Recruitment Strategies for Cervical Cancer Prevention Study

doi:10.1006/gyno.2002.6592

Gynecologic Oncology

Volume 85, Issue 2, May 2002, Pages 250-254

https://doi.org/10.1006/gyno.2002.6592 Get rights and content

Abstract

Objective. The aim of this study was to describe recruitment strategies for a single-visit cervical cancer prevention study.

Methods. From January through December 1999, low-income, predominantly Latino women were recruited to participate in a single-visit cervical cancer prevention study. For the first 6 months, all women who had ever visited one of two community-based study clinics were invited to participate (clinic registry recruitment). For the remainder of the year, recruitment was modified to be primarily inclusive of advertisements in English- and Spanish-language community newspapers and fliers left in local businesses and organizations (media campaign recruitment). Eligible volunteers were randomized to one of two study arms, usual-care program or single-visit program. All study subjects completed demographic and medical questionnaires delivered by bilingual staff. Women who declined to participate in this study were asked to provide reasons for this preference. Statistical analyses included the use of chi-square, logistic regression, and Student's t test.

Results. The proportion of women who agreed to participate was higher in the media recruitment group than in the clinic registry group [51% (535/1041) compared to 26% (405/1542), P < 0.001]. The no-show rate among participants solicited from the media strategy was significantly less than that from the clinic registry. There were no significant differences in the median age, number of months since the last Papanicolaou smear, incidence of abnormal Papanicolaou smear, education, or income of the subjects based on the recruitment strategy.

Conclusion. A media-based recruitment strategy was effective for this single-visit cervical prevention study. This approach may be effective for recruitment of other low-income groups to clinical trials.

References (14)

RA Burger et al.
Single-visit program for cervical cancer prevention in a high-risk population
Obstet Gynecol
(1995)
MS McCabe et al.
Efforts to recruit the economically disadvantaged to national clinical trials
Semin Oncol Nurs
(1994)
EJ Pérez-Stable et al.
Self-reported use of cancer screening tests among Latinos and Anglos in a prepaid health plan
Arch Intern Med
(1994)
RE Roberts et al.
Medical care use by Mexican-Americans
Public Med Care
(1980)
JM Samet et al.
Delay in seeking care for cancer symptoms. A population-based study of elderly New Mexicans
J Natl Cancer Inst
(1988)
FA Hubbell et al.
Access to medical care for documented and undocumented Latinos in a Southern California county
West J Med
(1991)

There are more references available in the full text version of this article.

Cited by (35)

