| Organizational structure |
| Establish centralized prescreening databases |
Prescreening databases permit real-time evaluation of outreach and screening efforts, allowing for the identification of the impact of centralized and local recruitment efforts while also assessing whether specific groups may be lost at varying levels of prescreening activities. |
| Establish a minimal data set for recruitment |
Incorporating standardized data elements through the use of a minimal data set for recruitment ensures consistent data capture as it relates to race and ethnicity and may also enable collection of sociocultural factors (eg, education, occupation, socioeconomic status, neighborhood health variables), research attitudes, and other relevant constructs. |
| Provide earmarked funding for recruitment of participants from underrepresented groups |
Line-item budgets do not typically offer differential reimbursement based on participant demographics. Offering specific support for sites to engage in diverse recruitment supports efforts to recruit underrepresented participants. |
| Select sites with diverse teams |
Participants from underrepresented racial and ethnic groups may feel more comfortable communicating with and participating at sites with diverse study teams. Facilitate and reward sites for increasing the diversity of investigators. |
| Invest in community partnerships |
Community-based organizations are often trusted gatekeepers. Providing funding to substantiate and strengthen relationships between sites and these organizations may enhance local recruitment of participants from underrepresented racial and ethnic groups. Engaging community advocates in study design and recruitment planning can ensure culturally sensitive designs. Identify participants from underrepresented groups who might serve as research ambassadors. |
| Study-specific approaches |
| Develop a protocol-specific recruitment and retention plan |
Comprehensive recruitment and retention study plans that prioritize diverse enrollment are essential to inclusivity and representation. |
| Develop specific recruitment strategies for unique underrepresented groups |
Barriers to recruitment are likely to differ among unique communities. Unique strategies may be necessary to facilitate enrollment of underrepresented groups. This may require focus groups and market research to optimize recruitment messaging or may require more comprehensive strategies specific to groups. |
| Ensure that underrepresented groups are not disproportionately excluded by eligibility criteria |
Broad inclusion criteria, adjusted for unique biological or cultural norms, may be necessary to optimally include participants from underrepresented groups. Performing data collection, especially cognitive testing, in non-English languages may be essential to ensuring inclusive enrollment. |
| Seek earned media opportunities to describe study recruitment needs |
Earned media may increase awareness of the study through a trusted source. In particular, media stories through outlets serving underrepresented communities may offer promise. |
| Quantify site and central recruitment efforts and costs |
Quantifying the costs associated with different recruitment strategies and cost per enrolled and randomized participant for each strategy can help future studies develop reasonable recruitment budgets. |
