Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 12, 2021
Date Accepted: Apr 18, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Decídetexto: Proactive versus reactive recruitment of Latinos into a mobile smoking cessation randomized clinical trial
ABSTRACT
Background:
Latinos remain disproportionately underrepresented in clinical trials, comprising only 2-3% of research participants. Increasing enrollment of Latino smokers in smoking cessation trials is paramount to addressing health disparities; however, there is limited research examining effective recruitment strategies for recruiting this population.
Objective:
The current paper assessed the effectiveness of proactive and reactive recruitment strategies on overall recruitment of Latino smokers to a randomized smoking cessation trial – Decidetexto – and how the type of recruitment might influence the characteristics of the study participants.
Methods:
Latino smokers were enrolled into Decídetexto using proactive and reactive recruitment strategies from multiple communities in four states – New Jersey, Kansas, Missouri, and New York. Participants were recruited from August 2018 until March 2021. Proactive recruitment strategies included in-person community-based recruitment (e.g., festivals and health fairs) and calling, texting, or emailing a list of smokers provided by a healthcare system or community-based organizations (CBOs). Reactive recruitment strategies included bilingual (English and Spanish) advertisements via newspaper, television, radio, church bulletins, flyers, Decídetexto website, and referrals from friends/family. Recruitment and eligibility were conducted by a team of trained bilingual (English and Spanish) recruiters from different countries of origin (e.g., Cuba, Dominican Republic, Ecuador, El Salvador, Mexico, Nicaragua, Peru, Puerto Rico, Venezuela).
Results:
Of 1,112 individuals who completed screening, 890 (80.0%) met eligibility criteria, and 459 (51.6%) enrolled in the trial. Compared to the proactive method, individuals screened in the reactive method were significantly more likely to be eligible (87.1% vs 78.9%; OR = 1.80, 95% CI=1.17-2.77, P=.007) and significantly more likely to enroll in the study (61.8% vs 36.4%; OR = 2.82, 95% CI=2.07-3.82, P<.001). Participants recruited proactively were significantly more likely to have health insurance (72.6% vs 51.5%, P<.001) and lived significantly longer years in the U.S. compared to those recruited reactively (mean years 30.6 vs 25.6, P=.003). Participants recruited proactively also had higher rates of depression (sum score 1.6 vs 1.2; P=.020) and anxiety (sum score 1.8 vs 1.4; P=.017) and yielded significantly more participants from the Caribbean, South America, and the U.S. (35.7%, 27.1%, and 25.8% P<.001). Participants recruited reactively yielded significantly more Spanish-speaking participants than those recruited proactively (82.1% vs 65.5%; P<.001) and yielded significantly more participants from Mexico and Central America (39.6% and 7.5%, P<.001). Participants recruited reactively were also significantly more likely to be 1st generation U.S. Latinos (85.3% vs 75.8%, P=.030) and had significantly higher alcohol use (mean score 5.0 vs 3.9, P<.001).
Conclusions:
Both proactive and reactive recruitment strategies should be implemented for studies interested in recruiting Latino participants across the socioeconomic, acculturation, and country of origin spectrum. Clinical Trial: ClinicalTrials.gov Identifier: NCT03586596
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