Use of a Best Practice Alert (BPA) to Increase Diversity Within a US-Based Autism Research Cohort

Area of Science:

• Clinical Research
• Pediatric Health
• Autism Spectrum Disorder Research

Background:

• Recruiting diverse participants for autism spectrum disorder (ASD) research is crucial for generalizability.
• Traditional recruitment methods often underrepresent minority and socioeconomically diverse populations.
• Pediatric primary care practices (TCPs) offer a potential avenue for broader participant recruitment.

Purpose of the Study:

• To evaluate the effectiveness of a best practice alert (BPA) system in recruiting underrepresented families into an ASD research cohort.
• To compare recruitment outcomes between TCPs and subspecialty clinics.
• To identify potential barriers to equitable recruitment.

Main Methods:

• A BPA system was implemented in TCPs serving diverse communities.
• BPA-response outcomes (Interested, Declined, Enrolled, Dismissed) were compared between TCPs and subspecialty clinics.
• Outcomes were analyzed based on insurance type and patient race/ethnicity.

Main Results:

• TCPs showed higher 'Interested' responses for privately insured patients (60.9% vs. 46.2%) and non-white patients (47.7% vs. 33.3%) compared to subspecialty clinics.
• TCPs had a higher proportion of 'Dismissed' responses for publicly insured patients (30.1% vs. 20.0%).
• Certain patient groups experienced higher rates of 'Dismissed' alerts, indicating potential selection bias.

Conclusions:

• Targeted BPAs in primary care can enhance recruitment of diverse populations into ASD research.
• BPAs can improve equitable representation in research cohorts.
• Addressing potential pediatrician selection bias is necessary for fully realizing equitable recruitment through BPAs.