UMass Chan Medical School Faculty Publications

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Department of Family Medicine and Community Health; Center for Integrated Primary Care

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Community-Based Research | Endocrine System Diseases | Health Services Administration | Health Services Research | Nutritional and Metabolic Diseases | Race and Ethnicity | Telemedicine | Women's Health


BACKGROUND: The development of evidence-based care geared towards Black and Latina women living with uncontrolled type 2 diabetes is contingent upon their active recruitment into clinical interventions. Well-documented impediments to recruitment include a historical mistrust of the research community and socioeconomic factors that limit awareness and access to research studies. Although sociocultural and socioeconomic factors deter minorities from participating in clinical research, it is equally important to consider the role of stigma in chronic disease intervention studies.

OBJECTIVE: We aim to share our discovery of diabetes-related stigma as an underrecognized impediment to recruitment for the Women in Control 2.0 virtual diabetes self-management education study.

METHODS: Our initial recruitment plan used traditional strategies to recruit minority women with uncontrolled type 2 diabetes, which included letters and phone calls to targeted patients, referrals from clinicians, and posted flyers. After engaging a patient advisory group and consulting with experts in community advocacy, diabetes-related stigma emerged as a prominent barrier to recruitment. The study team reviewed and revised recruitment scripts and outreach material in order to better align with the lived experience and needs of potential enrollees.

RESULTS: Using a more nuanced, community-centered recruitment approach, we achieved our target recruitment goal, enrolling 309 participants into the study, exceeding our target of 212.

CONCLUSIONS: There is a need for updated recruitment methods that can increase research participation of patients who experience internalized diabetes stigma. To address disparities in minority health, further research is needed to better understand diabetes-related stigma and devise strategies to avert or address it. Jessica Martin-Howard, Paula Gardiner. Originally published in JMIR Diabetes (, 03.05.2021.


diabetes, disparities, minority health, recruitment, research, stigma, virtual health, virtual management

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Copyright ©Suzanne Mitchell, Alexa Bragg, Ioana Moldovan, Shakiyla Woods, Katherine Melo, Jessica Martin-Howard, Paula Gardiner. Originally published in JMIR Diabetes (, 03.05.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Diabetes, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.

DOI of Published Version



Mitchell S, Bragg A, Moldovan I, Woods S, Melo K, Martin-Howard J, Gardiner P. Stigma as a Barrier to Participant Recruitment of Minority Populations in Diabetes Research: Development of a Community-Centered Recruitment Approach. JMIR Diabetes. 2021 May 3;6(2):e26965. doi: 10.2196/26965. PMID: 33938811; PMCID: PMC8129881. Link to article on publisher's site

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JMIR diabetes

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Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.