The Symbolic Value and Limitations of Racial Concordance in Minority Research Engagement

Fryer, Craig S.; Passmore, Susan Racine; Maietta, Raymond C.; Petruzzelli, Jeff; Casper, Erica T.; Brown, Nesbitt D.; Butler, James P.; Garza, Mary A.; Thomas, Stephen B.; Quinn, Sandra Crouse

doi:10.1177/1049732315575708

Cited by 99 publications

(92 citation statements)

References 36 publications

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“…In RECRUIT, sixty percent of the specialist investigators and 71% of coordinators were non-Hispanic white. Data from the Parkinson’s disease minority recruitment trial 31 and other studies 50 cast some doubt on the need for racial and ethnic concordance between specialist investigators and potential trial participants. In the Parkinson’s disease trial 31 the high minority enrolling specialist investigators and coordinators were predominantly Caucasian non-Hispanic.…”

Section: Resultsmentioning

confidence: 99%

Design of a cluster-randomized minority recruitment trial: RECRUIT

et al. 2017

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Background Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities, and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics, and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement (CQI) intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the design of RECRUIT. Specialty clinic follow-up continues through April 2017. Methods We hypothesized that specialist physician investigators and coordinators trained in the trust-based CQI intervention would enroll a greater proportion of minority participants in their specialty clinics than specialist physician investigators in control specialty clinics. Specialty clinic was the unit of randomization. Using CQI, the specialist physician investigators and coordinators tailored recruitment approaches to their specialty clinic characteristics and populations. Primary analyses were adjusted for clustering by specialty clinic within parent trial and matching covariates. Results RECRUIT was implemented in four multi-site clinical trials (parent trials) supported by three NIH Institutes and included 50 associated specialty clinics from these parent trials. Using current data, we have 88% power or greater to detect a 0.15 or greater difference from the currently observed control proportion adjusting for clustering. We detected no differences in baseline matching criteria between intervention and control specialty clinics (all p-values >0.17). Conclusions RECRUIT was the first multi-site randomized control trial to examine the effectiveness of a trust-based CQI intervention to increase minority recruitment into clinical trials. RECRUIT’s innovations included its focus on building trust between specialist investigators and minority-serving physicians, the use of CQI to tailor the intervention to each specialty clinic’s specific racial/ethnic populations and barriers to minority recruitment, and the use of specialty clinics from more than one parent multi-site trial to increase generalizability. The effectiveness of the RECRUIT intervention will be determined after the completion of trial data collection and planned analyses.

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Section: Resultsmentioning

confidence: 99%

Design of a cluster-randomized minority recruitment trial: RECRUIT

et al. 2017

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“…Previous research suggests that engaging key opinion leaders, community stakeholders, and/or community coalitions in recruitment and delivery of an intervention are advantageous strategies to enhance participant recruitment and engagement [63, 70]. Matching study staff to the demographic characteristics of a target population can also be enhance participant engagement [71, 72], as AA women enjoy to socialize and receive health information from women they perceive as similar or “like” themselves [13, 73, 74]. For example, if the goal a program is to promote PA among older low-income AA women, hiring older low-income women AA women to recruit and deliver the PA program is advised.…”

Section: Resultsmentioning

confidence: 99%

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development

Joseph

Keller

Affuso

et al. 2016

J. Racial and Ethnic Health Disparities

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Background African American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e. 57% are obese, 49% have cardiovascular disease) The marked health disparities among African American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring PA programs to address the sociocultural norms, values, beliefs, and behaviors of African American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African American women and to present a conceptual framework to guide intervention development. Methods Development of the framework was based on our previous physical activity research with African American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African American culture, and key determinants of physical activity engagement among African American women. Results Three key concepts are discussed in the conceptual framework: 1) Developmental milestones and life stage transitions of African American women, 2) Historical, social and cultural influences associated with physical activity engagement, and 3) Intervention delivery strategies. Discussion Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African American women.

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“…This writer, a Black middle-class man (lead author of this paper) and a Black middle-class woman (second author) facilitated the focus groups with the support of graduate research assistants who took detailed notes. Race and gender matching focus group facilitators has been documented as a best practice in qualitative research as matching has been shown to improve rapport and promote more authentic responses [66]. Focus group questions included but were not limited to the following: "Describe some of the stressors that you experience?…”

Section: Data Collection and Recruitmentmentioning

confidence: 99%

The Price of the Ticket: Health Costs of Upward Mobility among African Americans

Hudson

Sacks

Irani

et al. 2020

IJERPH

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There is a growing literature that has documented diminishing health returns on upward social mobility among Black Americans. Due to historical policies and practices, upward social mobility is often an arduous, isolating process for Black Americans, especially as they navigate predominately white educational and workplace settings. This paper advances the literature in several meaningful and innovative ways. The goal of this paper is to provide a qualitative account of the health costs of upward social mobility and describe how these costs could diminish health returns despite greater levels of socioeconomic resources. Focus groups and surveys were the data collection methods for the study. Inclusion criteria for the study were that respondents identified as African American or Black, were 24 years or older and had completed college. The total sample was 32 college-educated Black men (n = 12) and women (n = 20). The mean age for men was 39 (range = 26–50) and 33 years of age (range = 24–59) for women. Key findings highlighted in this paper include (1) hypervisibility and subsequent vigilance; (2) uplift stress; and (3) health costs associated with social mobility. The sum of these stressors is posited to affect multiple health outcomes and elucidate the mechanisms through which socioeconomic returns on health are diminished.

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The Symbolic Value and Limitations of Racial Concordance in Minority Research Engagement

Cited by 99 publications

References 36 publications

Design of a cluster-randomized minority recruitment trial: RECRUIT

Design of a cluster-randomized minority recruitment trial: RECRUIT

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development

The Price of the Ticket: Health Costs of Upward Mobility among African Americans

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