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Cited by 30Ethics in Clinical ResearchSurvey Methodology and NonresponseHealth Literacy and Information Accessibility

The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index; none of the 72 sources its claims cite is checked for support yet.

Recruitment and Retention Strategies Among Racial and Ethnic Minorities in Web-Based Intervention Trials: Retrospective Qualitative Analysis

Open access
Hwang, DaSol Amy, Lee, Alex, Song, Jae Min, Han, Hae-Ra·2021·Journal of Medical Internet Research
DOI 10.2196/23959PMC PMC8314154

Published version of a preprint

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Abstract

Background: Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States. Identifying effective recruitment and retention strategies among minority groups and their subpopulations is an important research agenda. Web-based intervention approaches are becoming increasingly popular with the ubiquitous use of the internet. However, it is not completely clear which recruitment and retention strategies have been successful in web-based intervention trials targeting racial and ethnic minorities. Objective: This study aims to describe lessons learned in recruiting and retaining one of the understudied ethnic minority women—Korean Americans—enrolled in a web-based intervention trial and to compare our findings with the strategies reported in relevant published web-based intervention trials. Methods: Multiple sources of data were used to address the objectives of this study, including the study team’s meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews. In addition, an electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions. Qualitative analysis was then performed to identify common themes addressing recruitment and retention strategies across the trials using web-based intervention modalities. Results: A total of 9 categories of recruitment and retention strategies emerged: authentic care; accommodation of time, place, and transportation; financial incentives; diversity among the study team; multiple, yet standardized modes of communication; mobilizing existing community relationships with efforts to build trust; prioritizing features of web-based intervention; combined use of web-based and direct recruitment; and self-directed web-based intervention with human support. Although all the studies included in the analysis combined multiple strategies, prioritizing features of web-based intervention or use of human support were particularly relevant for promoting recruitment and retention of racial and ethnic minorities in web-based intervention trials. Conclusions: The growing prevalence of internet use among racial and ethnic minority populations represents an excellent opportunity to design and deliver intervention programs via the internet. Future research should explore and compare successful recruitment and retention methods among race and ethnic groups for web-based interventions. Trial Registration: ClinicalTrials.gov NCT03726619; https://clinicaltrials.gov/ct2/show/NCT03726619.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This retrospective qualitative analysis describes recruitment and retention lessons from a web-based cancer screening pilot trial with Korean American women and compares them with 7 relevant published web-based intervention studies. It identifies 9 strategy categories, with prioritizing web-based intervention features and human support as particularly relevant for racial and ethnic minority recruitment and retention.

Key findings

  • Nine categories of recruitment and retention strategies emerged: authentic care; accommodation of time, place, and transportation; financial incentives; diversity among the study team; multiple, yet standardized, modes of communication; mobilizing existing community relationships with efforts to build trust; prioritizing features of web-based intervention; combined use of web-based and direct recruitment; and self-directed web-based intervention with human support.
  • In the e-CHECC-uP trial, 72% (52/72) of screened women were eligible; 8 eligible women refused and 4 could not be reached, yielding 40 enrolled women (77% response rate). Most (n=38) enrolled face-to-face and 2 enrolled on the web; 34 completed the 6-month assessment (85% retention).
  • The electronic search yielded 163 articles, and 7 relevant studies—including 2 systematic reviews—were included for comparison. Although all included studies combined multiple strategies, prioritizing web-based intervention features or using human support were particularly relevant for promoting recruitment and retention of racial and ethnic minorities in web-based intervention trials.
  • In the e-CHECC-uP sample, 97.5% (39/40) reported texting at least weekly and 85% (34/40) reported texting daily; 90% (36/40) reported internet access at baseline, while 70% (28/40) of intervention women agreed or strongly agreed they would need technical support to use the product.

