TY - JOUR
T1 - Challenges and opportunities using online portals to recruit diverse patients to behavioral trials
AU - Tabriz, Amir Alishahi
AU - Fleming, Patrice Jordan
AU - Shin, Yongyun
AU - Resnicow, Ken
AU - Jones, Resa M.
AU - Flocke, Susan A.
AU - Shires, Deirdre A.
AU - Hawley, Sarah T.
AU - Willens, David
AU - Lafata, Jennifer Elston
N1 - Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2019/11/15
Y1 - 2019/11/15
N2 - We describe the use of an online patient portal to recruit and enroll primary care patients in a randomized trial testing the effectiveness of a colorectal cancer (CRC) screening decision support program. We use multiple logistic regression to identify patient characteristics associated with trial recruitment, enrollment, and engagement. We found that compared to Whites, Blacks had lower odds of viewing the portal message (OR = 0.46, 95% CI = 0.37-0.57), opening the attached link containing the study material (OR = 0.75, 95% CI = 0.62-0.92), and consenting to participate in the trial (OR = 0.85, 95% CI = 0.67-0.93). We also found that compared to Whites, Asians had lower odds of viewing the portal message (OR = 0.53, 95% CI = 0.33-0.64), opening the attached link containing the study material (OR = 0.76, 95% CI = 0.54-0.97), consenting to participate in the trial (OR = 0.68, 95% CI = 0.53-0.95), and completing the trial's baseline questionnaire (OR = 0.59, 95% CI = 0.36-0.90). While portals offer an opportunity to mitigate human bias in trial invitations, because of racial disparities - not only in who has a portal account, but in how they interact with trial recruitment and enrollment material within the portal - using portals alone for trial recruitment may generate study samples that are not racially diverse.
AB - We describe the use of an online patient portal to recruit and enroll primary care patients in a randomized trial testing the effectiveness of a colorectal cancer (CRC) screening decision support program. We use multiple logistic regression to identify patient characteristics associated with trial recruitment, enrollment, and engagement. We found that compared to Whites, Blacks had lower odds of viewing the portal message (OR = 0.46, 95% CI = 0.37-0.57), opening the attached link containing the study material (OR = 0.75, 95% CI = 0.62-0.92), and consenting to participate in the trial (OR = 0.85, 95% CI = 0.67-0.93). We also found that compared to Whites, Asians had lower odds of viewing the portal message (OR = 0.53, 95% CI = 0.33-0.64), opening the attached link containing the study material (OR = 0.76, 95% CI = 0.54-0.97), consenting to participate in the trial (OR = 0.68, 95% CI = 0.53-0.95), and completing the trial's baseline questionnaire (OR = 0.59, 95% CI = 0.36-0.90). While portals offer an opportunity to mitigate human bias in trial invitations, because of racial disparities - not only in who has a portal account, but in how they interact with trial recruitment and enrollment material within the portal - using portals alone for trial recruitment may generate study samples that are not racially diverse.
KW - colorectal cancer screening
KW - electronic health record
KW - health disparities
KW - patient portal
KW - pragmatic clinical trial
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U2 - 10.1093/jamia/ocz157
DO - 10.1093/jamia/ocz157
M3 - Article
C2 - 31532482
AN - SCOPUS:85075093981
SN - 1067-5027
VL - 26
SP - 1637
EP - 1644
JO - Journal of the American Medical Informatics Association
JF - Journal of the American Medical Informatics Association
IS - 12
ER -