforts of an employee can be gender-stereotyped as feminine and masculine efforts respectively. We also explore employer authenticity to be an important signal during this process where job seekers evaluate a prospective employer and its actions to form a judgment. We test our hypotheses across two studies conducted in the field and the laboratory. Our results provide a nuanced understanding of women’s perceptions of fit based on social responsibility type and recruitment material wordings.

Adapting and Developing an Academic and Community Practice Collaborative Care Model for Metastatic Breast Cancer Care (Project ADAPT): Protocol for an Implementation Science-Based Study.

BackgroundMetastatic breast cancer (MBC) remains incurable despite significant treatment advances. Coordinating care for patients with MBC can be challenging given the various treatment options, available clinical trials, and frequent need for ancillary services. To optimize MBC care, we designed a project for adapting and developing an academic and community practice collaborative care model for MBC care (Project ADAPT), based on the Ending Metastatic Breast Cancer for Everyone (EMBRACE) program developed at Dana Farber Cancer Institute.ObjectiveWe aim to describe the implementation science–based study design and innovative components of Project ADAPT.MethodsProject ADAPT uses the Dynamic Adaptation Process informed by the Exploration, Preparation, Implementation, Sustainment framework. Washington University School of Medicine (WUSM) partnered with 3 community hospitals in the St. Louis region covering rural and urban settings. The exploration and preparation phases provide patient and provider feedback on current referral practices to finalize the approach for the implementation phase. At the implementation phase, we will enroll patients with MBC at these 3 community sites to evaluate potential collaborative care at WUSM and assess the impact of this collaborative care model on referral satisfaction and acceptability for patients with MBC and their providers. Patients may then return to their community site for care or continue to receive part of their care at WUSM. We are incorporating virtual and digital health strategies to improve MBC care coordination in order to minimize patient burden.ResultsThe exploration phase is ongoing. As of August 2021, we have recruited 21 patient and provider participants to complete surveys of the current collaborative care process at WUSM. Using a 2-tailed paired t test, 44 patients (including 10 patients from the exploration phase) and 32 oncologists are required to detect an effect size of 0.5 with 80% power at a level of significance of .05. Throughout this phase and in preparation for the implementation phase, we have iteratively updated and refined our surveys for the implementation phase based on testing of our data collection instruments. Our partner sites are in various stages of the single institutional review board (IRB) approval process. We have ongoing engagement with all partner sites, which has helped solidify our participant recruitment strategies and design patient-friendly recruitment materials. In addition, we have included a patient advocate on the research team. Members of the research team have launched a single IRB Support Network at WUSM to create a repository of the single IRB procedures in order to streamline the partner site onboarding process and facilitate enhanced collaboration across institutions.ConclusionsWith this robust model, we expect that patients with MBC will receive optimal care regardless of geographical location and the model will improve patient and provider experiences when navigating the health system.International Registered Report Identifier (IRRID)DERR1-10.2196/35736

Women's Perspectives on Factors Influencing Florida Pregnancy Risk Assessment Monitoring System (PRAMS) Response.

ObjectivesTo inform updates to the Pregnancy Risk Assessment Monitoring System (PRAMS) design and processes, African American/Black and Hispanic/Latina women in Florida provided feedback on their awareness and perceptions of the PRAMS survey, and preferences for survey distribution, completion, design and content.MethodsFocus groups were conducted in English and Spanish with 29 women in two large metropolitan counties. Participants completed a brief survey, reviewed the PRAMS questionnaire and recruitment materials, engaged in discussion, and gave feedback directly onto cover design posters.ResultsParticipants reported limited awareness of PRAMS. Preferences for survey distribution and completion varied by participant lifestyle. Interest in topics covered by PRAMS was as a motivator for completion, while distrust and confidentiality concerns were deterrents. Participants were least comfortable answering questions about income, illegal drug use, and pregnancy loss/infant death. Changes to the length of the survey, distribution methods, and incentives/rewards for completion were recommended.Conclusions for PracticeResults highlight the need to increase PRAMS awareness, build trust, and consider the design, length and modality for questionnaire completion as possible avenues to improve PRAMS response rates.

