Successful Recruitment of Drug Users in Research Participation: Do Differences Matter?

Aims: Drug use is common, yet drug users are regularly excluded from research through exclusion criteria and lack of knowledge of opportunities to participate. We assessed what specific characteristics differentiate the two groups besides their drug use, and whether this translates into different rates of enrollment in health studies.

Methods: The Transformative Approach to Reduce Research Disparities Towards Drug Users randomized drug users and non-drug users to navigation through a community health worker (CHW) or through an “ambassador” who also provided transportation and other support to give opportunities to participate in research. Enrollment status was taken from study coordinators' records.  We analyzed how drug users differed from non-drug users in lifestyle, life events, and rate of enrollment.

Results: In this sample of 614 18 to 85 year old community recruited adults, 329 endorsed current drug use and 285 endorsed no drug use.  Drug users were more likely to be food insecure (45% vs. 35%), consider themselves homeless (23% vs. 15%), feel unsettled (40% vs. 31%), have unpredictable daily activities (49% vs. 39%), have more days where they felt unable to control important things [8.15 (95% CI 6.92,9.38) vs. 5.88 (4.74,7.03)] and more life chaos [5.00 (95%CI 4.67,5.34) vs. 3.97(95%CI 3.65,4.3)].  Outcomes from this intervention trial showed that drug users versus non-drug users were not significantly different (32% vs. 26%, p = 0.0944).

Conclusion: In this study, drug users did not significantly differ from non-drug users in rates of study enrollment despite the differences in their lives; they can and should be enrolled in research studies.