Methods

  • Retrospective qualitative analysis using multiple e-CHECC-uP data sources: study team weekly meeting minutes, postintervention interview transcripts, recruitment and retention tracking logs, survey reports, and contact logs such as phone counseling logs. Descriptive statistics summarized recruitment and retention rates, and thematic analysis identified participant experiences.
  • An electronic search was conducted in April 2020 in PubMed and CINAHL using terms for recruitment, retention, web-based/internet/computers, and ethnic groups/minorities. Inclusion criteria were US racial and ethnic minority populations, technology or internet interventions, discussion of recruitment and retention strategies, publication in the last 10 years in English; studies using technology only for recruitment were excluded.
  • The search yielded 163 articles; after abstract and full-text screening, 7 articles, including 2 systematic reviews, were identified as relevant and compared with the e-CHECC-uP strategies.

Limitations

  • The paper states that because multiple recruitment and retention strategies were used, it could not distinguish the most successful strategies; it also lacked established metrics to measure the significance and impact of cash incentives. The number of relevant web-based intervention trials may have been reduced by the focus on recruitment and retention strategies, the e-CHECC-uP sample was small and convenient, and only US studies were included, limiting generalizability to other countries.
  • Evident from the text: the analysis centers on one pilot trial of Korean American women recruited largely through ethnic churches, so findings may not transfer to other racial and ethnic groups or non-faith-based settings; the qualitative/thematic design cannot establish the efficacy of individual strategies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/23959

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 72 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    97% of the participants felt that they received enough study information.

    “These interventions contributed to high survey completion rates throughout the study (84% at 3-months postintervention), high satisfaction rates (81%), and positive study experiences (97% of the participants felt that they received enough study information, and 80% (32/40) of the participants felt that their questions were answered properly).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Despite initially operating with the notion that the study population would best respond to female study team members, the study discovered that there were no observable differences in participant interaction or receptivity with male study team members.

    “Finally, despite initially operating with the notion that the study population would best respond to female study team members, as the e-CHECC-uP study focuses on women's cancer screening, we discovered that there were no observable differences in participant interaction or receptivity with male study team members.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Several church members refused to participate in the e-CHECC-uP trial because of their parental and familial duties.

    “Several church members refused to participate in the e-CHECC-uP trial because of their parental and familial duties.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Qualtrics proved to be a viable resource for data collection, especially with the onset of COVID-19.

    “Qualtrics proved to be a viable resource, especially with the onset of COVID-19.”
    Quote in the paperSubstantial claim
  • Findingown data

    When proposed with alternative midweek and weekend options, some eligible women stated that it was simply too inconvenient to schedule meetings because of their children's schedules.

    “When proposed with alternative midweek and weekend options, some eligible women stated that it was simply too inconvenient to schedule meetings because of their children’s schedules.”
    Quote in the paperSubstantial claim
  • It may state two separate claims as one. 40
  • Probably not a substantial claim. 37

  • It may state two separate claims as one.

    Findingown data

    Although 90% (36/40) of the participants reported having access to the internet at baseline, 70% (28/40) of the intervention women agreed or strongly agreed that they would need the support of a technical person to be able to use the product.

    “Although 90% (36/40) of our participants reported having access to the internet at baseline, 70% (28/40) of the intervention women agreed or strongly agreed that they would need the support of a technical person to be able to use the product.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    The interventions in the relevant studies included the Fitbit device, weekly interactive web-based comics with text and email reminders, web-based education involving in-person visits, and social media websites using a mobile chat function in participants' mother language.

    “The interventions included the Fitbit device, weekly interactive web-based comics with text and email reminders, web-based education involving in-person visits, and social media websites using a mobile chat function in participants’ mother language.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    The follow-up period for the relevant studies ranged from 3 weeks to 24 months.

    “The follow-up period for these studies ranged from 3 weeks to 24 months.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingnone given

    The scope of web-based interventions included in the relevant studies addressed health promotion and participant education.

    “The scope of web-based interventions included in the relevant studies addressed health promotion and participant education.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingnone given

    Of the 7 relevant studies, 4 randomized controlled trials and 1 RCT-based secondary analysis focused on various racial and ethnic minority groups, including Asian Americans (Chinese, Korean, and Japanese), African Americans, and Black or Latino.

