Translational Research at Community Health Centers: Challenges and Successes in Recruiting and Retaining Low-Income Latino Patients With Type 2 Diabetes Into a Randomized Clinical Trial
Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Medicine, Division of Cardiovascular Medicine; Department of Family Medicine and Community Health
Community Health Centers; Randomized Controlled Trials as Topic; Patient Selection; Hispanic Americans; Diabetes Mellitus, Type 2; Translational Research
Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Preventative Medicine
PURPOSE: To describe methods used to recruit and retain low-income Latinos in a randomized clinical trial (RCT) of a diabetes self-management intervention at 5 community health centers (CHCs) in Massachusetts.
METHODS: Consent from primary care providers (PCPs) was obtained to screen their patients. Trained site research coordinators (SRCs) screened, recruited, and enrolled participants following a multistep process (medical record reviews, PCP approval, a patient eligibility interview) and provided support for retention efforts. Assessment staff were trained in motivational strategies to facilitate retention and received ongoing support from a retention coordinator. Electronic tracking systems facilitated recruitment and retention activities.
RESULTS: Of an initial pool of 1176 patients, 1034 were active at the time of screening, 592 (57%) were eligible by medical record review, and 487 received PCP approval (92% of reviewed patients). Of these, 293 patients completed the patient screening interview (60% of patients with PCP approval, and 76% of those reached), and 276 were eligible. Sixteen percent of all active patients refused participation, and 8% of contacted patients were unreachable. Two hundred fifty-two patients were randomized after completion of baseline assessments. Clinical, behavioral, and psychosocial assessment completion rates were 92%, 77%, and 86% at 12-month follow-up, respectively, and 93% of patients completed at least one study assessment at 12 months.
CONCLUSIONS: CHCs are a prime setting for translation research aimed to eliminate diabetes health disparities. Successful recruitment and retention efforts must address institutional/organizational, research team, and patient-related challenges.
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Citation: Diabetes Educ. 2010 Sep-Oct;36(5):733-49. Epub 2010 Aug 20.