Recruiting an underserved, difficult to reach population into a cancer trial: Strategies from the Restore-2 Rehabilitation Trial for gay and bisexual prostate cancer patients.
Recruiting an underserved, difficult to reach population into a cancer trial: Strategies from the Restore-2 Rehabilitation Trial for gay and bisexual prostate cancer patients.
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DOI：
10.1177/17407745221077678
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发表时间：
2022-06
期刊：
影响因子：
2.7
通讯作者：
West, William
中科院分区：
文献类型：
--
作者：
Rosser, B. R. Simon;Wright, Morgan;Hoefer, Chris J.;Polter, Elizabeth J.;Kohli, Nidhi;Wheldon, Christopher W.;Haggart, Ryan;Mc Talley, Kristine;Mitteldorf, Darryl;Kilian, Gunna;Konety, Badrinath R.;Ross, Michael W.;West, William
关键词：
性少数群体是规模较小、研究不足的人群，他们患癌症的风险不成比例，癌症预后不佳。被描述为“隐藏人群”的主要研究挑战一直是开发有效的方法来识别和招募这类癌症患者进行癌症研究。在线招聘战略，以及使用来自电子医疗记录的患者输入性取向和性别认同(SOGI)数据的有针对性的诊所招聘，都有可能改变招聘，但测试如何使用这些招聘效果的研究尚未发表。2019年，我们进行了一项自然主义的三臂分层前瞻性研究，以比较三种招募策略：(A)从同性恋健康和泌尿外科诊所基于诊所招募前列腺癌患者；(B)直接从同性恋社区招募；以及(C)在线招募(通过癌症支持、性/约会和社交网站)。对于每种策略，我们估计了所涉及的时间、工作负载和直接成本。为了研究招聘策略如何影响抽样，我们测试了不同地点的保留率、人口统计学和结果差异。使用这些方法，我们成功地招募了401名同性恋和双性恋前列腺癌患者参加一项随机、对照、为期24个月的试验，测试为这一人群量身定做的在线性和尿路康复课程。有七个关键结果。首先，如果使用在线招募方法，就有可能招募大量的性少数族裔男性参加前列腺癌研究。第二，我们观察到不同的招聘来源在入职学习过程中的辍学情况有很大差异。第三，在在线招聘中，在线性爱/约会应用程序(APP)是最成功和最有效的，其次是癌症支持网站，然后是社交网站。第四，虽然诊所是招聘成本最低的来源，但它们时间密集，收益率低。第五，癌症支持网站和性/约会应用程序的招募人员有几个不同的特点，前者更专注于康复，而后者更年轻，性生活更活跃。第六，我们发现三个在线招聘网站的结果几乎没有差异。第七，由于在线学习中的留存一直是一个令人担忧的问题，我们证实，在试验的3个月和6个月时，流失率非常低。对于性少数癌症研究，需要更多关于如何使用SOGI电子病历数据进行临床招募的研究。对于其他规模较小或难以接触到的人群，研究人员应该比较并发布线上和线下的招聘策略。
Sexual minorities are small and under-researched populations that are at disproportionate risk for cancer and poor cancer outcomes. Described as a “hidden population,” the principal research challenge has been to develop effective methods to identify and recruit such cancer patients into cancer studies. Online recruitment strategies, as well as targeted clinic recruitment using patient-entered sexual orientation and gender identity (SOGI) data from electronic medical records have potential to transform recruitment, but studies testing the effects of how to recruit using these have not been published. In 2019, we conducted a naturalistic, 3-arm, stratified prospective study to compare three recruitment strategies: (a) clinic based recruitment of prostate cancer patients from gay health and urology clinics; (b) directly from the gay community; and, (c) online recruitment (through cancer support, sex/dating, and social sites). For each strategy, we estimated time, workload, and direct costs involved. To study how recruitment strategy may affect sampling, we tested for retention rates, demographic and outcome differences across sites. Using these methods, we successfully recruited 401 gay and bisexual prostate cancer patients into a randomized, controlled, 24-month trial testing an online sexual and urinary rehabilitation curriculum tailored for this population. There were seven key results. First, it is possible to recruit substantial numbers of sexual minority men into prostate cancer studies provided online recruitment methods are used. Second, we observed big differences in drop out during study onboarding by recruitment source. Third, within online recruitment, the online sex/dating application (app) was the most successful and efficient, followed by the cancer support site, and then the social networking site. Fourth, while clinics were the cheapest source of recruitment, they were time intensive and low in yield. Fifth, the cancer support site and sex/dating app recruits differed by several characteristics, with the former being more rehabilitation-focused while the latter were younger and more sexually active. Sixth, we found almost no differences in outcomes across the three online recruitment sites. Seventh, because retention in online studies has been a concern, we confirm very low attrition at 3- and 6-months into the trial. For sexual minority cancer research, more research on how to use SOGI electronic medical record data for clinic-based recruitment is needed. For other small or hard-to-reach populations, researchers should compare and publish online versus offline recruitment strategies.
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