Retention and Structural Inequities in Clinical Research: Insights from a Breastfeeding Intervention Study.

Objective. To be effective and generalizable, research must include diverse populations representative of the intended beneficiaries. Among women with low income in the United States, 74.9% initiate breastfeeding, but only 47.5% continue to six months. This analysis examined how structural inequitie...

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Publicado en:Journal of Health Care for the Poor & Underserved Vol. 37; no. 2; pp. 673 - 692
Autores principales: LaPlant, Helen Wie, Cunningham, Shayna, Guan, Zhe, Franics-Edoziuno, Confidence, Alhabodal, Ashwag, Scott, Dana rie, rshall-Crim, ry, Freytes, Idelisa, Henderson, Wendy, Walsh, Stephen, Lucas, Ruth
Formato: pictorial research Journal Article
Publicado: Johns Hopkins University Press May2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2026
      vid: 37
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      pub: Johns Hopkins University Press
      place: Baltimore, Maryland
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        194878396
        194878396
        194878396
        10.1353/hpu.2026.a992136
        194878396
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        atl: Retention and Structural Inequities in Clinical Research: Insights from a Breastfeeding Intervention Study.
      aug:
        au:
          LaPlant, Helen Wie
          Cunningham, Shayna
          Guan, Zhe
          Franics-Edoziuno, Confidence
          Alhabodal, Ashwag
          Scott, Dana rie
          rshall-Crim, ry
          Freytes, Idelisa
          Henderson, Wendy
          Walsh, Stephen
          Lucas, Ruth
      sug:
        subj:
          Research, Medical
          Research Subject Retention
          Health Status Disparities
          Health Inequities
          Breast Feeding Promotion
          Program Evaluation
          Economic Factors
          Race Factors
          Ethnic Groups
          Human
          Female
          Adolescence
          Adult
          Secondary Analysis
          Prospective Studies
          Descriptive Statistics
          Data Analysis Software
          Interviews
          Algorithms
          Kaplan-Meier Estimator
          Survival Analysis
          Log-Rank Test
          Cox Proportional Hazards Model
          Multivariate Analysis
          Hispanic Americans
          Bivariate Statistics
          Income
          Socioeconomic Factors
          Age Factors
          Educational Status
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
      ab: Objective. To be effective and generalizable, research must include diverse populations representative of the intended beneficiaries. Among women with low income in the United States, 74.9% initiate breastfeeding, but only 47.5% continue to six months. This analysis examined how structural inequities, indicated by income, race, and ethnicity, affect participant retention in a breastfeeding intervention. Methods. Participants (N=250) enrolled in PROMPT, a longitudinal randomized text-based breastfeeding self-management intervention trial. Cox proportional hazards models were used to analyze retention over 24 weeks. Results. Overall retention was 72%. Dropout risk was significantly higher among Hispanic and non-Hispanic Black participants (HR 2.86, p<.001), and among those with lower income (HR 2.61, p<.001). A three-factor model (including income, race/ethnicity, and age) was statistically significant overall (p=.0001), though individual predictors were not. Conclusion. Structural inequities may contribute to differential retention in breastfeeding trials, highlighting the need for equity-focused recruitment and retention strategies.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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