Sex robots and personality: It is more about sex than robots

Examining the links between personality traits and attitudes toward sex robots can provide insights into who may desire such machines, and why. This online study thus examined the associations between the Big-Five, traits related to sexuality, technology, and (sexual) novelty, and people's willingness to engage with and perceived appropriateness of using sex robots in a convenience sample of 492 adults (≥18 years; 283 ciswomen, 171 cismen, and 37 non-binary and gender nonconforming individuals with access to the recruitment material on social media, the Concordia University participant pool, or flyers/word-of-mouth in the Montreal Community). Correlational analyses showed that willingness to engage with and perceived appropriateness of using sex robots were more closely related to erotophilia and sexual sensation seeking than any other traits. Mixed repeated measures ANOVAs and independent samples t-tests with Bonferroni corrections also showed that cismen and non-binary/gender nonconforming individuals were more willing to engage with sex robots and perceive their use as more appropriate than ciswomen. These findings suggest that erotophilic individuals seeking novel or more intense sexual experiences may be(come) the primary users of sex robots and influence their development. These findings are important given the growing place of technology in our intimate lives and relationships.

Implementing CAPABLE With Care Partners Through an Area Agency on Aging: Identifying Barriers and Facilitators Using the Consolidated Framework for Implementation Research.

Community Aging in Place, Advancing Better Living for Elders (CAPABLE) is an evidence-based intervention to promote aging in place. Although CAPABLE has been implemented in more than 40 community sites, wide variation in implementation exists. Guided by the Consolidated Framework for Implementation Research (CFIR), this study sought to determine key barriers and facilitators that may influence CAPABLE implementation with older adult and care partner dyads through an area agency on aging (AAA). A formative evaluation was completed using qualitative data from the pilot of a Hybrid Trial Type 1 study implementing CAPABLE in an AAA. Multiple sources of data were collected, including 2 focus groups, field notes, a tracking log, and meetings with CAPABLE interventionists. Data were analyzed using a framework method and validated through a negative case analysis approach in NVivo 12 Pro. Fourteen dyads enrolled in the pilot and 6 completed the CAPABLE intervention. Key themes aligned with 10 constructs from 5 domains of the CFIR. Facilitators included adaptability of the intervention, cost, networks and communication, and knowledge and belief of individuals. Barriers included intervention complexity, client needs and resources, and executing the planned process. Results enhance understanding of contextual factors that can influence the implementation of CAPABLE with care partners. Strategies to overcome barriers include simplifying recruitment materials and targeting older adults with recent onset of disability. The CFIR is a valuable resource for planning and evaluation of the implementation of evidence-based interventions to promote aging in place.

Active monitoring of adverse reactions following COVID-19 and other vaccinations: a feasibility study as part of the CoVaKo project

BackgroundThe Corona-Vakzin-Konsortium project (CoVaKo) analyses the efficacy and safety of COVID-19 vaccines in a real-world setting, as well as breakthrough infections in Bavaria, Germany. A subproject of CoVaKo aims to identify adverse reactions of the COVID-19 vaccine and compare these to adverse reactions of other vaccines in an online survey. In a preceding feasibility study, the study materials were tested for comprehensibility, visual design, and motivation to participate, as well as for their ability to be implemented and carried out in primary care practices and vaccination centres.MethodsWe used a mixed-methods research design. First, three focus groups consisting of general population participants were organised to evaluate the study materials and survey. Second, a test roll-out was conducted in vaccination centres and primary care practices that involved implementing and quantitatively evaluating the online survey. Third, interviews were conducted with participating general practitioners and heads of vaccination centres four weeks after the test roll-out.ResultsParts of the information and registration form proved incomprehensible, specifically regarding the recruitment material and/or online survey. For example, headings were misleading given that, relative to other vaccinations, the COVID-19 vaccination was overemphasised in the title. Participants requested additional information regarding the procedure and completion time. Within 31 days, 2199 participants, who received either a COVID-19 vaccination (99%) or at least one of the control vaccinations (1%), registered for the study. Participants (strongly) agreed that the registration process was easy to understand, that the completion time was reasonable, and that the technical setup was straightforward. Physicians and heads of the vaccination centres perceived the study as easy to integrate into their workflow. The majority expressed willingness to participate in the main study.ConclusionsOur study indicated that identifying and documenting adverse reactions following vaccinations using an online survey is feasible. Testing materials and surveys provided valuable insight, enabling subsequent improvements. Participation from health professionals proved essential in ensuring the practicality of procedures. Lastly, adapting the study’s organisation to external fluctuating structures and requirements confirmed necessary for a successful implementation, especially due to dynamic changes in the nation’s COVID-19 vaccination strategies.Trial registrationThe trial was retrospectively registered at the “Deutsches Register Klinischer Studien” (DRKS-ID: DRKS00025881) on Oct 14, 2021.

