Strategic recruitment of an ethnically diverse cohort of overweight survivors of breast cancer with lymphedema

• Published in: Cancer 2018-01, Vol.124 (1), p.95-104
• Main Authors: Sturgeon, Kathleen M., Hackley, Renata, Fornash, Anna, Dean, Lorraine T., Laudermilk, Monica, Brown, Justin C., Sarwer, David B., DeMichele, Angela M., Troxel, Andrea B., Schmitz, Kathryn H.
• Format: Article
• Language: English
• Subjects: African American; African Americans; Aged; Body weight; Breast cancer; breast cancer lymphedema; Breast Cancer Lymphedema - complications; Breast Cancer Lymphedema - therapy; Breast Neoplasms; Cancer; Cancer Survivors; Clinical trials; Education; Ethnic Groups; European Continental Ancestry Group; exercise; Exercise Therapy; Female; Humans; Intervention; Lymphedema; Middle Aged; Minority & ethnic groups; Minority Groups; Obesity - complications; Obesity - therapy; Oncology; Overweight; Overweight - complications; Overweight - therapy; patient recruitment; Patient Selection; Population studies; Randomization; Randomized Controlled Trials as Topic; Recruitment; Weight Loss; Weight Reduction Programs
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.30935

BACKGROUND Black women are more likely to experience adverse effects from cancer treatment such as lymphedema. Thus, black women may particularly benefit from research regarding interventions to improve lymphedema. Herein, the authors report the challenges and strategies related to the recruitment of minority survivors of breast cancer and to the recruitment of survivors of breast cancer with lymphedema into the Women In Steady Exercise Research (WISER) Survivor Clinical Trial. METHODS Subjects for this community‐based trial were recruited from the Philadelphia area through active (mailings) and passive (printed materials and Web site) recruitment strategies. In addition, education sessions coordinated through partner hospitals in communities with a predominantly minority population were conducted to increase awareness of lymphedema in survivors of breast cancer. Women who were interested in the study were screened for lymphedema via telephone questionnaire and invited to see a study‐related certified lymphedema therapist to confirm the presence of lymphedema. RESULTS Screening was conducted among 2295 women: 628 were eligible, 450 consented, and 351 were randomized. Minority women comprised 38% of the study population. Letters to women on state and hospital registries resulted in a 0.4% randomization rate; education sessions yielded a 10% randomization rate. The authors observed that approximately 23.6% of the study sample had no previous diagnosis of lymphedema. CONCLUSIONS The WISER Survivor Clinical Trial faced multiple recruitment challenges and used unique strategies to successfully enroll minority survivors of breast cancer into a lifestyle intervention. Cancer 2018;124:95‐104. © 2017 American Cancer Society. Better representation of target populations in clinical research studies leads to more persuasive study results, and will enable providers to shape the care of survivors of breast cancer in a manner relevant to those of all ethnicities and backgrounds. The WISER Survivor Clinical Trial faced multiple recruitment challenges and used unique strategies to successfully enroll minority survivors of breast cancer into a lifestyle intervention.