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Published in: Systematic Reviews 1/2021

Open Access 01-12-2021 | Protocol

Enrollment, retention, and strategies for including disadvantaged populations in randomized controlled trials: a systematic review protocol

Authors: Abigail LaPlante, Renata W. Yen, Talia Isaacs, Joanna Crocker, Zsofia Demjen, Danielle Schubbe, Alice M. Kennedy, Jaclyn Engel, Nancy O’Brien, Carla Richters, Marie-Anne Durand

Published in: Systematic Reviews | Issue 1/2021

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Abstract

Background

Many randomized controlled trials fail to reach their target sample size. When coupled with the omission and underrepresentation of disadvantaged groups in randomized controlled trials, many trials fail to obtain data that accurately represents the true diversity of their target population. Policies and practices have been implemented to increase representation of disadvantaged groups in many randomized controlled trials, with some trials specifically targeting such groups. To our knowledge, no systematic review has quantified the enrollment metrics and effectiveness of inclusion and retention strategies in randomized controlled trials focused on disadvantaged populations specifically.

Methods

We will conduct a systematic search across EMBASE, MEDLINE, Web of Science, and CINAHL as well as grey literature, conference proceedings, research monographs, and Google Scholar from inception onwards. We will include randomized controlled trials where at least 50% of enrolled participants are considered to be disadvantaged, as per the RCT authors’ definition and in line with our inclusion criteria. Two independent researchers per article will conduct preliminary title and abstract screening, subsequent full text review, and data extraction for the selected trials, with a third reviewer available to resolve conflicts. We will assess the quality of all included studies using specific criteria regarding data reporting, external validity, and internal validity. We will combine all selected studies and conduct a narrative synthesis to assess enrollment metrics. If there is sufficient homogeneity and sufficient trials comparing recruitment strategies within disadvantaged populations, we will conduct a random effects meta-analysis to evaluate the effectiveness of strategies designed to maximize the inclusion of disadvantaged populations in randomized controlled trials.

Discussion

The findings of this systematic review will establish baseline recruitment and enrollment metrics of trials targeting disadvantaged populations to elucidate the scope of the challenge of recruiting such populations. We hope that our findings will promote future research on the distinct barriers that may prevent disadvantaged populations from participating in health intervention research, will encourage more trials exploring effective, tailored recruitment strategies, and will establish a foundation to track future progress in the recruitment of disadvantaged populations.

Trial registrations

PROSPERO ID: CRD42020152814
Appendix
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Literature
18.
go back to reference Kosma M, Cardinal BJ, McCubbin JA. Recruitment techniques among understudied populations and their implications for physical activity promotion. 2004;56(4):413–20. Kosma M, Cardinal BJ, McCubbin JA. Recruitment techniques among understudied populations and their implications for physical activity promotion. 2004;56(4):413–20.
22.
go back to reference Jull J, Whitehead M, Petticrew M, Kristjansson E, Gough D, Petkovic J, et al. When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework. BMJ Open. 2017;7(9):e015815.CrossRefPubMedPubMedCentral Jull J, Whitehead M, Petticrew M, Kristjansson E, Gough D, Petkovic J, et al. When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework. BMJ Open. 2017;7(9):e015815.CrossRefPubMedPubMedCentral
24.
go back to reference Walters SJ, Bonacho Dos Anjos Henriques-Cadby I, Bortolami O, Flight L, Hind D, Jacques RM, et al. Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme. BMJ Open. 2017;7(3):e015276.CrossRefPubMedPubMedCentral Walters SJ, Bonacho Dos Anjos Henriques-Cadby I, Bortolami O, Flight L, Hind D, Jacques RM, et al. Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme. BMJ Open. 2017;7(3):e015276.CrossRefPubMedPubMedCentral
26.
go back to reference Treweek S, Pitkethly M, Cook J, Fraser C, Mitchell E, Sullivan F, et al. Strategies to improve recruitment to randomised trials. Cochrane Database Syst Rev. 2018;2:MR000013.PubMed Treweek S, Pitkethly M, Cook J, Fraser C, Mitchell E, Sullivan F, et al. Strategies to improve recruitment to randomised trials. Cochrane Database Syst Rev. 2018;2:MR000013.PubMed
30.
go back to reference World Health Organization & UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. Using lay health workers to improve access to key maternal and newborn health interventions in sexual and reproductive health: World Health Organization; 2013. World Health Organization & UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. Using lay health workers to improve access to key maternal and newborn health interventions in sexual and reproductive health: World Health Organization; 2013.
34.
go back to reference Breitkopf CR, Dawson L, Grady JJ, Breitkopf DM, Nelson-Becker C, Snyder RR. Intervention to improve follow-up for abnormal Papanicolaou tests: a randomized clinical trial. Health Psychol. 2014;33(4):307.CrossRefPubMed Breitkopf CR, Dawson L, Grady JJ, Breitkopf DM, Nelson-Becker C, Snyder RR. Intervention to improve follow-up for abnormal Papanicolaou tests: a randomized clinical trial. Health Psychol. 2014;33(4):307.CrossRefPubMed
35.
go back to reference Zoellner JM, Hedrick VE, You W, Chen Y, Davy BM, Porter KJ, et al. Effects of a behavioral and health literacy intervention to reduce sugar-sweetened beverages: a randomized-controlled trial. Int J Behav Nutr Phys Act. 2016;13(1):1–12.CrossRef Zoellner JM, Hedrick VE, You W, Chen Y, Davy BM, Porter KJ, et al. Effects of a behavioral and health literacy intervention to reduce sugar-sweetened beverages: a randomized-controlled trial. Int J Behav Nutr Phys Act. 2016;13(1):1–12.CrossRef
36.
go back to reference Durand M-A, Carpenter L, Dolan H, Bravo P, Mann M, Bunn F, et al. Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta-analysis. Malaga G, editor. PLoS One. 2014;9(4):e94670. Durand M-A, Carpenter L, Dolan H, Bravo P, Mann M, Bunn F, et al. Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta-analysis. Malaga G, editor. PLoS One. 2014;9(4):e94670.
39.
go back to reference Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. bmj. 2020;368. Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. bmj. 2020;368.
Metadata
Title
Enrollment, retention, and strategies for including disadvantaged populations in randomized controlled trials: a systematic review protocol
Authors
Abigail LaPlante
Renata W. Yen
Talia Isaacs
Joanna Crocker
Zsofia Demjen
Danielle Schubbe
Alice M. Kennedy
Jaclyn Engel
Nancy O’Brien
Carla Richters
Marie-Anne Durand
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2021
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-021-01790-7

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