Impact of financial incentives on electronic health record-driven recruitment of underrepresented communities in research: randomized controlled trial (Preprint)

BACKGROUND Disparities in electronic health record (EHR) portal use exist. Thus, EHR-driven recruitment for research may exacerbate underrepresentation. OBJECTIVE In this study, we evaluated whether a financial incentive improved response rates to recruitment messages in an equitable fashion. METHODS A random sample of 1,200 patients with diagnoses of either breast, colorectal, prostate, or lung cancer received a recruitment message for a fictitious cross-sectional survey study, “The Social Aspects of Cancer Care” via their EHR portal. Two strata of patients were sampled, those who identify as non-Hispanic White (n = 600) and those with another race or ethnicity (n = 600) and randomized to receive an offer of a $20 monetary incentive (n=400) or no incentive (n=800). RESULTS Overall, 39% of participants viewed the recruitment message and 13% responded that they were interested. Response rates were higher (p < 0.001) among non-Hispanic White patients (18%) than for African American or Black (7%) and members of other racial/ethnic groups (13%). No differences were observed in the response rate for the incentive cohort compared to no incentive (15% vs. 12%, p = 0.206). CONCLUSIONS Cancer patients who identify as a racial and ethnic minority were less likely to view and respond to recruitment messages for research studies through their EHR patient portal. The impact of a $20 financial incentive did not significantly impact patient participation.