Conducting Intervention Research Among Underserved Populations: Lessons Learned and Recommendations for Researchers

Abstract

Randomized controlled trials (RCTs) are considered the gold standard in research design for establishing treatment efficacy. However, the rigorous and highly controlled conditions of RCTs can be difficult to attain when conducting research among individuals living with a confluence of disability, low socioeconomic status, and being a member of a racial/ethnic minority group, who may be more likely to have unstable life circumstances. Research on effective interventions for these groups is urgently needed, as evidence regarding approaches to reduce health disparities and improve health outcomes is lacking. In this methodological paper we discuss the challenges and lessons learned in implementing the Lifestyle Redesign® for Pressure Ulcer Prevention in Spinal Cord Injury (LR-PUPS) study among a highly disadvantaged population. These issues are discussed in terms of strategies to enhance recruitment, retention, and intervention relevance to the target population. Recommendations for researchers seeking to conduct RCTs among socioeconomically disadvantaged, ethnically diverse populations are provided.

Retaining traditionally hard to reach participants: Lessons learned from three childhood obesity studies

“…These strategies are similar to others reported in similar trials [8,16–17] , and we believe they are essential to building trust between research staff, organizations, and participants. It was very apparent that the relationship between our academic setting and the research setting (i.e, Head Start programs, WIC ) needed to a cooperative partnership, especially in the school setting where our intervention did not address traditional academic content.…”

“…[32–33] Higher loss to follow-up is a significant problem among low-income and minority populations due to transportation challenges, transient living situations, distrust of research, inconsistent contact information, and language barriers. [9,14,16] …”

An Exploratory Analysis of the Smoking and Physical Activity Outcomes From a Pilot Randomized Controlled Trial of an Exercise Assisted Reduction to Stop Smoking Intervention in Disadvantaged Groups

“…those of low-socioeconomic status) attempt to quit at the same rate as others their success in quitting is lower 2 . This is leading to increasing disparities in smoking prevalence between the upper and lower social grades in the United Kingdom 3 , with similar trends being observed in the United States 4 , suggesting a need for interventions specifically designed for these groups 5 .…”

Effectiveness of a Virtual Grocery Store Tour on the Confidence and Ability of Parents to Understand and Use the Nutrition Facts Panel

“…The past research had success at increasing their involvement from lowincome populations, while they did not discuss major failures. Pyatak et al (2013) conducted a quantitative study about the challenges observed in a randomized control study, Redesign for Pressure Ulcer Prevention in Spinal Cord Injury. The study focused on a demographic of low socioeconomic status, ethnicity, and disability.…”