title: Recruitment and enrollment of rural and urban medically underserved elderly into a randomized trial of telemedicine case management for diabetes care.
abstract: Our goal was to identify reasons for enrollment or refusal to participate in a randomized trial of telemedicine case management of diabetes. We performed a prospective survey of participants and non-participants during recruitment for the Informatics for Diabetes Education and Telemedicine (IDEATel) study, a randomized trial of telemedicine case management of diabetes mellitus in medically underserved elderly. There were two recruitment areas: urban New York City, and rural upstate New York. A Participant Questionnaire (PQ) was administered at the baseline IDEATel visit, and a Non-Participant Questionnaire (NPQ) was administered during the recruitment telephone call. Both questionnaires listed possible responses; subjects could choose more than one response or give their own. Of 1,660 IDEATel participants, 99.7% completed the PQ. Most frequent reason for participation was the belief that the technology could help them (52% and 42% of urban and rural respondents, respectively). Of the 2,231 subjects refusing participation, 28% answered the NPQ (90% of respondents were from rural area). Most frequent reasons not to participate in the rural area were being too busy (23%), and discomfort with the technology (22%), and in the urban area the belief that the technology could not help them (71%), discomfort with it (52%), and not liking to participate in studies (52%). In multivariate analysis (rural respondents only), knowing how to use a computer was an independent predictor of participation (p < 0.001). In conclusion, perceptions and beliefs regarding technology, including the expectation to benefit from it, played an important role in the decision to participate.
authors.affiliation: Department of Medicine, Columbia University, New York, NY 10032, USA. wp56@columbia.edu
authors.forename: Walter
authors.initials: W
authors.lastname: Palmas
authors.forename: Jeanne
authors.initials: J
authors.lastname: Teresi
authors.forename: Philip
authors.initials: P
authors.lastname: Morin
authors.forename: L Thomas
authors.initials: LT
authors.lastname: Wolff
authors.forename: Lesley
authors.initials: L
authors.lastname: Field
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Eimicke
authors.forename: Linnea
authors.initials: L
authors.lastname: Capps
authors.forename: Alejandro
authors.initials: A
authors.lastname: Prigollini
authors.forename: Irma
authors.initials: I
authors.lastname: Orbe
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009518:New York; D009519:New York City; D018579:Patient Selection; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012424:Rural Population; D012648:Self Care; D017216:Telemedicine; D014505:Urban Population