UCLA researchers say embedding study recruitment in pre-appointment check-in may significantly boost participation

FINDINGS

UCLA researchers find that they can electronically recruit patients for biomedical research at rates up to 40 times higher than the traditional method of patient portal messages by embedding study recruitment into the pre-appointment preCheck-in page.

BACKGROUND

While patient portal messages are increasingly used to recruit patients for research studies, this method typically results in study enrollment rates of 1-8%. In addition, this method of study recruitment has historically led to underrepresentation of racial and ethnic minorities in biomedical research.

METHOD

The researchers pioneered a new method of study recruitment called preCheck-in recruitment. This technique embedded all study recruitment material into the workflow that patients normally use to electronically check in before doctor visits. The researchers created a new functionality that allowed patients to review and electronically sign documents such as research authorization forms. They tested this new methodology in a two-week period in November, 2021 at a single UCLA primary care clinic. Of 843 patients seen in the clinic during that time, 386 completed preCheck-in. Of those, 308 signed the research authorization form for a 37% study enrollment rate. The enrolled sample was socio-demographically representative of the health system at-large, suggesting preCheck-in Recruitment may help improve representation in biomedical research.

The researchers sent post-appointment surveys to 93 of these patients, and 45 completed it for a 48% completion rate.

The findings are limited by inclusion of only patients with an active portal who had upcoming appointments with UCLA primary care physicians, the lack of a control group, and a small sample size.

IMPACT

PreCheck-in recruitment may increase research study participation and contribute to more equitable socio-demographic representation in biomedical research.

COMMENT

“Biomedical research is at the foundation of healthcare advances, but the way that we recruit patients to study these innovations is highly flawed,” said lead author Dr. Richard Leuchter, clinical instructor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. “Our current recruitment practices often rely on resource intensive methods such as financial incentives and in-person or telephone communications, and regularly result in poor representation of historically marginalized communities in the U.S. By embedding research recruitment within a workflow that patients were already completing in advance of their doctor visits, we enrolled a highly diverse patient population without any financial incentives, patient portal messages, or utilizing staff to recruit patients. This minimally-disruptive recruitment method produced enrollment rates many times higher than what we typically see for patient portal based recruitment, so it is a promising new tool to improve research recruitment and diversity in biomedical research.”

AUTHORS

Study co-authors are Suzette Ma, Dr. Douglas Bell, Ron Hays, Fernando Javier Sanz Vidorreta, Sandra Binder, and Dr. Catherine Sarkisian of UCLA. Sarkisian also has an appointment with VA Greater Los Angeles Healthcare System Geriatric Research Education and Clinical Center.

JOURNAL

The study is published in the peer-reviewed Journal of the American Medical Informatics Association.

FUNDING

The study was funded by the National Institutes of Health (1K38 HL164955-01, P30-AG021684, UL1TR001881, 5K24AG047899-06), the UCLA Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elders (RCMAR/CHIME), and the UCLA Clinical and Translational Science Institute (CTSI).