Resolving Clinical Trial Subject Disengagement in Socioeconomically Disadvantaged Subjects.

BACKGROUND: Clinical trialists may be reluctant to enroll socioeconomically disadvantaged participants because of concerns for subject disengagement leading to noncompliance with longitudinal measures and high lost to follow-up (LTFU) rates. OBJECTIVES: We describe the LTFU problem associated with d...

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Publicado en:Journal of Neuroscience Nursing Vol. 51; no. 4; pp. 164 - 169
Autores principales: Rhudy, James P., Lewis, Jonathan C., Alexandrov, Andrei V., Alexandrov, Anne W.
Formato: pictorial research Journal Article
Publicado: Lippincott Williams & Wilkins Aug2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2019
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Resolving Clinical Trial Subject Disengagement in Socioeconomically Disadvantaged Subjects.
      aug:
        au:
          Rhudy, James P.
          Lewis, Jonathan C.
          Alexandrov, Andrei V.
          Alexandrov, Anne W.
        affil: Jonathan C. Lewis, MDiv BCC, is Program Manager of UT and Conference Ministries, Faith and Health Division, Methodist Le Bonheur Healthcare, Memphis, TN.
      sug:
        subj:
          Clinical Trials
          Research Subjects
          Disengagement Prevention and Control
          Socioeconomic Factors
          Strategic Planning
          Human
          Research Subject Recruitment
          Research Subject Retention
          Geographic Information Systems
          Health Status Disparities
          Clinical Exemplars
      ab: BACKGROUND: Clinical trialists may be reluctant to enroll socioeconomically disadvantaged participants because of concerns for subject disengagement leading to noncompliance with longitudinal measures and high lost to follow-up (LTFU) rates. OBJECTIVES: We describe the LTFU problem associated with disadvantaged participants and propose strategies to reduce clinical trial disengagement. METHODS: Difficulties encountered in recruiting and retaining socioeconomically disadvantaged participants along with antecedents of disengagement are discussed. Data in the public domain were used to derive, symbolize, and map engagement by census tract. Exemplars of engaged and disengaged clinical trial participants are shared, and geospatial distribution of socio-spatial disengagement risk is presented. RESULTS: Subject disengagement can be visualized by geospatial informatics suggesting areas of low and high socio-spatial disengagement risk. By failing to enroll socioeconomically disadvantaged subjects, researchers may deliberately exclude those who may benefit the most because of significant health disparities. DISCUSSION: We propose a study of realistic LTFU rates for disadvantaged participants. Realistic clinical trial end points and methods may reduce disengagement among disadvantaged participants.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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