Recruiting Chinese Americans With Chronic Conditions Through Electronic Health Records and Community Engagement

TL;DR

This study compares recruitment methods for Chinese Americans with chronic conditions, finding that electronic health records attract higher socioeconomic participants, while community engagement reaches older, lower-income individuals.

Contribution

The study highlights recruitment disparities and emphasizes the need for complementary approaches to improve representativeness in clinical trials involving Chinese Americans.

Findings

Participants recruited via electronic health records had higher socioeconomic status and fewer language barriers.

Community engagement recruited older, retired individuals with lower income and Chinese as the primary language.

Complementary recruitment strategies are needed to ensure diverse representation in clinical studies.

Abstract

Clinical trials are essential for evaluating the effects of new technologies and treatments on health outcomes; however, varied recruitment approaches may introduce biases that affect the representativeness of study samples, particularly recruiting disproportionately low participation of Asian Americans, including Chinese Americans. This study thus aimed to compare the characteristics of Chinese Americans with chronic conditions recruited through different approaches. In Study I, we recruited 11 Chinese Americans with type 2 diabetes (T2D) via electronic health records, while in Study II, we recruited 11 older Chinese Americans with comorbid T2D and mild cognitive impairment (MCI) through community engagement (e.g., Adult Day Care Center). In Study I, participants’ mean age was 55.6 ± 9.5 years (ranging from 42-77), with 72.7% being male, 81.8% employed, 81.8% at least a college education, 100.0% of family income>$50,000, and 81.8% of primary language being English. In contrast, in Study II, participants had a mean age of 74.5 ± 5.2 years (ranging from 67-86), with 63.6% being female, 100% retired, 36.4% at least a college education, 90.9% family income<$30,000, and 100.0% of primary language being Chinese. Our findings indicate that participants recruited via electronic health records tend to have higher socioeconomic status and fewer language barriers than those recruited through community engagement. Complementary approaches are crucial to recruiting a minoritized population in clinical studies to achieve representativeness. Additionally, linguistically sensitive programs, providers, and healthcare systems are essential for community engagement.