“Why so Many Words?” Students’ Perspectives on College Access and Success Terminology

This study explores the perspectives of Black men on terminology often used in college access and success recruitment and programmatic materials. The authors suggest that deficit models often result in student enculturation and arise from linguistic complexity and misunderstandings. The findings provide avenues for student affairs professionals to avoid deficit terminology usage and outline methods to include student voices in college access and success program recruitment and program materials.

The unreachable doorbells of South Texas: community engagement in colonias on the US-Mexico border for mosquito control

Mosquitoes and the diseases they transmit continue to place millions of people at risk of infection around the world. Novel methods of vector control are being developed to provide public health officials with the necessary tools to prevent disease transmission and reduce local mosquito populations. However, these methods will require public acceptance for a sustainable approach and evaluations at local settings. We present our efforts in community engagement carried out in colonias of the Lower Rio Grande Valley in south Texas for mosquito surveillance, control, and ecological projects. Along the US-Mexico border the term colonia refers to impoverished communities that are usually inhabited by families of Hispanic heritage. The different engagements were carried out from September 2016 to February 2019; during this time, we had three distinct phases for community engagement. In Phase 1 we show the initial approach to the colonias in which we assessed security and willingness to participate; in Phase 2 we carried out the first recruitment procedure involving community meetings and house-to-house recruitment; and in Phase 3 we conducted a modified recruitment procedure based on community members’ input. Our findings show that incorporating community members in the development of communication materials and following their suggestions for engagement allowed us to generate culturally sensitive recruitment materials and to better understand the social relationships and power dynamics within these communities. We were able to effectively reach a larger portion of the community and decrease the dropout rate of participants. Progress gained with building trust in the communities allowed us to convey participant risks and benefits of collaborating with our research projects. Community engagement should be viewed as a key component of any local vector control program as well as for any scientific research project related to vector control. Even in the face of budgetary constraints, small efforts in community engagement go a long way.

Informing a Randomized Control Trial in Rural Populations: Adaptation of a Diabetes Self-Management Education and Support Intervention.

BackgroundOver 34 million people in the United States have diabetes, with 1.5 million diagnosed every year. Diabetes self-management education and support (DSMES) is a crucial component of treatment to delay or prevent complications. Rural communities face many unique challenges in accessing DSMES, including geographic barriers and availability of DSMES programs that are culturally adapted to rural context.ObjectiveBoot Camp Translation (BCT) is an established approach to community-based participatory research used to translate complex clinical and scientific information into concepts, messages, and materials that are understandable, meaningful, and relevant to community members and patients. This study aimed to utilize BCT to adapt an existing DSMES program for delivery in rural primary care for English- and Spanish-speaking people with diabetes.MethodsThe High Plains Research Network (HPRN) Community Advisory Council (C.A.C.) partnered with researchers at the University of Colorado and University of Utah to use BCT to aid in translating medical jargon and materials from an existing DSMES program, called “Diabetes One Day (D1D).” BCT consisted of 10 virtual meetings over a 6-month period among the C.A.C., which included 15 diverse community stakeholders. Both English-speaking and bilingual Spanish-English–speaking C.A.C. members were recruited to reflect the diversity of the rural communities in which the adapted program would be delivered.ResultsThe BCT process guided adaptations to D1D for use in rural settings (R-D1D). R-D1D adaptations reflect both content and delivery to assure that the intervention is appropriate and likely to be accepted by rural English- and Spanish-speaking people with diabetes. Additionally, BCT informed the design of recruitment and program materials and identification of recruitment venues. During the BCT process, the importance of tailoring materials to reflect culture differences in English- and Spanish-speaking patients was identified.ConclusionsBCT was an effective strategy for academic researchers to partner with rural community members to adapt an existing DSMES intervention for delivery in rural areas to both English- and Spanish-speaking patients with diabetes. Through BCT, adaptations to recruitment materials and methods, program content and delivery, and supplemental materials were developed. The need to culturally adapt Spanish materials with input from stakeholders rather than simply translate materials into Spanish was highlighted. The importance of increasing awareness of the connection between diabetes and depression or diabetes distress, adaptations to include local foods, and the importance of the relationship between people with diabetes and their primary care practices were identified.

Leveraging patient engagement to optimize a phase 3 clinical trial design, study participation and recruitment for women diagnosed with triple-negative breast cancer (TNBC).

