Skip to main content
SpringerLink
Log in

Recruitment for an Internet-Based Diabetes Self-Management Program: Scientific and Ethical Implications

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Little is known about the reach of Internet self-management interventions.

Purpose

The aim of this study was to evaluate different definitions of participation rate and compare characteristics among subcategories of participants and nonparticipants on demographic and clinical factors using de-identified electronic medical record data.

Methods

Data are presented on recruitment results and characteristics of 2,603 health maintenance organization members having type 2 diabetes invited to participate in an Internet self-management program.

Results

There was a 37% participation rate among all members attempted to contact and presumed eligible. There were several significant differences between participants and nonparticipants and among subgroups of participants (e.g., proactive volunteers vs. telephone respondents) on factors including age, income, ethnicity, smoking rate, education, blood pressure, and hemoglobin A1c.

Conclusion

These results have important implications for the impact of different recruitment methods on health disparities and generalization of results. We provide recommendations for reporting of eligibility rate, participation rate, and representativeness analyses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Thoolen B, de Ridder D, Bensing J, Gorter K, Rutten G. Who participates in diabetes self-management interventions? Issues of recruitment and retention. Diab Educ. 2007; 33: 465–474.

    Article  Google Scholar 

  2. Glasgow RE. What types of evidence are most needed to advance behavioral medicine? Ann Behav Med. 2007; 35: 19–25.

    Google Scholar 

  3. Van Spall HGC, Toren A, Kiss A, Fowler RA. Eligibility criteria of randomized controlled trials published in high-impact general medical journals. J Am Med Assoc. 2007; 297: 1233–1240.

    Article  Google Scholar 

  4. Shavers-Hornaday VL, Lynch CF, Burmeister LF, Torner JC. Why are African-Americans underrepresented in medical research studies? Ethn Health. 1997; 2: 31–45.

    Article  CAS  PubMed  Google Scholar 

  5. Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trials: Race-, sex-, age-based disparities. J Am Med Assoc. 2004; 291: 2726.

    Article  Google Scholar 

  6. Wendler D, Kington R, Madans J, et al. Are racial and ethnic minorities less willing to participate in health research? PLoS Med. 2005; 3: e19.

    Article  PubMed  Google Scholar 

  7. Strecher V. Internet methods for delivering behavioral and health-related interventions (eHealth). Annu Rev Clin Psychol. 2007; 3: 53–76.

    Article  PubMed  Google Scholar 

  8. Tate D. Introduction to special series on the Science of Internet Intervention Research. Annals Behav Med. 2010. In Press.

  9. Pena-Purcell N. Hispanic use of Internet health information: An exploratory study. J Med Libr Assoc. 2008; 96: 101–107.

    Article  PubMed  Google Scholar 

  10. Wilson JJ, Mick R, Wei J, Rustgi AK. Clinical trial resources on the Internet must be designed to reach underrepresented minorities. Cancer J. 2006; 12: 475–481.

    Article  PubMed  Google Scholar 

  11. Glasgow RE, Klesges LM, Dzewaltowski DA, Bull SS, Estabrooks P. The future of health behavior change research: What is needed to improve translation of research into health promotion practice? Ann Behav Med. 2004; 27: 3–12. PMID 14979358.

    Article  PubMed  Google Scholar 

  12. Stopponi MA, Alexander GL, McClure JB, et al. Recruitment to a randomized web-based nutritional intervention trial: Characteristics of participants compared to non-participants. J Med Internet Res. 2009; 11: e38.

    Article  PubMed  Google Scholar 

  13. Toobert DJ, Glasgow RE, Strycker LA, Barrera M Jr, Ritzwoller DP, Weidner G. Long-term effects of the Mediterranean lifestyle program: A randomized clinical trial for postmenopausal women with type 2 diabetes. Int J Behav Nutri Phys Act. 2007; 17: 1. PMID 17229325.

    Article  Google Scholar 

  14. Danaher BG, Seeley JR. Methodological issues in research on web-based behavioral interventions. Annals Behav Med. 2010. In Press.

  15. Glasgow RE, Strycker LA, King D, et al. Robustness of a computer-assisted diabetes self-management intervention across patient characteristics, healthcare settings, and intervention staff. Am J Manage Care. 2006; 12: 137–145. PMID 16524346.

    Google Scholar 

  16. Centers for Disease Control and Prevention. Age adjusted percentage of population with diagnosed diabetes by race and sex, 1980-2006. www.cdc.gov/diabetes/statistics/prev/national/figraceethsex.htm . Accessed September 21, 2009.

  17. Nielson J. Digital divide: The three stages. Useit.com. www.pewinternet.org/pdfs/PIP_Shifing_net-pop-report.pdf . Retrieved August 22, 2009.

