Recruitment of Asians and Pacific Islanders with Type 2 Diabetes Into a Clinical Research Trial of Enhancing Diabetes Self-Management
Asians and Pacific Islanders (API) comprise a diverse group of cultures whose population in the United States (U.S.) is rapidly growing yet continues to be under-represented in federally-funed research. A problem commonly encountered during implementation of research studies relates to recruitment of participants from ethnic minority populations within the United States (Durant et al., 2007; Glickman et al., 2008; George et al, 2014; Kaopua et al, 2004; Toigo et al., 2001). Barriers to inclusion of minorities have been categorized as researcher specific barriers and participant barriers. Much of what is known about recruitment of minority populations into research studies has focused on the African American population and little has been published on the API population. Researcher specific barriers often stem from a lack of understanding of the unique sociocultural factors that impact decision making within the target minority groups. Inability to culturally adapt promotion and recruitment strategies result in ineffective communication and recruitment outcomes (George et al, 2014; Kaopua et al, 2004.). Participant specific barriers indentified within the API community include fear, distrust, linguistic, socioeconomic, and cultural factors (Dilworth-Anderson, Thaker, & Detry Burke, 2005; George et al, 2015; Gollin, Harrigan, Perez, Easa, & Calderon, 2005; Han, Kang, Kim, Ryu, & Kim, 2007; Knobf et al., 2007; Robinson & Trochim, 2007; Smith et al., 2007). The results of a qualitative study of 50 APIs indicated that the most frequently mentioned barriers were fear and distrust of the research team (Gollin et al., 2005). Furthermore, a lack of understanding regarding the research process and informed consent by participants gave the perception that research was secretive, which perpetuates the sense of distrust (George et al, 2014; Gollin et al., 2005).
The objective of the study was to evaluate strategies and barriers to recuriting Asians and Pacific Islanders(API) with Type 2 diabtes, into clinical trials. Descriptive statistics and content analysis were utilized to analyze reasons for non-participation. A "talk story" interview method was employed to recruit participants and uncover reasons for non-participation. A total of 1891 potential participants were identified and 340 declined participation. Eighty who declined were randomly selected to provide their reasons for non-participation. Socioeconomic issues faced by this population, such as earning wages to meet basic needs and care giving took precedence over altruistic participation in research.
Additional content will be provided upon request.