Strategies to Engage Lower-SES, Working-Age Adults in Health Research: Results From the SMART Life Study

Saturday, 29 July 2017

Lindsey N. Horrell, BSN
School of Nursing, Univeristy of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Shawn M. Kneipp, PhD, MS, BSN
Healthcare Environments Division, School of Nursing, Univeristy of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Cecilia M. Gonzales, BA
Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Mary Grace Flaherty, PhD, MS
School of Information & Library Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Laura A. Linnan, ScD
Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Matthew Lee Smith, PhD, MPH
Department of Health Promotion & Behavior, The University of Georgia, College of Public Health, Athens, GA, USA
Ziya Gizlice, PhD
UNC Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Purpose: The Chronic Disease Self-management Program (CDSMP) is a six-week, community-based education intervention that has been associated with positive health outcomes, improved healthcare utilization, and decreased healthcare costs among participants managing at least one chronic condition (Ory et al., 2015; Lorig et al., 1999). While these results have been observed among a wide age-range of adult participants (Ory et al., 2014), this course has been primarily implemented among older, white, female populations of higher socioeconomic status (SES). As a result, marketing materials for this program often display messages and images that overwhelmingly reflect the motivations and characteristics of this aging population. This presents considerable challenges to researchers currently trying to engage younger, lower-SES adults, who face rapidly rising rates and disproportionate adverse outcomes related to chronic conditions, in the CDSMP. The purpose of this presentation is to discuss the development, dissemination, and evaluation of recruitment materials utilized by the SMART Life Study, which is an ongoing RCT at the University of North Carolina at Chapel Hill that studies the effect of the CDSMP on work productivity, health, and healthcare utilization among working-aged, lower-wage earning adults.

Methods: To develop recruitment materials for the SMART Life Study, the project team convened an advisory panel of community members that reflected the study’s target population according to key demographic and socioeconomic characteristics. This panel informed the development of all recruitment materials and methods through an approximately 6-month iterative process.

Results: Following the suggestions of the advisory panel members, SMART Life recruitment materials largely incorporate messages reflecting themes of enhanced financial and employment stability and increased ability to spend time with and provide for family members. The materials also contain hopeful messages of “better health” and “decreased stress” rather than loss-framed messages. While recruitment is ongoing, these advertisements have engaged the interest of approximately 1,055 adults who have completed the study registration form. Among those engaged, approximately 85% are female, 43% identify with a minority racial status, and 5% identify as Hispanic. Additionally, the mean age of respondents is currently 48.2 years old, and 49% report living in homes in which the annual household income is less than $60,000.

Conclusion: The results of this process indicate that developing targeted recruitment materials is an effective approach to engaging the interest of working-age, lower-SES adults in studies of the CDSMP. Incorporating the advertisement cue and strategy preferences discussed during this presentation could enable future nurse leaders to further engage this group in similar health promotion/disease prevention programs. In doing so, we may finally begin to curb the disparities in health outcomes that continually plague this population across the globe.