  18. Moore M, Bias RG, Prentice K, Fletcher R, Vaughn T. Web usability testing with a Hispanic medically underserved population. J Med Libr Assoc. 2009; 97: 114–121.

    Article  PubMed  Google Scholar 

  19. Fogel J, Albert SM, Schnabel F, Ditkoff BA, Neugut AI. Racial/ethnic differences and potential psychological benefits in use of the Internet by women with breast cancer. Psychooncology. 2003; 12: 107–117.

    Article  PubMed  Google Scholar 

  20. Tunis SR, Stryer DB, Clancey CM. Practical clinical trials. Increasing the value of clinical research for decision making in clinical and health policy. J Am Med Assoc. 2003; 290: 1624–1632.

    Article  CAS  Google Scholar 

  21. Glasgow RE, Magid DJ, Beck A, Ritzwoller D, Estabrooks PA. Practical clinical trials for translating research to practice: Design and measurement recommendations. Med Care. 2005; 43: 551–557. PMID 15908849.

    Article  PubMed  Google Scholar 

  22. Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: An evidence-based approach. Am J Prev Med. 2002; 22: 267–284.

    Article  PubMed  Google Scholar 

  23. Glasgow RE, Goldstein MG, Ockene J, Pronk NP. Translating what we have learned into practice: Principles and hypotheses for addressing multiple behaviors in primary care. Am J Prev Med. 2004; 27: 88–101. PMID 15275677.

    Article  PubMed  Google Scholar 

  24. Glasgow RE, Christiansen S, Kurz D, King D, Woolley T, Faber A, et al. Engagement in a diabetes self-management website: Usage patterns and correlates. Submitted for publication, 2009.

  25. Quinn E. PAR-Q: The physical activity readiness questionnaire, take the PAR-Q before you start and exercise program. http://sportsmedicine.about.com/od/fitnessevalandassessment/qt/PAR-Q.htm . Accessed September 21, 2009.

  26. Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004; 36: 588–594.

    PubMed  Google Scholar 

  27. Glasgow RE. Outcomes of and for diabetes education research. Diab Educ. 1999; 25: 74–88.

    Article  CAS  Google Scholar 

  28. Parra-Medina D, D'Antonio A, Smith SM, Levin S, Kirkner G, Mayer-Davis E. Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medially underserved counties of South Carolina: The POWER study. J Am Diet Assoc. 2004; 104: 70–75.

    Article  PubMed  Google Scholar 

  29. Des Jarlais DC, Lyles C, Crepaz N, TREND Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement. Am J Public Health. 2004; 94: 361–366.

    Article  PubMed  Google Scholar 

  30. Scott JC, Conner DA, Venohor I, et al. Effectiveness of a group outpatient visit model for chronically ill older health maintenance organization members: A 2-year randomized trial of the Cooperative Health Care Clinic. J Am Geriatr Soc. 2004; 52: 1463–1470.

    Article  PubMed  Google Scholar 

  31. Chong N. The Latino Patient: A Cultural Guideline for Health Care Providers. Boston: International Press; 2002.

    Google Scholar 

Download references

Acknowledgements

This research was supported by Grant 2 R01 DK035524-21 from the National Institute of Diabetes and Digestive and Kidney Diseases. The authors have no relevant conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Denver, CO, 80237-8066, USA

    Russell E. Glasgow Ph.D., Deanna Kurz B.A., C.C.R.P., Andrew Faber B.A., Hillary Bell M.A., Jennifer M. Dickman M.S.W., Eve Halterman M.B.A. & Diego Osuna M.D.

  2. Oregon Research Institute, 1715 Franklin Blvd., Eugene, OR, 97403-1983, USA

    Lisa A. Strycker M.A.

  3. Virginia Tech Riverside, 1 Riverside Circle SW, Suite #104, Roanoke, VA, 24016, USA

    Paul A. Estabrooks Ph.D.

Authors
  1. Russell E. Glasgow Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa A. Strycker M.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deanna Kurz B.A., C.C.R.P.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew Faber B.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hillary Bell M.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jennifer M. Dickman M.S.W.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eve Halterman M.B.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paul A. Estabrooks Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Diego Osuna M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Russell E. Glasgow Ph.D..

About this article

Cite this article

Glasgow, R.E., Strycker, L.A., Kurz, D. et al. Recruitment for an Internet-Based Diabetes Self-Management Program: Scientific and Ethical Implications. ann. behav. med. 40, 40–48 (2010). https://doi.org/10.1007/s12160-010-9189-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-010-9189-1

Keywords

Search

Navigation