    “Of the 7 relevant studies, 4 randomized controlled trials (RCTs) and 1 RCT-based secondary analysis focused on various racial and ethnic minority groups, including Asian Americans (Chinese, Korean, and Japanese, specifically), African Americans, and Black or Latino.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    50% (20/40) of the study participants reported that they were unable to make phone calls in English and 58% (23/40) reported that they would not be able to go to an American hospital without an interpreter.

    “Our findings were similar, with 50% (20/40) of our participants reporting that they were unable to make phone calls in English and 58% (23/40) reporting that they would not be able to go to an American hospital without an interpreter.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data

    The search yielded 163 articles, and following abstract and full-text screening, 7 articles, including 2 systematic reviews, were identified as relevant.

    “Our search yielded 163 articles, and following the abstract and full-text screening, 7 articles, including 2 systematic reviews, were identified as being relevant to our discussion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    72% (52/72) of women who were screened for the e-CHECC-uP study were considered eligible for enrollment.

    “72% (52/72) women who were screened for this study were considered as eligible for enrollment.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    8 of the eligible women refused to enroll in the e-CHECC-uP study because of time constraints (n=4), health reasons (n=1), lack of interest (n=1), and reluctance to undergo a cancer screening test in the United States because of inconvenience (n=1).

    “However, 8 of those eligible women refused to enroll in our study because of time constraints (n=4), health reasons (n=1), lack of interest (n=1), and reluctance to undergo a cancer screening test in the United States because of inconvenience (n=1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingnone given

    There were 2 systematic reviews of e-mental health interventions among Asian American women and mobile health research participation among African Americans, including 79 studies and 56 studies, respectively.

    “There were 2 systematic reviews of e-mental health interventions among Asian American women and mobile health (mHealth) research participation among African Americans, including 79 studies and 56 studies, respectively.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingreasoning

    Overall, text messaging was the most effective and preferred method to reach Korean American women in the e-CHECC-uP trial because it is quick to read and more accessible than phone calls or email.

    “Overall, text messaging was the most effective and preferred method to reach Korean American women in the e-CHECC-uP trial because it is quick to read and more accessible than phone calls or email.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Using Qualtrics, the e-CHECC-uP study was able to retain all remaining participants at the onset of COVID-19 and achieved a retention rate of 85% (34/40).

    “Using Qualtrics, we were able to retain all remaining participants at the onset of COVID-19 and achieved a retention rate of 85% (34/40).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    39 out of 40 participants (97.5%) at baseline reported that they text at least once a week, and 34 participants (85%) reported that they text daily.

    “In fact, 39 out of 40 participants (97.5%) at baseline reported that they text at least once a week, and 34 participants (85%) reported that they text daily.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data

    The majority of women (n=38) were enrolled face-to-face and 2 were enrolled on the web.

    “The majority of women (n=38) were enrolled face-to-face and 2 were enrolled on the web.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    The e-CHECC-uP study participants were recruited over a span of 6 months (July to December 2019) from 5 Korean churches in the Greater Baltimore area.

    “The e-CHECC-uP study participants were recruited over a span of 6 months (July to December 2019) from 5 Korean churches in the Greater Baltimore area”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    Reasons for withdrawal from the e-CHECC-uP study included time constraints (n=3), participation burden (n=1), change of mind (n=1), and lost contact (n=1).

    “Reasons for withdrawal included time constraints (n=3), participation burden (n=1), change of mind (n=1), and lost contact (n=1).”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    4 eligible women could not be reached after initial contact, yielding 40 women enrolled in the e-CHECC-uP study (77% response rate).

    “In addition, we could not reach 4 eligible women after initial contact, yielding 40 women enrolled in the study (77% response rate).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Findingown data

    Although the study did not measure the efficacy of each individual strategy, the thematic analysis resulted in particularly rich themes related to strategies addressing the quality of the bilingual research team.

    “Although we did not measure the efficacy of each individual strategy, our thematic analysis resulted in particularly rich themes related to strategies addressing the quality of the bilingual research team.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Participants found the study team members' assistance and monthly phone counseling to be helpful and vital to successful screening; 12 of 14 participants from the intervention group who completed the 6-month survey claimed that human support from the study team, phone counseling specifically, helped them to complete the screenings.

