Recruitment and enrollment of rural and urban medically underserved elderly into a randomized trial of telemedicine case management for diabetes care

• Published in: Telemedicine journal and e-health Vol. 12; no. 5; p. 601
• Main Authors: Palmas, Walter, Teresi, Jeanne, Morin, Philip, Wolff, L Thomas, Field, Lesley, Eimicke, Joseph P, Capps, Linnea, Prigollini, Alejandro, Orbe, Irma, Weinstock, Ruth S, Shea, Steven
• Format: Journal Article
• Language: English
• Published: United States 01.10.2006
• Subjects: Aged; Aged, 80 and over; Data Collection; Diabetes Mellitus; Female; Humans; Male; Medically Underserved Area; Middle Aged; New York; New York City; Patient Selection; Prospective Studies; Randomized Controlled Trials as Topic; Rural Population; Self Care; Telemedicine; Urban Population; New York City; New York
• ISSN: 1530-5627
• DOI: 10.1089/tmj.2006.12.601

Our goal was to identify reasons for enrollment or refusal to participate in a randomized trial of telemedicine case management of diabetes. We performed a prospective survey of participants and non-participants during recruitment for the Informatics for Diabetes Education and Telemedicine (IDEATel) study, a randomized trial of telemedicine case management of diabetes mellitus in medically underserved elderly. There were two recruitment areas: urban New York City, and rural upstate New York. A Participant Questionnaire (PQ) was administered at the baseline IDEATel visit, and a Non-Participant Questionnaire (NPQ) was administered during the recruitment telephone call. Both questionnaires listed possible responses; subjects could choose more than one response or give their own. Of 1,660 IDEATel participants, 99.7% completed the PQ. Most frequent reason for participation was the belief that the technology could help them (52% and 42% of urban and rural respondents, respectively). Of the 2,231 subjects refusing participation, 28% answered the NPQ (90% of respondents were from rural area). Most frequent reasons not to participate in the rural area were being too busy (23%), and discomfort with the technology (22%), and in the urban area the belief that the technology could not help them (71%), discomfort with it (52%), and not liking to participate in studies (52%). In multivariate analysis (rural respondents only), knowing how to use a computer was an independent predictor of participation (p < 0.001). In conclusion, perceptions and beliefs regarding technology, including the expectation to benefit from it, played an important role in the decision to participate.