1073 Background: The importance of Patient Engagement (PE) on clinical trial design is well established. PE in oncology medicines development can serve many purposes including obtaining input on trial design/procedures, identifying recruitment challenges and barriers to participation, and understanding retention strategies. Designing a clinical trial with procedures that have been confirmed as acceptable to participants is also likely to improve patient adherence to treatments. Triple-Negative Breast Cancer (TNBC) is a virulent subtype associated with early onset and increased risk of early recurrence and accounts for 15% to 20% of breast cancers. In addition, a higher risk exists in premenopausal and Black women. Chemotherapy is the mainstay of curative therapy recommended by guidelines. The aim was to obtain insights from patients to inform key aspects of a clinical study design including choice of chemotherapy regimen, study feasibility and recruitment strategies. Methods: Two groups of US women (N = 20) ages 28-54; (race 55% Caucasian, 30% African American, 10% Hispanic, 5% Native American) diagnosed with Stage IIb-IV TNBC and in active or completed treatment were recruited to participate in two in person IRB approved sessions. Trained 3rd party facilitators used qualitative methods to elicit patient feedback. Preliminary research included interviews with key stakeholders, including TNBC advocacy group leaders and a review of online patient communities. Patients reviewed a study design with an investigational agent every 3 weeks plus chemotherapy (nab-paclitaxel; paclitaxel) or placebo plus chemotherapy. Results: Patient reaction to the choice of taxane chemotherapy in the standard of care arm was neutral to negative. Approximately 50% of the patients identified taxane treatment as a barrier to participation. All patients requested flexibility in treatment choices, clear information about required tests and visits, and more diversity in recruitment materials. Black and Hispanic women impacted by TNBC did not feel they had equal access to clinical trials due to race, rural location, and other factors. Patient insights reinforced the decision to add another standard-of-care option (carboplatin plus gemcitabine) as a treatment arm to the trial design and was confirmed with investigators. Patient feedback was incorporated into the trial along with additional strategies to support recruitment of diverse patients in the clinical study. Conclusions: On November 13, 2020 the FDA approved this regimen in the label for pembrolizumab in combination with chemotherapy, as the 1st line treatment in women with locally recurrent or metastatic TNBC. Both patients and physicians perceived that a flexible chemotherapy backbone was a benefit.

Digital Resources for Residency Recruitment: A Pilot Study of What Applicants Really Utilize

The COVID-19 pandemic in 2020 led to multiple changes in graduate medical education programs across the country, including the switch to virtual interviews for all residency applicants instead of on-site visits. The rapid transition to virtual interviews introduced challenges, including limited opportunities to formally and informally interact with residents and faculty, observe the clinical and educational environments, and explore the local culture and community. As a result, programs were advised to heavily invest in and create comprehensive digital resources including but not limited to video tours and multimedia resources describing programmatic details.In preparation for the virtual interview season of 2020-2021, digital recruitment materials were created for the University of Nebraska Medical Center's Anesthesiology residency applicants to provide the information that they would traditionally receive during an in-person interview experience. The objectives of the study were (1) to assess which digital materials residency applicants accessed most frequently during the interview season, and (2) to determine if the digital materials were helpful for the residency applicant in best determining program fit as part of the interview process. A post-interview survey and user analytics were analyzed.With a survey response rate of 58% (n = 87 of 150) and a Web-based email-open rate of 98% (n =147 of 150), the data revealed that the favored digital materials were the "What Residents Say" video and the Residency Applicant Handbook. These were also the most helpful for the residency applicant in best determining program fit.This study shows that resources that allowed students to better assess their "fit" in the program were highly accessed and valued, as were detailed descriptions of the clinical and educational aspects of the training program found in the resident handbook.

At-risk patient and healthcare provider perspectives on clinical trial participation for ductal carcinoma in situ.

