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Recruiting older women to research studies: the san diego cooperative mammography project
G R Sadler1, L K Olson, A S Krause
1Community Outreach, UCSD Cancer Center, La Jolla 92093-0658, USA. gsadler@ucsd.edu
Background:
Despite the growing number of older people in the population, this age group continues to be under represented in clinical trials. As a result, physicians must base treatment decisions for older patients on data from studies involving primarily younger, and presumably healthier, adults. Little experience is available to guide the development of study methodologies that will enhance the recruitment of older patients to clinical studies.
Methods:
This pilot study compared two methods of recruiting women 75 years and older to a clinical research study related to their most recent screening mammogram. The effectiveness of a single, "in-person" invitation to participate made during the screening mammogram appointment was compared with the effectiveness of a single invitation to participate sent "by-mail" following a screening mammogram.
Results:
Both methods succeeded in recruiting a sizable sample (N=2,394). The "in-person" invitation to participate was more labor-intense and less likely to be inclusive of all eligible women, but secured a significantly greater proportion of the women to participate. However, once recruited, women in the "by-mail" method were significantly more likely to comply with the optional elements of the study and to express a willingness to continue with follow-up studies than those recruited by the "in-person" method.
Conclusions:
Lack of participation of older women in clinical research may be more a reflection of not being asked, rather than their lack of willingness to participate, thus reinforcing the key role health care providers can play in recruiting older women to clinical studies.
Insights
Older women are underrepresented in clinical trials. This study found that while in-person invitations recruit more older women, mail invitations lead to better study compliance and willingness for follow-up. Healthcare providers play a key role.
Area of Science:
- Gerontology
- Clinical Research Methodology
- Health Services Research
Background:
- Older adults are underrepresented in clinical trials, leading to treatment decisions based on data from younger populations.
- Limited methodologies exist to enhance the recruitment of older individuals into clinical studies.
Purpose of the Study:
- To compare the effectiveness of in-person versus mail invitations for recruiting women aged 75 and older to a clinical research study.
- To assess recruitment and compliance differences between two distinct invitation methods.
Main Methods:
- A pilot study compared two recruitment strategies: in-person invitations during mammogram appointments versus mail invitations post-mammogram.
- Effectiveness was measured by participation rates, inclusivity, compliance with optional elements, and willingness for follow-up.
Main Results:
- Both methods recruited a substantial sample (N=2,394).
- In-person invitations were more labor-intensive and less inclusive but yielded higher participation rates.
- Mail-recruited participants showed significantly higher compliance and willingness for future studies.
Conclusions:
- Older women's underrepresentation may stem from not being invited, rather than unwillingness to participate.
- Healthcare providers are crucial in recruiting older women to clinical studies.
- Mail invitations may enhance long-term engagement in research.