Development of a cancer clinical trials multi-media intervention: Clinical Trials: Are they Right for You?
2012, Patient Education and Counseling
Citation Excerpt :
Thus, innovative communication interventions are required to facilitate informed decision-making [6] and to prepare individuals for a discussion of CTs. There have been numerous efforts to improve communication about CTs published in peer-reviewed literature including interventions to increase awareness about cancer CTs through positive messaging [4,15,22–28]. CT communication interventions include educational brochures [15,25,26], fliers and patient letters [4,23], websites [15], newspaper advertisements [23], and audiovisual materials [24–27].
To describe processes used to develop a multi-media psycho-educational intervention to prepare patients for a discussion about cancer clinical trials (CTs).
Guided by a Steering Committee, formative research was conducted to develop an informative and engaging tool about cancer CTs. Twenty-three patients and caregivers participated in formative in-depth interviews to elicit information about perceptions of cancer CTs to inform production of a new media product.
Formative research revealed participants had concerns about experimentation, held beliefs that cancer CTs were for patients who had no other treatment options, and wanted a balance of information about pros and cons of CT participation. The value of physicians as credible spokespersons and the use of patients as role-models were supported. Using iterative processes, the production team infused the results into creation of a multimedia psycho-educational intervention titled Clinical Trials: Are they Right for You?
An intervention, developed through an iterative consumer-focused process involving multiple stakeholders and formative research, may result in an engaging informative product.
If found to be efficacious, Clinical Trials: Are they Right for You? is a low-cost and easily disseminated multimedia psycho-educational intervention to assist cancer patients with making an informed decision about cancer CTs.
Recruiting underrepresented groups into the carbohydrates and related biomarkers (CARB) cancer prevention feeding study
2012, Contemporary Clinical Trials
Citation Excerpt :
Media-based strategies successfully recruited a relatively higher proportion of African Americans, which may suggest broader readership of such media compared to Hispanics. Alternatively other factors not measured in this study (e.g., reluctance to participate in a “study” or work or childcare constraints [14]) may account for the differences observed in these groups. The stringent eligibility criteria and extensive study procedures meant that the “hit rate” (the number who enrolled in the study divided by the number who initially contacted the project office) was relatively low (9%).
Using data from a randomized, controlled feeding study, which aimed to recruit 88 participants (including 22 Hispanics and 22 African Americans), we examined strategies for recruiting individuals from underrepresented groups into research trials. Study eligibility criteria included participants who 1) were 18–45 years old; 2) had a body mass index (BMI) > 18 < 24.9 or BMI > 28.0 < 40.0; 3); had no preexisting health conditions; 4) were non-smoking; 5) had normal fasting blood glucose level (< 100 mg/dL); and 6) spoke English. Participants were recruited using two overarching methods: media-based strategies (flyers and posters, email announcements, announcements in local and campus newspapers, and the Internet) and in-person strategies (presentations in university classes and community events). Participants were enrolled March 2006–March 2009. We present the numbers of individuals requesting study information, completing pre-enrollment screening questionnaires, and enrolling in the study. A total of 1036 individuals requested study information, and 396 completed a pre-enrollment screening questionnaire; 90 enrolled in the study (22 Hispanics and 18 African Americans). Among enrolled participants, in-person recruitment strategies were reported by 39% of African Americans, 73% of Hispanics, and 30% of non-Hispanic Whites (P < 0.001). In-person recruitment strategies were successful among Hispanics. Mass media recruitment strategies were successful among non-Hispanic Whites but enlisted relatively few Hispanic participants. Both strategies recruited nearly equal percentages of African Americans. These data suggest that different strategies are needed to effectively recruit racial/ethnic population subgroups into intervention studies.
Recruitment of minority and underserved populations in the United States: The centers for population health and health disparities experience
2008, Contemporary Clinical Trials
Citation Excerpt :
These strategies were implemented individually by some Centers, and either incrementally or concurrently by other Centers. Some of these same strategies have resulted in successful recruitment in previous studies [34,52–68]. As with any study, there are several limitations and strengths in summarizing the Centers' approach to participant recruitment.
The recruitment of minority and underserved individuals to research studies is often problematic. The purpose of this study was to describe the recruitment experiences of projects that actively recruited minority and underserved populations as part of The Centers for Population Health and Health Disparities (CPHHD) initiative.
Principal investigators and research staff from 17 research projects at eight institutions across the United States were surveyed about their recruitment experiences. Investigators reported the study purpose and design, recruitment methods employed, recruitment progress, problems or challenges to recruitment, strategies used to address these problems, and difficulties resulting from Institutional Review Board (IRB) or Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements. Additionally, information was collected about participant burden and compensation. Burden was classified on a three-level scale. Recruitment results were reported as of March 31, 2007.
Recruitment attainment ranged from 52% to 184% of the participant recruitment goals. Commonly reported recruitment problems included administrative issues, and difficulties with establishing community partnerships and contacting potential participants. Long study questionnaires, extended follow-up, and narrow eligibility criteria were also problematic. The majority of projects reported difficulties with IRB approvals, though few reported issues related to HIPAA requirements. Attempted solutions to recruitment problems varied across Centers and included using multiple recruitment sites and sources and culturally appropriate invitations to participate. Participant burden and compensation varied widely across the projects, however, accrual appeared to be inversely associated with the amount of participant burden for each project.
Recruitment of minority and underserved populations to clinical trials is necessary to increase study generalizbility and reduce health disparities. Our results demonstrate the importance of flexible study designs which allow adaptation to recruitment challenges. These experiences also highlight the importance of involving community members and reducing participant burden to achieve success in recruiting individuals from minority and underserved populations.
Latino recruitment to cancer prevention/screening trials in the Southwest: setting a research agenda
2008, Applied Nursing Research
Examples of cancer prevention and screening trials in the Southwest are reviewed as a platform for highlighting gaps in research on Latino recruitment. Three trials are described, using “message/source/channel” categories as a framework. Each trial engaged community members to facilitate recruitment and developed tailored strategies to meet challenges emerging after recruitment began. Although we affirm that culturally relevant messages, community member referral networks, and adjustment to community realities seem important to Latino recruitment, current anecdotal and research findings do not allow evidence-based recommendations to be made. We suggest a research agenda to further illuminate critical factors for successful Latino recruitment.
Recruitment strategies and HPV self-collection return rates for under-screened women for cervical cancer prevention
2023, PLoS ONE
Interventions targeted at women to encourage the uptake of cervical screening
2021, Cochrane Database of Systematic Reviews

View all citing articles on Scopus

^☆: Presented at the 32nd Annual Meeting of the Society of Gynecologic Oncologists, Nashville, Tennessee, March 3–7, 2001.

²: To whom correspondence and reprint requests should be addressed at Epidemiology Division, Department of Medicine, University of California, Irvine, 224 Irvine Hall, Irvine, CA 92697-7550. Fax: (949) 824-4773. E-mail: [email protected].

View full text

Regular ArticleRecruitment Strategies for Cervical Cancer Prevention Study☆

Abstract

Obstet Gynecol

Semin Oncol Nurs

Self-reported use of cancer screening tests among Latinos and Anglos in a prepaid health plan

Arch Intern Med

Medical care use by Mexican-Americans

Public Med Care

Delay in seeking care for cancer symptoms. A population-based study of elderly New Mexicans

J Natl Cancer Inst

Access to medical care for documented and undocumented Latinos in a Southern California county

West J Med

Regular Article
Recruitment Strategies for Cervical Cancer Prevention Study☆