Background
Data suggest that establishing trust supports willingness to participate in research studies; yet there is a shortage of standardized systematic studies testing the effectiveness of ...various methods of building trust. The Building Bridges pilot study examined ways of establishing trust in communities of color comparing two different interventions.
Method
Using African American community leaders’ input, we conducted a mixed method study to investigate participants’ 1) preferred format for community‐based interventions, 2) comfort with discussing dementia with researchers/healthcare providers, and 3) attitudes of trust about research and researchers. African American subjects (age ≥ 45 years) without self‐reported cognitive impairment completed research attitudes (RAQ) and trust in medical researcher questionnaires, pre‐ and post‐intervention; individual medication reviews (n = 48) and/or public community talks (n = 49). Quantitatively, we compared pre‐ and post‐ intervention outcomes with paired Wilcoxon non‐parametric sign rank tests; all qualitative themes were analyzed using Nvivo QSR 12.
Result
Participants’ mean age was 64 (SD = 9.9). See Table 1 for demographics. Quantitatively, there was greater change in research attitudes and trust following a medication review intervention compared to experiencing a community talk (Figure 1); e.g., participants expressed “positive views about medical research in general” on questionnaires following medication reviews (p = 0.007). Qualitatively, we found a similar trend during our focus group discussions. Focus group members expressed more comfort with the medication review than the community talk resulting from “positive bedside manners, positive feedback, personal 1‐on‐1 interactions and race concordance.” Focus group participants noted a willingness to participate in future studies because of trust built from their Building Bridges team interactions. “Commonality, better connection, relatability, affinity and cultural similarities” all influenced trust and willingness to participate in future studies. Factors found to reduce trust included: “negative feedback, stereotypes, predominantly white practitioners in medicine and research, clinician unskillfulness, and not feeling seen as a “whole person” by providers” (Figure 2).
Conclusion
Findings continue to support our hypothesis that more personalized community engagement approaches have a greater influence on participants’ research attitudes and build interest in research. Additional studies of person‐centered recruitment strategies are essential to understanding how to improve trust and positive research attitudes among communities of color.
Background
Several studies have shown the importance of establishing trust in supporting an individual’s willingness to participate in research; yet evidence is limited regarding systematic studies ...testing the effectiveness of various methods used to build trust. Our pilot study examined two methods of building trust in communities of color by measuring willingness to participate in research pre‐ and post‐intervention. We hypothesized that a more personalized intervention would be more effective than a non‐personalized one in changing attitudes about research participation.
Methods
97 non‐randomized African American participants, without self‐reported cognitive impairment, completed the research attitudes questionnaire (RAQ) before and after participating in two different community engagement (CE) activities: 1) personalized medication review (MR), n = 48; and/or 2) a less personalized public community talk (Talk), n = 49. Numeric comparisons were conducted using student t‐tests. We used chi‐square and Fisher’s exact test for categorical comparisons. Pre‐ and post‐Talk and MR outcomes were tested for significant changes using the paired Wilcoxon non‐parametric sign rank test.
Results
In this predominantly female sample (80% female), mean age was 64 (standard deviation = 9.9). Study participant characteristics provided in Table 1. There were no significant differences in RAQ or trust questions in the pre‐ and post‐Talk session. However, during the MR session, significant changes were seen on the question “I have a positive view about medical research in general” (P = 0.007). During the pre‐MR, 16.7% strongly agreed with this statement, while 39.6% strongly agreed at the post‐MR. Similarly, agreement with the statements “Medical researchers treat people from my racial group as guinea pigs” (p = 0.004) and “Medical researchers work hard to keep participants’ information private and secure” (P = 0.01) were also significantly different following the intervention (see Figure 5).
Conclusions
These findings support our hypothesis that a more personalized community engagement approach would have a greater influence on participant’s research attitudes. Compared to individuals with ≤ 1 co‐morbidities at baseline, those with ≥2 co‐morbidities had positive responses prior to an intervention and felt less responsibility to volunteer post med review. Additional studies are needed to further investigate these findings and the role of trust in association with research attitudes.
