Shifts in recruitment demographics due to the effects of the COVID-19 pandemic for the CAPTURE COPD Study

Context: Primary Care Research seeks to “meet our patients where they are” to make research more accessible and inclusive. During the COVID-19 pandemic, recruitment practices shifted. Letters, emails, phone calls took the place of in-person recruitment.

Objective: Evaluate the effect of COVID–19 on recruitment demographics across primary care practices within a single health system for “The CAPTURE study: Validating a unique COPD case finding tool in primary care.”

Study Design and Analysis: Comparative analysis of demographics including race, gender, age from ten urban and rural clinics. The analysis included five practices with in-person recruitment pre-pandemic and 5 with virtual recruitment practices during the pandemic.

Setting: Family and Internal Medicine practices, rural and urban. Population Studied: Patients (45-80, male and female)

Intervention/Instrument: Before March 2020, pre-pandemic, our team focused on in-person recruitment. Clinicians’ schedules were screened for patients who were then consented and enrolled during a clinic visit. After March 2020, our team transitioned to virtual recruit using a population report to identify patients. An email or mailed letter was sent to patients followed by a phone call.

Outcome Measures: Percent enrolled relative to total clinic populations (pop).

Results: In-person, 31.6% of enrollees were male compared to the clinic pop. of 41.5%. With virtual recruitment, 40.9% of enrollees were male compared to the clinic pop. of 39.9%. This gender difference was statistically significant (t-test p<0.05). In-person, 21.0% of enrollees were self-reported African American/Black (AA/Black) compared to the clinic pop. of 14.6%. With virtual recruitment, 18.1% of enrollees self-reported as AA/Black compared to the clinic pop. of 23.6%. In-person, 60.0% of enrollees were between the 45-64 compared to the clinic pop. of 55.0%. With virtual recruitment, 54.7% of enrollees were 45-64 compared to the clinic pop. of 60.8%. Although there was a trend toward fewer AA/Black enrollees and enrollees 45-64 through virtual recruitment, the difference was not statistically significant.

Conclusion: During the COVID-19 pandemic, remote recruitment significantly increased the proportion of male participants but trended toward reduced proportion of AA/Black participants as well as those between the age of 45-64. These results suggest changing recruitment strategies between in person and virtual can alter recruitment outcomes.