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Contextualizing Response Rates During the COVID-19 Pandemic: Experiences From a Boston-Based Community Health Centers
Merrily E LeBlanc1, Christian Testa, Pamela D Waterman
1Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Messrs Testa and Breedlove, Mss Waterman, Mbaye, and Nwamah, and Drs Reisner, Chen, and Krieger); The Fenway Institute, Fenway Health, Boston, Massachusetts (Ms LeBlanc and Drs Reisner and Mayer); Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts (Dr Reisner); Harvard Medical School, Boston, Massachusetts (Dr Reisner); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Dr Mayer); and Center for Community Health Education, Research and Service, Boston, Massachusetts (Dr Oendari).
Objectives:
The focus of this study was to calculate and contextualize response rates for a community-based study conducted during the COVID-19 pandemic, a topic on which scant data exist, and to share lessons learned from recruiting and enrolling for implementation of future studies.
Design:
The Life+Health Study, a cross-sectional population-based study designed to advance novel methods to measure and analyze multiple forms of discrimination for population health research.
Setting:
The study recruited participants from 3 community health centers in Boston, Massachusetts, between May 2020 and July 2022.
Participants:
A total of 699 adult participants between the ages of 25 and 64 years who were born in the United States and had visited one of the health centers within the last 2 years.
Main Outcome Measures:
The response rate was calculated as follows: (number of completions + number of dropouts)/(dropouts + enrollments). To contextualize this response rate, we synthesized evidence pertaining to local COVID-19 case counts, sociopolitical events, pandemic-related restrictions and project protocol adjustments, and examples of interactions with patients.
Results:
Our study had a lower-than-expected response rate (48.4%), with the lowest rates from the community health centers serving primarily low-income patients of color. Completion rates were lower during periods of higher COVID-19 case counts. We describe contextual factors that led to challenges and lessons learned from recruiting during the pandemic, including the impact of US sociopolitical events.
Conclusions:
The Life+Health Study concluded recruitment during the pandemic with a lower-than-expected response rate, as also reported in 4 other US publications focused on the impact of COVID-19 on response rates in community-based studies. Our results provide an example of the impact of the pandemic and related US sociopolitical events on response rates that can serve as a framework for contextualizing other research conducted during the pandemic and highlight the importance of best practices in research recruitment with underserved populations.
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