    “Participants still found our study team members' assistance and monthly phone counseling to be helpful and vital to successful screening; 12 of 14 participants from the intervention group who completed the 6-month survey claimed that human support from the study team, phone counseling specifically, helped them to complete the screenings.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingnone given

    The study team members reflected and agreed that the participants from those churches were more engaging, asking questions, and being responsive to their contact.

    “Our study team members reflected and agreed that the participants from those churches were more engaging, asking questions, and being responsive to our contact.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data

    Some participants reported that the financial incentives contributed to their motivation to join the study, and 1 participant stated that the cash incentives were used to buy basic necessities such as her child's school lunch.

    “For example, some of our participants reported that the financial incentives contributed to their motivation to join our study, and 1 participant stated that the cash incentives were used to buy basic necessities such as her child’s school lunch.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The community health worker helped the study team to build rapport with the pastor and church members, provided a brief introduction about the study, gathered those who showed interest, and advised on the timing of visits and how to approach potential participants.

    “Our community health worker helped us to build rapport with the pastor and church members, provided a brief introduction about the study, gathered those who showed interest, and advised on the timing of visits and how to approach potential participants.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingnone given

    The e-CHECC-uP study included a small and convenient sample of Korean American women.

    “Similarly, the e-CHECC-uP study included a small and convenient sample of Korean American women.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    A systematic review identified various factors salient to racial and ethnic minority participation in research.

    “A systematic review of studies addressing research participation among racial and ethnic minorities [6] revealed various factors salient to racial and ethnic minority participation in research.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] source

  • It may state two separate claims as one.

    Premisecitation

    In an RCT to decrease obesity risk among Black and Latino children, DeFrank et al reported assigning dedicated research staff as one of the key strategies, and 81% of children at 3 months postintervention were very satisfied or extremely satisfied with how the study staff communicated and interacted with them.

    “In an RCT to decrease obesity risk among Black and Latino children (aged 9-12 years), DeFrank et al [16] reported assigning dedicated research staff as one of the key strategies. By doing so, DeFrank et al [16] noted that 81% of children at 3 months postintervention were very satisfied or extremely satisfied with how the study staff communicated and interacted with them.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DeFrank et al [16]

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    DeFrank et al reported that a well-designed, standardized communication system was a key recruitment and retention strategy.

    “DeFrank et al [16] also reported that a well-designed, standardized communication system was a key recruitment and retention strategy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    An internet-based study reported that racial and ethnic minority women responded well to race-concordant research assistants.

    “An internet-based study reported that racial and ethnic minority women responded well to race-concordant research assistants [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] source

  • It may state two separate claims as one.

    Premisecitation

    Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States.

    “Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States.”
    • Also stated in: § Background · plain
      “However, these benefits are not shared equally, particularly among the racial and ethnic minority groups in the United States, as they are vastly underrepresented in biomedical research.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    A recent systematic review revealed that adding email and telephone support to existing internet-based mental health interventions led to high completion rates and favorable mental health outcomes.

    “A recent systematic review [19] revealed that adding email and telephone support to existing internet-based mental health interventions led to high completion rates and favorable mental health outcomes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

  • Probably not a substantial claim.

    Study design and conductown data

    Multiple sources of data were used to address the objectives of this study, including the study team's meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews.

    “Multiple sources of data were used to address the objectives of this study, including the study team’s meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews.”
    • Also stated in: § Sources of Data · plain
      “We used multiple data sources for the e-CHECC-uP trial to address the study purpose, including the study team’s weekly meeting minutes, transcripts for postintervention interviews, recruitment and retention tracking logs, survey reports, and other study forms recording contacts with participants such as phone counseling logs.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    According to the Health Information National Trends Survey by National Cancer Institute in 2007, 70% of 4092 respondents indicated that they had access to the internet, excluding work and public spaces, and there was consistent use of social networking sites among racial and ethnic minorities.

