JMIR Publications

ABSTRACT

Background:

Older Black adults remain underrepresented in dementia research, particularly in studies using speech-based methods for early cognitive assessment. Understanding how to effectively recruit and engage this population in research involving audio-recorded interactions is critical to ensuring equitable inclusion and developing culturally responsive study designs. However, recruiting older Black adults into dementia research remains a significant challenge.

Objective:

This study assessed the feasibility of recruiting older Black home healthcare patients into speech-based cognitive research and examined factors influencing participation and participants’ data collection experiences.

Methods:

We implemented a four-component recruitment pipeline at a nonprofit HHC agency: (1) patient outreach and enrollment, (2) in-home audio-recorded cognitive assessments, (3) follow-up calls, and (4) audio-recorded patient-clinician encounters. Both patients and their corresponding nurse providers were included in this study. Eligible participants were Black adults aged 60+ receiving HHC services in New York City. Patient demographic and clinical characteristics were compared between those who consented and those who declined. Qualitative feedback was gathered through patient interviews and clinician questionnaires and analyzed using thematic analysis.

Results:

Of the 246 patients contacted, 71 verbally agreed to participate. Participation remained high across subsequent study components: 60 completed cognitive assessments, 48 took part in follow-up calls, and 54 consented to audio-recorded clinician visits. Patients who did not participate were more likely to experience greater medical burden and functional limitations. Both patients and clinicians reported positive experiences with the audio-recording process, noting minimal disruption to care.

Conclusions:

Recruiting Black older adults receiving HHC into speech-based dementia research was feasible and well accepted. Culturally tailored recruitment may enhance equitable participation and guide future research using audio-recorded speech for early cognitive detection.