Abstract: SA-OR030
Addressing Social Barriers to Improve Research Engagement of Study Participants from an Underserved, Minoritized Population in a Community-Based Dietary Intervention for CKD
Session Information
- Diversity and Equity in Kidney Health: Research and Cases
November 08, 2025 | Location: Room 361A, Convention Center
Abstract Time: 04:50 PM - 05:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Montgomery, Aisha H, Premier, Inc., Charlotte, North Carolina, United States
- Kitzman, Heather, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Khan, Mahbuba, Baylor Scott & White Health, Dallas, Texas, United States
- Allison, Patricia, Baylor Scott & White Health, Dallas, Texas, United States
- Wesson, Donald E., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background
Minoritized communities suffer greater prevalence of chronic kidney disease (CKD) and poorer outcomes. Such communities also disproportionately suffer health-related social factors which limit access to health resources that help prevent CKD and reduce its adverse outcomes. The Fruits and Vegetables (F&V) for Kidney Health trial (R21DK113440) utilized a community-based design to evaluate effects of increased F&V intake on CKD in an underserved, minoritized community. We sought to identify and address health-related social barriers that limit study engagement.
Methods
The trial was a community-based, two-arm, randomized dietary intervention to evaluate effects of increased F&V intake with or without cooking instruction in African American (AA) adults with CKD. After the first six-week primary intervention during which participants received F&V directly, participants retrieved F&V through a voucher redemption system for the subsequent 18 weeks. Voucher tracking analysis revealed decreasing study engagement. To identify reasons for decreasing engagement, we collected qualitative participant feedback through satisfaction surveys, phone, email, or in-person conversations to identify barriers limiting sustained engagement.
Results
Participants (n=142) were 100% self-declared AAs, 77% female, mean age 56.5 years, and 47.1% had ≤$25K annual income. Primary reported health-related social barriers to F&V voucher redemption included 1) lack of transportation, 2) competing economic and social demands (time off work or away from family commitments), 3) economic instability (misplaced or unused vouchers), and 4) lack of social support (independent shopping at select farm stands vs. retrieving preselected produce bags as with the primary six-week intervention). Voucher redemption was modified to allow pre-orders and use of multiple vouchers to accommodate reported barriers, increasing average number of vouchers redeemed per week from [mean (SD)] 3.74 (2.38) to 7.38 (4.96) and led to 71% final study retention.
Conclusion
Social factors experienced in this underserved AA community hindered sustained study engagement when following the original protocol design, but engagement improved when procedures were adapted to accommodate social barriers.
Funding
- NIDDK Support