    “According to the Health Information National Trends Survey by National Cancer Institute in 2007 [9], 70% of 4092 Health Information National Trends Survey respondents indicated that they had access to the internet, excluding work and public spaces, and there was consistent use of social networking sites among racial and ethnic minorities.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] source

  • It may state two separate claims as one.

    Interpretationnone given

    Technologically inclined staff on the e-CHECC-uP study team were vital for troubleshooting issues with the web-based education modules, developing user-friendly remote surveys with prerecorded web-based instructions, and facilitating lines of e-communication with research participants via automated text messaging.

    “In addition, the technologically inclined staff on the e-CHECC-uP study team were vital for troubleshooting issues with the web-based education modules, developing user-friendly remote surveys with prerecorded web-based instructions, and facilitating lines of e-communication with research participants via automated text messaging.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    A substantial number of racial and ethnic minority groups experience logistical problems such as transportation, time commitment, and financial means to make office visits, lack of social support, low socioeconomic status, lack of culturally targeted or sensitive information, and education about the study.

    “In addition, a substantial number of racial and ethnic minority groups experience logistical problems such as transportation, time commitment, and financial means to make office visits [7], lack of social support, low socioeconomic status, lack of culturally targeted or sensitive information, and education about the study [8].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] source
    • cites [8] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    DeFrank et al noted that incremental monetary compensation through gift cards, selected based on formative research by surveying participants and the community, was an effective recruitment and retention strategy.

    “DeFrank et al [16] also noted that incremental monetary compensation through gift cards, which was selected based on formative research by surveying participants and the community, was an effective recruitment and retention strategy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DeFrank et al [16]

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Provider biases against minority patients, such as assumptions about patient preferences, knowledge, and compliance, especially when accompanied with language barriers, may contribute to a provider's failure to offer opportunities for their patients to participate in research.

    “Finally, provider biases against minority patients, such as assumptions about patient preferences, knowledge, and compliance, especially when accompanied with language barriers, may contribute to a provider’s failure to offer opportunities for their patients to participate in research [7].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] source

  • Probably not a substantial claim.

    Study design and conductown data

    An electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions.

    “In addition, an electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions.”
    • Also stated in: § Sources of Data · plain
      “Our search was conducted in April 2020, and the strategy involved 2 electronic databases: PubMed and CINAHL.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    According to World Data sourced by the World Bank, the share of the United States population using the internet increased from 69% in 2006 to 76% in 2016.

    “According to the World Data sourced by the World Bank, the share of the United States population using the internet increased from 69% in 2006 to 76% in 2016 [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] RoserMRitchieHOrtiz-OspinaEOur World in DataWorld Bank2020-04-09http://ourworldindata.org/internet

  • It may state two separate claims as one.

    Premisecitation

    In 2018, racial and ethnic minority participation in cancer clinical trials was approximately 20% compared with 80% of White counterparts, and this has yielded only a 2% increase in the past two decades.

    “For example, racial and ethnic minority participation in cancer clinical trials was approximately 20% compared with 80% of White counterparts in 2018 [3], and this has yielded only a 2% increase in the past two decades.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    According to the Association of Asian Pacific Community Health Organizations, Korean Americans reported the second highest (46%) limited English proficient rates, followed by Vietnamese (53%), and had the highest rate of reporting poor patient-physician communication (34%) compared with other subethnic groups.

    “According to the Association of Asian Pacific Community Health Organizations [26], Korean Americans reported the second highest (46%) limited English proficient rates, followed by Vietnamese (53%), and had the highest rate of reporting poor patient-physician communication (34%) compared with other subethnic groups.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Association of Asian Pacific Community Health Organizations20142020-06-18https://www.aapcho.org/wp/wp-content/uploads/2014/08/AANHOPI-LEP-Fact-Sheet_2014_final.pdf

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Although the studies that provided incentives yielded a higher retention rate, James et al recommended that researchers carefully determine the type and structure of incentives tailored to specific populations, communities, and targeted health behaviors.

