Abstract B001: Rural interventions to improve breast, cervical and colorectal screening rates: Recruitment strategies for women in rural areas
Authors: Baltic Ryan D , Young Gregory S , Katz Mira L , Rawl Susan , Champion Victoria , Paskett Electra D 
Published: September 2020

Abstract
Rural areas of the United States have less access to quality healthcare, higher rates of cancer incidence and mortality, and lower screening rates compared to urban areas. The Rural Interventions for Screening Effectiveness (RISE) Study conducted by Indiana University and The Ohio State University focuses on improving breast, cervical and colorectal cancer screening rates in rural Indiana and Ohio by encouraging female residents ages 50-74 years to receive necessary screenings. Two interventions are tested: an interactive DVD, and the DVD combined with patient navigation. Recruitment occurred October 2017 - June 2019. This paper evaluates recruitment strategies used by RISE in order to better understand which method was most effective and to determine if participants differed demographically by recruitment method. An array of recruitment strategies were used, including purchasing contact lists to call women in the recruitment area, internet advertising, and physical advertisements placed within the communities. Outbound mailing and calling, the sole method initially planned, was performed for the first 6 months of recruitment, using purchased phone and address lists of female residents of rural counties of northeast Indiana and northwest Ohio. Internet advertising was primarily conducted using Facebook to target female users 50 years or older in rural areas of both states. Community advertising was performed by mailing flyers to be displayed in rural libraries, senior and community centers, and other locations where residents congregate. Recruitment strategies differed in effort, cost, and yield. Mailing and calling using purchased lists was used to attempt to reach 5240 women, successfully reaching and reviewing medical records for 275 women, yielding 154 eligible women. Median household income of these women was $50,000-$59,999 and median age was 63 years. This strategy was costly, high effort, and did not yield enough participants to warrant continuing. Community advertising involved identifying suitable locations and requesting permission to post promotional materials. Although this strategy’s reach cannot be determined, 163 women contacted staff to request more information, 67 progressed to medical record review, and 38 were enrolled. Median household income of these participants was $70,000-$79,999 and median age was 62 years. Through Internet advertising, 3116 spoke to interviewers about the study, with 1297 progressing to medical record review, yielding 793 eligible participants. Median household income was $70,000-$79,999; median age was 58 years. Although Internet recruitment was the most successful strategy, it may have unintentionally targeted younger or more affluent women who own and use smartphones or home computers with internet access. With technology becoming increasingly pervasive and as people become more hesitant to answer phone calls from foreign numbers, recruitment strategies must be evaluated to ensure the study population is truly being reached.
Citation Format: Ryan D Baltic, Gregory S Young, Mira L Katz, Susan Rawl, Victoria Champion, Electra D Paskett. Rural interventions to improve breast, cervical and colorectal screening rates: Recruitment strategies for women in rural areas [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B001.