Abstract
Purpose :
To identify rates of study enrollment using electronic medical record recruitment (EMR), community-engaged enrollment, and quality improvement strategies. Diabetic retinopathy (DR) is a leading cause of blindness more prevalent and more severe in Black, Latina/o, Indigenous, and low-income individuals. The Sight-Saving Engagement and Evaluation in New Haven (SEEN) intervention identifies individuals at high-risk for blindness.
Methods :
Our team identified characteristics associated with proliferative DR based on a retrospective cohort Cox-model analysis. Using the EMR potential participants with diabetes that did not have a documented eye examination in the last year were identified. Participants were required to opt into the pilot study. Identified participants were risk stratified. We invited those that were in the highest quartile of the risk calculator that met inclusion criteria to participate. In parallel, the research team worked with the Community Engaged Research Steering Committee to identify community events and organizations catering to those in populations at high-risk for blindness. The team hosted educational events and recruited participants. After poor recruiting through the EMR system, a quality improvement approach identified patients that met the inclusion criteria. Descriptive statistics summarized each recruitment method.
Results :
10,604 participants met broad inclusion criteria. 1,473 participants viewed our recruitment message. 58 participants replied to recruitment messaging. 3 potential participants met criteria and we enrolled 3 participants (0.028%). Our team attended 10 community events including 4 presentations at senior centers in target neighborhoods. 20 potential participants were identified, and we enrolled 1 participant. Our quality improvement initiative identified 5,712 potential participants that met inclusion criteria. Of those 334 were screened and 19 (5.6%) are scheduled or enrolled.
Conclusions :
Recruitment is a challenge that Is underdiscussed in research. We identify three strategies: EMR messaging, community-engaged, and quality improvement targeting. In our vulnerable research population, targeted quality improvement approach is superior to EMR recruitment in identifying high-risk participants. A multi-faceted approach is required when recruiting marginalized communities to participate in research.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.