    “Although the studies that provided incentives yielded a higher retention rate, James et al [21] recommended that researchers carefully determine the type and structure of incentives tailored to specific populations, communities, and targeted health behaviors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites James et al [21]

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    In a systematic review of 56 studies focusing on African American participation in eHealth or mHealth intervention studies, James et al found that 25 of the included studies offered some type of incentive, ranging from monetary (US $10-US $175) to nonmonetary incentives such as prepaid cell phones, free hypertension medication, and gym membership.

    “In a systematic review of 56 studies focusing on African American participation in eHealth or mHealth intervention studies, James et al [21] found that 25 of the included studies offered some type of incentive, ranging from monetary (US $10-US $175) to nonmonetary incentives such as prepaid cell phones, free hypertension medication, and gym membership.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites James et al [21]

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    DeFrank et al noted that offering flexible hours was one of the factors associated with a high retention rate of 84%.

    “DeFrank et al [16] also noted that offering flexible hours was one of the factors associated with a high retention rate of 84%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DeFrank et al [16]

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Racial and ethnic minorities constituted 40% of the US population in 2018, and this number is projected to make up more than 50% of the total population by 2050.

    “Racial and ethnic minorities constituted 40% of the US population in 2018 [4], and this number is projected to continue to rise, making up more than 50% of the total population by 2050 [5].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [4] American Community Survey 1-year EstimatesUnited States Census Bureau20182020-04-10https://data.census.gov/cedsci/table?q=race&d=ACS%201-Year%20Estimates%20Detailed%20Tables&tid=ACSDT1Y2018.B02001&hidePreview=true&y=2018&tp=true&moe=false&t=Race%20and%20Ethnicity
    • cites [5] United States Population Projections: 2000 to 2050United States Census Bureau20002020-04-09https://www.census.gov/content/dam/Census/library/working-papers/2009/demo/us-pop-proj-2000-2050/analytical-document09.pdf

  • Probably not a substantial claim.

    Interpretationcitation

    The growing prevalence of internet use, particularly among racial and ethnic minority populations, represents an excellent opportunity for researchers to design and deliver intervention programs using technology.

    “The growing prevalence of internet use, particularly among racial and ethnic minority populations, represents an excellent opportunity for researchers to design and deliver intervention programs using technology.”
    • Also stated in: § Conclusions · plain
      “The growing prevalence of internet use among racial and ethnic minority populations represents an excellent opportunity to design and deliver intervention programs via the internet.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationown data

    The study's communication interventions contributed to high survey completion rates, high satisfaction rates, and positive study experiences.

    “These interventions contributed to high survey completion rates throughout the study (84% at 3-months postintervention), high satisfaction rates (81%), and positive study experiences (97% of the participants felt that they received enough study information, and 80% (32/40) of the participants felt that their questions were answered properly).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationown data

    Bilingual study staff were instrumental in developing partnerships with study sites and community resources, disseminating critical information such as details on the consent forms during recruitment, and providing phone counseling for participants.

    “In particular, the bilingual study staff were instrumental in developing partnerships with study sites and community resources, disseminating critical information such as details on the consent forms during recruitment, and providing phone counseling for participants.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationown data

    The multilevel approach of using both web-based and direct recruitment allowed the study to meet its target sample size and resulted in a more diverse participant pool, as this strategy was successful for relatively younger, bilingual participants who were in different life stages than the majority of the participants.

    “This multilevel approach of using both web-based and direct recruitment allowed us to meet our target sample size and resulted in a more diverse participant pool, as this strategy was successful for relatively younger, bilingual participants who were in different life stages than the majority of our participants.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    The involvement of community consultants and leaders in research not only increased positive recruitment results but also provided vital advice on how to approach participants and gain their trust.

    “The involvement of community consultants and leaders in research not only increased positive recruitment results but also provided vital advice on how to approach participants and gain their trust [15].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] source

  • It may state two separate claims as one.

    Premisecitation

    Of the 75 children who completed the survey, 68% were very satisfied or satisfied with their experience in the study, and 81% of the children were extremely satisfied or satisfied with how the study staff communicated and interacted with them.

