Systematic review identifies community-based strategies that improve diversity in pediatric research recruitment

This systematic review searched PubMed, PsycNET, and Cochrane for articles published between January 1, 1993, and September 1, 2024, evaluating recruitment and retention strategies in pediatric clinical studies. The goal was to assess how well these strategies achieved adequate representation across races and ethnicities, age groups, and community locations, relative to current published national recruitment rates in pediatric research.

From 2,272 studies identified, 23 met inclusion criteria for detailing specific strategies targeting diverse pediatric populations in general pediatric health topics. Collectively these studies enrolled 5,482 participants, with child and adolescent ages ranging from 0.55 to 19.8 years, and a mean parental age of 35.5 years in studies focused on parents.

For recruitment, community-based approaches were the most effective method for engaging underrepresented populations. Approaches varied by subgroup: family services and flexible scheduling worked best for parents and young children, while monetary compensation and group-oriented efforts resonated more with adolescents. For retention, flexible scheduling, family services, and compensation were successful across populations, with follow-up reminders and logistical incentives also noted as supportive.

The authors conclude that tailored recruitment and retention strategies addressing cultural, social, and logistical needs are essential for ensuring diversity of age, race, ethnicity, and geographic location in pediatric research. They emphasize that addressing data gaps on recruitment and retention efforts will be critical to future work aiming to improve representation and pediatric health outcomes.

Limitations are inherent to a qualitative synthesis of heterogeneous study designs, and the abstract does not report pooled effect sizes, safety outcomes, or quantitative comparisons against the referenced national rates. Clinicians and investigators designing pediatric studies may find the strategy patterns useful, though local adaptation is likely needed.