title: Enrolling African-American and Latino patients with asthma in comparative effectiveness research: Lessons learned from 8 patient-centered studies.
abstract: African-American and Latino patients are often difficult to recruit for asthma studies. This challenge is a barrier to improving asthma care and outcomes for these populations.
  
  
  
  We sought to examine the recruitment experiences of 8 asthma comparative effectiveness studies that specifically targeted African-American and Latino patients, and identify the solutions they developed to improve recruitment.
  
  
  
  Case report methodology was used to gather and evaluate information on study design, recruitment procedures and outcomes from study protocols and annual reports, and in-depth interviews with each research team. Data were analyzed for themes, commonalities, and differences.
  
  
  
  There were 4 domains of recruitment challenges: individual participant, institutional, research team, and study intervention. Participants had competing demands for time and some did not believe they had asthma. Institutional challenges included organizational policies governing monetary incentives and staff hiring. Research team challenges included ongoing training needs of recruitment staff, and intervention designs often were unappealing to participants because of inconveniences. Teams identified a host of strategies to address these challenges, most importantly engagement of patients and other stakeholders in study design and troubleshooting, and flexibility in data collection and intervention application to meet the varied needs of patients.
  
  
  
  Asthma researchers may have greater success with recruitment by addressing uncertainty among patients about asthma diagnosis, engaging stakeholders in all aspects of study design and implementation, and maximizing flexibility of study and intervention protocols. However, even with such efforts, engagement of African-American and Latino patients in asthma research may remain low. Greater investment in research on engaging these populations in asthma research may ultimately be needed to improve their asthma care and outcomes.
authors: Public Health - Seattle & King County, Seattle, Wash.
authors: C Bradley
authors: CB
authors: Kramer
authors: Abt Associates, Cambridge, Mass.
authors: Lisa
authors: L
authors: LeRoy
authors: Abt Associates, Cambridge, Mass.
authors: Sara
authors: S
authors: Donahue
authors: Division of Pulmonary, Allergy, & Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
authors: Andrea J
authors: AJ
authors: Apter
authors: Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
authors: Tyra
authors: T
authors: Bryant-Stephens
authors: Institute for Behavioral and Community Health, School of Public Health, San Diego State University, San Diego, Calif.
authors: John P
authors: JP
authors: Elder
authors: Environmental Health Section, Chronic Disease Prevention and Control Research Center, Baylor College of Medicine, Houston, Tex.
authors: Winifred J
authors: WJ
authors: Hamilton
authors: Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois at Chicago College of Medicine and Population Health Sciences Program, University of Illinois Hospital and Health Sciences System, Chicago, Ill.
authors: Jerry A
authors: JA
authors: Krishnan
authors: Children's National Health System, Washington, DC.
authors: Deborah Q
authors: DQ
authors: Shelef
authors: Department of Pediatrics and Health Services, University of Washington, Seattle, Wash.
authors: James W
authors: JW
authors: Stout
authors: Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Mo.
authors: Kaharu
authors: K
authors: Sumino
authors: Division of Emergency Medicine and the Department of Pediatrics, Children's National Health System, Washington, DC.
authors: Stephen J
authors: SJ
authors: Teach
authors: Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: alex.federman@mssm.edu.
authors: Alex D
authors: AD
authors: Federman
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D003150:Community Health Workers; D055812:Community-Based Participatory Research; D057186:Comparative Effectiveness Research; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D014481:United States
keywords: Comparative effectiveness research; asthma; patient-centered outcomes research; study recruitment; vulnerable populations