    “Of the 75 children who completed the survey, 68% were very satisfied or satisfied with their experience in the study, and 81% of the children were extremely satisfied or satisfied with how the study staff communicated and interacted with them [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.

    Premisecitation

    Some effective methods to create a relevant, useful web-based intervention are to work with target users during the development process.

    “Some effective methods to create a relevant, useful web-based intervention are to work with target users during the development process [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Evidence strongly supports the use of multiple strategies to maximize recruitment and retention yields among racial and ethnic minorities.

    “Nevertheless, evidence strongly supports the use of multiple strategies to maximize recruitment and retention yields among racial and ethnic minorities [27-30,33,35,40,41].”
    Quote in the paperNot a substantial claim0 of 8 sources checked
    • cites [27] source
    • cites [28] source
    • cites [29] source
    • cites [30] source
    • cites [33] source
    • cites [35] source
    • cites [40] source
    • cites [41] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    According to a recent systematic review, prioritizing the web-based intervention development enhanced participants' engagement.

    “According to a recent systematic review, prioritizing the web-based intervention development enhanced participants’ engagement [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    In a study, a short average length of time lowered the participant burden and resulted in a high satisfaction rate.

    “In a study, a short average length of time lowered the participant burden and resulted in a high satisfaction rate [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

  • It may state two separate claims as one.

    Interpretationown data

    Although several categories of recruitment and retention strategies identified from the analysis were also relevant to traditional in-person intervention programs, a few were unique to web-based interventions.

    “Although several categories of recruitment and retention strategies identified from our analysis were also relevant to traditional in-person intervention programs, a few were unique to web-based interventions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim.

    Premisecitation

    A systematic review of mHealth intervention studies with African Americans suggested that a multilevel recruitment approach that considers culture, learning styles, and personal engagement may result in a larger, more diverse participant pool than using a single recruitment strategy.

    “Similarly, a systematic review [21] of mHealth intervention studies with African Americans suggested that a multilevel recruitment approach that considers culture, learning styles, and personal engagement may result in a larger, more diverse participant pool than using a single recruitment strategy.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] source

  • It may state two separate claims as one.

    Interpretationnone given

    The study made deliberate efforts to constantly communicate with participants and church leaders and to disseminate study progress and findings amid the COVID-19 pandemic, ultimately establishing trust and enduring relationships.

    “Similarly, we made deliberate efforts to constantly communicate with our participants and church leaders and to disseminate study progress and findings amid the COVID-19 pandemic, ultimately establishing trust and enduring relationships.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationnone given

    Providing human support via phone counseling to remind the participants about web-based resources assisted in keeping participants in the loop but still maintaining social distancing to protect them.

    “Providing human support via phone counseling to remind the participants about web-based resources assisted in keeping participants in the loop but still maintaining social distancing to protect them.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Adding bilingual study team members with similar cultural backgrounds increases recruitment rates and has easier access to building trust and rapport with the participants; it also promotes acknowledging the importance of web-based interventions, as the study team can include culturally inclusive examples for better understanding.

    “Adding bilingual study team members with similar cultural backgrounds increases recruitment rates and has easier access to building trust and rapport with the participants; it also promotes acknowledging the importance of web-based interventions, as the study team can include culturally inclusive examples for better understanding [18].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Assessment of the usability of web-based intervention programs before launching the program may also increase the likelihood of its future use.

    “Assessment of the usability of web-based intervention programs before launching the program may also increase the likelihood of its future use [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    The word-of-mouth strategy is a well-known method for participant recruitment.

    “The word-of-mouth strategy is a well-known method for participant recruitment [27-30].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [27] source
    • cites [28] source
    • cites [29] source
    • cites [30] source

  • It may state two separate claims as one.

    Premisecitation

    Human support and privacy or anonymity are still valued when delivering web-based interventions.

    “However, human support and privacy or anonymity are still valued when delivering web-based interventions [19].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] source

  • It may state two separate claims as one.

    Premisecitation

    Active communication with study participants resulted in a high retention rate (84%) and high participant satisfaction with the study.