10539 Background: Significant challenges exist in recruiting newly diagnosed ductal carcinoma in situ (DCIS) patients to participate in presurgical intervention trials. Perceived motivators and barriers to participation have not been formally studied from the patient or healthcare provider (HCP) perspective. Based on our experience in the Promise Study (NCT02694809), we hypothesized that delaying surgery and concern for side effects are barriers to trial participation and that access to new treatments and financial benefits are motivators. To improve recruitment, we conducted focus groups to better understand barriers and motivators for trial participation in our patient population. Methods: Three focus groups with post-menopausal women (PMW) without history of DCIS, one focus group with patients previously treated for DCIS, and two HCP focus groups were conducted. Due to COVID-19, the focus groups took place online via videoconferencing and included participants from across the United States. A third-party facilitator generated discussion on predetermined topics including knowledge of DCIS, clinical trial recruitment materials, hormone replacement therapy, healthcare delivery and clinical trials during COVID-19, and perceived motivators and barriers to trial participation in general and specifically for women with DCIS. Here, we focus on comparing perceived influential factors for patient participation in DCIS clinical trials in PMW and HCP focus groups. Qualitative thematic analysis was completed on focus group transcripts in NVivo. Results: PMW had no knowledge of DCIS prior to the focus groups and believed DCIS should be removed promptly. PMW believed barriers to DCIS clinical trial participation included the potential for the study drug to cause harm, distrust of medicine, and the fact that DCIS is not life-threatening. PMW identified helping future DCIS patients, accessing better treatment, and easing anxiety as motivators for DCIS trial participation. HCPs believed patients were motivated by increased monitoring by the medical team, financial incentive, and access to newer treatment. HCPs believed that delays in DCIS surgery, the potential for the intervention to be harmful or ineffective, and the trial causing patient anxiety were barriers. Neither group emphasized time commitment as a barrier to DCIS trial participation. PMW were not motivated by financial incentives. Conclusions: Knowledge about DCIS is lacking in PMW. PMW and HCPs agreed that the risk of harm caused by study interventions is a deterrent to trial participation and that access to superior treatment is a motivator. However, PMW and HCPs did not agree on other motivators and barriers which could lead to missed recruitment opportunities. Providing educational materials on DCIS and addressing motivators and barriers to clinical trial participation may increase recruitment to presurgical DCIS trials. Clinical trial information: NCT02694809.

Perceived stigma and erotic technology: From sex toys to erobots

ABSTRACT The intersection of technology and sexuality in sex toys and erobots – artificial erotic agents (e.g. sex robots) – may generate stigma with their use. However, despite the growing prevalence of technology in human sexuality, researchers have yet to examine this stigma. Hence, this study provides the first quantitative evidence of perceived stigma related to erotic technology use (PSETU) and its association with people’s willingness to engage with erotic technologies. Based on previous research, we hypothesised that PSETU exists and increases as a function of products’ human-likeness (Hypothesis 1), and negatively correlates to participants’ willingness to engage with erotic technologies (Hypothesis 2), with stronger associations for women and sex toys and stronger associations for men and erobots (Hypothesis 3). A convenience sample of 365 adults (≥18 years; with access to the recruitment material) completed an online survey measuring their PSETU for sex toys, erotic chatbots, virtual partners, and sex robots, and their willingness to engage with these technologies. The results support Hypothesis 1, and partly support Hypotheses 2–3. Women and men also perceive the same technology-related stigma. These findings are important given the prevalence of sex toys, the advent of erobots, and the potential impact of stigma on their (future) users.

App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial.

BackgroundPeople of color (POC) who experience race-related stress are at risk of developing mental health problems, including high levels of stress, anxiety, and depression. Mindfulness meditation may be especially well suited to help POC cope, given its emphasis on gaining awareness and acceptance of emotions associated with discriminatory treatment. However, mindfulness meditation rarely reaches POC, and digital approaches could reduce this treatment gap by addressing traditional barriers to care.ObjectiveThis study will test the effectiveness of a self-directed app-based mindfulness meditation program among POC who experience elevated levels of race-related stress. Implementation outcomes such as treatment acceptability, adherence, and satisfaction will be examined.MethodsParticipants (n=80) will be recruited online by posting recruitment materials on social media and sending emails to relevant groups. In-person recruitment will consist of posting flyers in communities with significant POC representation. Eligible participants will be block randomized to either the intervention group (n=40) that will complete a self-directed 4-week mindfulness meditation program or a wait-list control condition (n=40) that will receive access to the app after study completion. All participants will complete measures at baseline, midtreatment, and posttreatment. Primary outcomes include changes in stress, anxiety, and depression, and secondary outcomes constitute changes in mindfulness, self-compassion, rumination, emotion suppression, and experiential avoidance. Exploratory analyses will examine whether changes in the secondary outcomes mediate changes in primary outcomes. Finally, treatment acceptability, adherence, and satisfaction will be examined descriptively.ResultsRecruitment began in October 2021. Data will be analyzed using multilevel modeling, a statistical methodology that accounts for the dependence among repeated observations. Considering attrition issues in self-directed digital interventions and their potential effects on statistical significance and treatment effect sizes, we will examine data using both intention-to-treat and per-protocol analyses.ConclusionsTo our knowledge, this will be the first study to provide data on the effectiveness of a self-directed app-based mindfulness meditation program for POC recruited based on elevated race-related stress, a high-risk population. Similarly, meaningful clinical targets for POC affected by stressors related to race will be examined. Findings will provide important information regarding whether this type of intervention is an acceptable treatment among these marginalized groups.Trial RegistrationClinicalTrials.gov NCT05027113; https://clinicaltrials.gov/ct2/show/NCT05027113International Registered Report Identifier (IRRID)DERR1-10.2196/35196

Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP): a feasibility study

BackgroundProgression of dental caries can result in irreversible pulpal damage. Partial irreversible pulpitis is the initial stage of this damage, confined to the coronal pulp whilst the radicular pulp shows little or no sign of infection. Preserving the pulp with sustained vitality and developing minimally invasive biologically based therapies are key themes within contemporary clinical practice. However, root canal treatment involving complete removal of the pulp is often the only option (other than extraction) given to patients with irreversible pulpitis, with substantial NHS and patient incurred costs. The European Society of Endodontology’s (ESE 2019) recent consensus statement recommends full pulpotomy, where the inflamed coronal pulp is removed with the goal of keeping the radicular pulp vital, as a more minimally invasive technique, potentially avoiding complex root canal treatment. Although this technique may be provided in secondary care, it has not been routinely implemented or evaluated in UK General Dental Practice.MethodThis feasibility study aims to identify and assess in a primary care setting the training needs of general dental practitioners and clinical fidelity of the full pulpotomy intervention, estimate likely eligible patient pool and develop recruitment materials ahead of the main randomised controlled trial comparing the clinical and cost-effectiveness of full pulpotomy compared to root canal treatment in pre/molar teeth of adults 16 years and older showing signs indicative of irreversible pulpitis. The feasibility study will recruit and train 10 primary care dentists in the full pulpotomy technique. Dentists will recruit and provide full pulpotomy to 40 participants (four per practice) with indications of partial irreversible pulpitis.DiscussionThe Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP) study will address the lack of high-quality evidence in the treatment of irreversible pulpitis, to aid dental practitioners, patients and policymakers in their decision-making. The PIP feasibility study will inform the main study on the practicality of providing both training and provision of the full pulpotomy technique in general dental practice.Trial registrationISRCTN Registry, ISRCTN17973604. Registered on 28 January 2021.Protocol versionProtocol version: 1; date: 03.02.2021

Evaluating the predictive validity of purging disorder by comparison to bulimia nervosa at long-term follow-up.

ObjectiveThe current study sought to examine the predictive validity of the purging disorder diagnosis at long‐term follow‐up by comparing naturalistic outcomes with bulimia nervosa.MethodWomen with purging disorder (N = 84) or bulimia nervosa (N = 133) who had completed comprehensive baseline assessments as part of one of three studies between 2000 and 2012 were sought for follow‐up assessment. Nearly all (94.5%) responded to recruitment materials and 150 (69% of sought sample; 83.3% non‐Hispanic white; 33.40 [7.63] years old) participated at an average of 10.59 (3.71) years follow‐up. Participants completed the Eating Disorder Examination, the Structured Clinical Interview for DSM‐IV, and a questionnaire battery. Diagnostic groups were compared on eating disorder (illness status, recovery status, and eating pathology) and related outcomes. Group differences in predictors of outcome were explored.ResultsThere were no significant differences in eating disorder presence (p = .70), recovery status (p = .87), and level of eating pathology (p = .17) between diagnostic groups at follow‐up. Post hoc equivalence tests indicated group differences were smaller than a medium effect size (p's ≤ .005). Groups differed in diagnosis at follow‐up (p = .002); diagnostic stability was more likely than cross‐over to bulimia nervosa for women with baseline purging disorder (p = .004).DiscussionAlthough purging disorder and bulimia nervosa do not differ in long‐term outcomes, the relative stability in clinical presentation suggests baseline group differences in clinical presentation may be useful in augmenting treatments for purging disorder.Public Significance StatementWhile purging disorder is classified as an “other specified” eating disorder, individuals who experience this disorder have comparable negative long‐term outcomes as those with bulimia nervosa. This highlights the importance of screening for and treating purging disorder as a full‐threshold eating disorder.