141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial
Objectives/Goals: Despite persistent health disparities, rural individuals are underrepresented in clinical trials, due in part to access barriers. We investigated if targeted strategies enhanced recruitment, engagement, and retention of rural adolescents in the TEENS+ randomized clinical trial, a 4...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-04-01
|
| Series: | Journal of Clinical and Translational Science |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866124008008/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850097863303888896 |
|---|---|
| author | Melanie Bean Sarah Farthing Morgan Beasley |
| author_facet | Melanie Bean Sarah Farthing Morgan Beasley |
| author_sort | Melanie Bean |
| collection | DOAJ |
| description | Objectives/Goals: Despite persistent health disparities, rural individuals are underrepresented in clinical trials, due in part to access barriers. We investigated if targeted strategies enhanced recruitment, engagement, and retention of rural adolescents in the TEENS+ randomized clinical trial, a 4-month family-based behavioral weight loss intervention. Methods/Study Population: Adolescents (12–16 y) and parents with obesity were eligible for TEENS+. Treatment converted to virtual in COVID-19, allowing eligibility to expand to more rural areas. We leveraged Informatics, a practice-based research network, and direct marketing to identify potential rural participants. Targeted engagement strategies included: rural physician outreach, physician-endorsed letters, providing tablets and mobile hotspots, reimbursing travel, and offering in-person or remote assessment visits. Chi-square tests evaluated differences in screener completion and enrollment of rural families before (T0) and after (T1) changes were made. Noninferiority tests evaluated rural vs. nonrural retention and engagement (% attendance, % dietary self-monitoring) and engagement based on digital tool receipt. Results/Anticipated Results: N = 211 dyads enrolled (n = 54 in T1: 48% male; 41% Black). Screener completion by rural families significantly increased from T0 (9.8%) to T1 (15.1%; p = .043). Yet, there was no significant change in rural adolescent enrollment (T0 = 10%; T1 = 9%; p = .844). Sixteen adolescents (30%) received study tablets, and none needed mobile hotspots. Mean adolescent attendance was 75%±28% for group and 94%±18% for individual sessions, with no significant differences based on rural status or tablet use. Rural adolescent self-monitoring (via app) was 28%, compared with 50% for non-rural adolescents (p = .074). Retention was 94% at 4m and 89% at 8m for T1 participants, with no differences based on rural status. At the primary endpoint (12 m), retention was significantly higher for rural (100%) vs. non-rural (87%) participants; p = .013. Discussion/Significance of Impact: Rural adolescent screener hits increased yet enrollment was unchanged. However, rural attendance was comparable and retention exceeded, compared to nonrural participants. Strategies to yield equitable representation and engagement in clinical trials are essential for geographic generalizability and to reduce rural health disparities. |
| format | Article |
| id | doaj-art-8012328c2bbd4352b700103f19eeab54 |
| institution | DOAJ |
| issn | 2059-8661 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj-art-8012328c2bbd4352b700103f19eeab542025-08-20T02:40:51ZengCambridge University PressJournal of Clinical and Translational Science2059-86612025-04-019414110.1017/cts.2024.800141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trialMelanie Bean0Sarah Farthing1Morgan Beasley2Virginia Commonwealth UniversityVirginia Commonwealth UniversityVirginia Commonwealth UniversityObjectives/Goals: Despite persistent health disparities, rural individuals are underrepresented in clinical trials, due in part to access barriers. We investigated if targeted strategies enhanced recruitment, engagement, and retention of rural adolescents in the TEENS+ randomized clinical trial, a 4-month family-based behavioral weight loss intervention. Methods/Study Population: Adolescents (12–16 y) and parents with obesity were eligible for TEENS+. Treatment converted to virtual in COVID-19, allowing eligibility to expand to more rural areas. We leveraged Informatics, a practice-based research network, and direct marketing to identify potential rural participants. Targeted engagement strategies included: rural physician outreach, physician-endorsed letters, providing tablets and mobile hotspots, reimbursing travel, and offering in-person or remote assessment visits. Chi-square tests evaluated differences in screener completion and enrollment of rural families before (T0) and after (T1) changes were made. Noninferiority tests evaluated rural vs. nonrural retention and engagement (% attendance, % dietary self-monitoring) and engagement based on digital tool receipt. Results/Anticipated Results: N = 211 dyads enrolled (n = 54 in T1: 48% male; 41% Black). Screener completion by rural families significantly increased from T0 (9.8%) to T1 (15.1%; p = .043). Yet, there was no significant change in rural adolescent enrollment (T0 = 10%; T1 = 9%; p = .844). Sixteen adolescents (30%) received study tablets, and none needed mobile hotspots. Mean adolescent attendance was 75%±28% for group and 94%±18% for individual sessions, with no significant differences based on rural status or tablet use. Rural adolescent self-monitoring (via app) was 28%, compared with 50% for non-rural adolescents (p = .074). Retention was 94% at 4m and 89% at 8m for T1 participants, with no differences based on rural status. At the primary endpoint (12 m), retention was significantly higher for rural (100%) vs. non-rural (87%) participants; p = .013. Discussion/Significance of Impact: Rural adolescent screener hits increased yet enrollment was unchanged. However, rural attendance was comparable and retention exceeded, compared to nonrural participants. Strategies to yield equitable representation and engagement in clinical trials are essential for geographic generalizability and to reduce rural health disparities.https://www.cambridge.org/core/product/identifier/S2059866124008008/type/journal_article |
| spellingShingle | Melanie Bean Sarah Farthing Morgan Beasley 141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial Journal of Clinical and Translational Science |
| title | 141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial |
| title_full | 141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial |
| title_fullStr | 141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial |
| title_full_unstemmed | 141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial |
| title_short | 141 Innovative strategies to enhance engagement by rural adolescents with obesity into the TEENS+ randomized clinical trial |
| title_sort | 141 innovative strategies to enhance engagement by rural adolescents with obesity into the teens randomized clinical trial |
| url | https://www.cambridge.org/core/product/identifier/S2059866124008008/type/journal_article |
| work_keys_str_mv | AT melaniebean 141innovativestrategiestoenhanceengagementbyruraladolescentswithobesityintotheteensrandomizedclinicaltrial AT sarahfarthing 141innovativestrategiestoenhanceengagementbyruraladolescentswithobesityintotheteensrandomizedclinicaltrial AT morganbeasley 141innovativestrategiestoenhanceengagementbyruraladolescentswithobesityintotheteensrandomizedclinicaltrial |