Messaging Informed by Behavioral Economics and Representativeness in Clinical Research Enrollment: Four Randomized...

Area of Science:

• Clinical research
• Health equity
• Biomedical informatics

Background:

• Clinical research enrollment faces challenges with low participation rates.
• Racial and ethnic minority groups are often underrepresented in studies.
• Effective recruitment strategies are crucial for generalizable research findings.

Purpose of the Study:

• To assess the impact of electronic message content on clinical trial enrollment.
• To identify effective recruitment methods for diverse populations.
• To improve participation of minority groups in research.

Main Methods:

• Four sequential randomized clinical trials (RCTs) were conducted with University of Pennsylvania Health System patients.
• Electronic messages (email, text, or both) varied in content, source, framing, and incentives.
• Enrollment fractions among Black and Hispanic participants were analyzed using intention-to-treat.

Main Results:

• Text message outreach showed higher enrollment fractions compared to email alone in initial trials.
• Incentives, particularly a $25 payment, significantly increased enrollment among minority participants.
• Appeals to altruism or social proof did not significantly alter enrollment rates compared to control messages.

Conclusions:

• Outreach via text message and the provision of financial incentives can enhance clinical trial enrollment among Black and Hispanic patients.
• These findings offer strategies to improve diversity and representation in research.
• Optimizing recruitment messages is key to overcoming participation barriers.