April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Theory-Based Message Design for Recruitment of Underrepresented Racial/Ethnic Groups into Alzheimer’s-Focused Research Registries
Introduction: An estimated 6.7 million U.S. adults aged 65 years and older are living with Alzheimer’s dementia (AD) in 2023.1 The racial and ethnic disparities in AD prevalence are such that Black older adults are up to twice as likely to have AD or other dementias and Hispanic adults 1.5 times as likely compared to non-Hispanic White adults.1. AD-focused participant recruitment registries can help aid in identifying eligible participants for AD studies, 2 but participation in limited among racial and ethnic groups most at risk for AD.
Theory-based health messages and campaigns have the potential to be effective approaches to participant recruitment because they provide a mechanism for addressing the needs of specific audiences 3,4. The present study describes STEP-UP (Study To Expand Registry Participation of Underrepresented Populations), which is a multi-component project to design persuasive messages, based on the Reasoned Action Approach (RAA),5 that would encourage enrollment among underrepresented groups. The research described here reports on the results from national survey data collected from Black, Hispanic, and White older adults to identify the salient RAA determinants of intention to enroll. An audience segmentation analysis6,7 based on intention status was used to determine potential message content (i.e., the salient beliefs relevant to signing up for an AD-focused brain health registry).
Method: Adults ages 50-80 years old living in the US (n=1,501) completed an online survey administered by the survey research firm SSRS. Data were collected between May/June 2021 and included oversamples of Black (n=334) and Hispanic (n=309) adults for group comparisons. Path analysis was used to estimate the relationship of the attitudes, norms, and perceived behavioral control on intention to sign up for an AD-focused research registry. Group level analyses were conducted for each racial/ethnic and sex group (i.e., Black women, Black men, Hispanic female, Hispanic men, White women, and White men) to identify the salient determinants for each group. We then conducted an audience segmentation analysis based on intender status.
Results: Across almost all racial/ethnic and sex groups, attitudes were an important determinant of intention, and norms and capacity were secondary determinants for Black and Hispanic adults, respectively. Attitudinal beliefs most salient to the behavior were primarily altruistic in that they focused on benefits to society in some way, either generally (i.e., “helping others in the future” or “advancing science”), or more specifically (i.e., “helping others like you”). Differences between groups were more apparent regarding perceived norms and capacity.
Conclusion: The study details the message development process for a theory-based campaign to increase AD registry enrollment among groups traditionally underrepresented in medical research. We identify key beliefs and determinants of enrollment into an AD-focused recruitment research registry. Attitudinal beliefs about advancing science and helping others in the future were important for nearly all the targeted groups and could inform a messaging strategy with universal appeal. Targeted recruitment messages based on beliefs that were common across the groups could be an efficient way of recruiting underrepresented participants.
Theory-based health messages and campaigns have the potential to be effective approaches to participant recruitment because they provide a mechanism for addressing the needs of specific audiences 3,4. The present study describes STEP-UP (Study To Expand Registry Participation of Underrepresented Populations), which is a multi-component project to design persuasive messages, based on the Reasoned Action Approach (RAA),5 that would encourage enrollment among underrepresented groups. The research described here reports on the results from national survey data collected from Black, Hispanic, and White older adults to identify the salient RAA determinants of intention to enroll. An audience segmentation analysis6,7 based on intention status was used to determine potential message content (i.e., the salient beliefs relevant to signing up for an AD-focused brain health registry).
Method: Adults ages 50-80 years old living in the US (n=1,501) completed an online survey administered by the survey research firm SSRS. Data were collected between May/June 2021 and included oversamples of Black (n=334) and Hispanic (n=309) adults for group comparisons. Path analysis was used to estimate the relationship of the attitudes, norms, and perceived behavioral control on intention to sign up for an AD-focused research registry. Group level analyses were conducted for each racial/ethnic and sex group (i.e., Black women, Black men, Hispanic female, Hispanic men, White women, and White men) to identify the salient determinants for each group. We then conducted an audience segmentation analysis based on intender status.
Results: Across almost all racial/ethnic and sex groups, attitudes were an important determinant of intention, and norms and capacity were secondary determinants for Black and Hispanic adults, respectively. Attitudinal beliefs most salient to the behavior were primarily altruistic in that they focused on benefits to society in some way, either generally (i.e., “helping others in the future” or “advancing science”), or more specifically (i.e., “helping others like you”). Differences between groups were more apparent regarding perceived norms and capacity.
Conclusion: The study details the message development process for a theory-based campaign to increase AD registry enrollment among groups traditionally underrepresented in medical research. We identify key beliefs and determinants of enrollment into an AD-focused recruitment research registry. Attitudinal beliefs about advancing science and helping others in the future were important for nearly all the targeted groups and could inform a messaging strategy with universal appeal. Targeted recruitment messages based on beliefs that were common across the groups could be an efficient way of recruiting underrepresented participants.