@article{0a71ca44dd3d41bda60bdd5533e4e974,
title = "Racial/ethnic concordance between patients and researchers as a predictor of study attrition",
abstract = "Rationale: The differential attrition of racial/ethnic minority participants in clinical research is a major threat to advancing medical and behavioral science. Objective: Our aim was to examine the influence of racial/ethnic concordance between participants and research staff on study attrition. Method: Data were pooled from participants and clinical research coordinators (CRCs) in six longitudinal studies of respiratory illness. Dyads were classified as concordant if the patient and CRC were of the same racial/ethnic group. Multilevel modeling examined the effect of racial/ethnic concordance on attrition at the first and one-year follow-ups. Results: Spanish language, lower education, and greater depressive symptoms predicted greater attrition, but these effects disappeared in adjusted models. Race/ethnicity, age, gender and health literacy did not predict attrition. Contrary to hypotheses, attrition was greater among concordant than discordant dyads: Attrition was almost five times greater at first follow-up for Black and Hispanic participants in concordant dyads, and almost four times greater at one year. Conclusions: Racial/ethnic concordance between participant and CRCs was related to greater attrition in a highly diverse sample of adults with respiratory illness. Differential attrition of racial/ethnic minorities is a major threat to advancing public health. Interactions with research staff may be critical to bridging the disparities gap.",
author = "Irina Mindlis and David Livert and Federman, {Alex D.} and Wisnivesky, {Juan P.} and Revenson, {Tracey A.}",
note = "Funding Information: Funding/Support: This secondary analysis was supported by a Graduate Center Fellowship to the first author by the Graduate Center, City University of New York . The original studies were supported by grants from National Heart, Lung, and Blood Institute ( 5R01HL131418 ; 5R01HL129198 ; 5R01HL126508 ; 5R01HL105385 ; 5R01HL096612 ), and the Patient Centered Outcomes Research Institute ( AS-1307-05584 ). Funding Information: Despite continuing efforts, rates of participation into research do not mirror U.S. demographics, with research samples lacking in their representativeness of racial and ethnic minority populations (Winter et al., 2018). Almost 30 years after the National Institute of Health's (NIH) Revitalization Act of 1993 (US Congress, 1993), which required NIH-funded clinical trials to include racial/ethnic minorities as participants and assess outcomes by race/ethnicity, this is still not the norm (Chen et al., 2014). A systematic review of NIH-funded RCTs found that only 13.4% analyzed or reported outcomes by race or ethnicity. Further, there had been no significant changes in inclusion, analyses or reporting by race or ethnicity in the period of 2009–2015 (Geller et al., 2018). In the specific case of attrition, differential rates have been found for racial/ethnic minorities, whose attrition rates are 7–12% higher than those of non-Hispanic Whites in various fields of study, including rheumatoid arthritis (Krishnan et al., 2004), psychiatric disorders (Lamers et al., 2012), and genomic medicine (Moore et al., 2017).Funding/Support: This secondary analysis was supported by a Graduate Center Fellowship to the first author by the Graduate Center, City University of New York. The original studies were supported by grants from National Heart, Lung, and Blood Institute (5R01HL131418; 5R01HL129198; 5R01HL126508; 5R01HL105385; 5R01HL096612), and the Patient Centered Outcomes Research Institute (AS-1307-05584). We thank all clinical research coordinators, who contributed to this work by both collecting the study data and participating as research subjects. Dr. Wisnivesky received consulting honorarium from Sanofi and Banook and research grants from Sanofi and Quorum. No conflict of interest, financial or other, exists for the other authors listed. Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",
year = "2020",
month = jun,
doi = "10.1016/j.socscimed.2020.113009",
language = "English (US)",
volume = "255",
journal = "Social Science and Medicine",
issn = "0277-9536",
publisher = "Elsevier Ltd",
}