    “Active communication with study participants resulted in a high retention rate (84%) and high participant satisfaction with the study [16].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] source

  • Probably not a substantial claim.

    Premisecitation

    Building upon existing community strengths and resources, faith-based organizations are well-suited community partners for health research and for long-term and sustainable collaboration.

    “Building upon existing community strengths and resources, faith-based organizations are well-suited community partners for health research and for long-term and sustainable collaboration [42].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [42] source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductreasoning

    The number of relevant web-based intervention trials included in the discussion might have been reduced because of the focus on recruitment and retention strategies.

    “The number of relevant web-based intervention trials included in our discussion might have been reduced because of our focus on recruitment and retention strategies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationnone given

    This analysis offers useful information regarding the recruitment and retention of racial and ethnic minority populations in web-based intervention trials.

    “In conclusion, this analysis offers useful information regarding the recruitment and retention of racial and ethnic minority populations in web-based intervention trials.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.

    Interpretationnone given

    This study contributes to the limited body of evidence that widely known strategies are essential and constructive in recruiting and retaining minority research participants.

    “This study contributes to the limited body of evidence that widely known strategies are essential and constructive in recruiting and retaining minority research participants.”
    Quote in the paperNot a substantial claim
66 of 66

  • The paper relies on this without support.

    There is a lack of research addressing recruitment and retention strategies among racial and ethnic minority populations in web-based intervention trials.

    “However, it is not completely clear which recruitment and retention strategies have been successful in web-based intervention trials targeting racial and ethnic minorities.”
    “However, there is a lack of research addressing recruitment and retention strategies among racial and ethnic minority populations in web-based intervention trials, suggesting an important gap in the literature.”

  • The paper relies on this without support.

    Language barriers remain one of the prevailing challenges among immigrants and are often associated with socioeconomic disadvantage, higher poverty, and uninsured rates.

    “Language barriers remain one of the prevailing challenges among immigrants and are often associated with socioeconomic disadvantage, higher poverty, and uninsured rates.”

  • The paper relies on this without support.

    The amount of time that participants committed to complete web-based activities was associated with the perceived study burden.

    “The amount of time that participants committed to complete web-based activities was associated with the perceived study burden.”

  • The paper relies on this without support.

    There is still a dearth of literature discussing whether and how racial and ethnic minorities have been recruited in clinical trials using technology-driven intervention approaches.

    “There is still a dearth of literature discussing whether and how racial and ethnic minorities have been recruited in clinical trials using technology-driven intervention approaches.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reported intervention-group denominator exceeds the possible group size

    Minor

    The paper describes 28 women as being in the intervention group, but only 40 women enrolled overall and 19 control participants completed the final assessment. That leaves at most 21 enrolled intervention participants.

  • Reasons for refusing enrollment account for only seven women

    Minor

    The listed reasons account for 7 women, although the paper says 8 eligible women refused to enroll.

    Reported 8 · recomputed 7

2 of 2

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. 10.2105/AJPH.2013.301706 · DOI · Paper page
  2. Lim, HJ, 2006, Stud Health Technol Inform, 122, 882

Cited by

Sorted by citations

Related

Metadata

Authors
Hwang, D. A., Lee, A., Song, J. M., & Han, H.-R.
Affiliations
Johns Hopkins University (US)
Corresponding author
Han, Hae-Ra
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2021-07-12
Volume
23
Issue
7
Pages
e23959
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/23959
PMC
PMC8314154
OpenAlex
W3182640256
Semantic Scholar
1584b27db93ba43fa597b862f2f29bb95d30aa8b
Cited by
30
References
40
Citations by year
2026: 2 · 2025: 10 · 2024: 5 · 2023: 8 · 2022: 5
FWCI
3.90
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Johns Hopkins University
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
  • Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
Keywords
recruitment strategies, participant retention, racial and ethnic minorities, online intervention, Korean American women, health disparities, community trust, financial incentives
MeSH terms
Internet-Based Intervention, Ethnicity, Female, Humans, Minority Groups, Retrospective Studies, United States, Patient Selection

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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