Overcoming Pandemic-Related Challenges in Recruitment and Screening: Strategies and Representation of Older Women With Cardiovascular Disease for a Multidomain Lifestyle Trial to Prevent Cognitive Decline

J Cardiovasc Nurs. 2024 Jul-Aug;39(4):359-370. doi: 10.1097/JCN.0000000000001000. Epub 2023 May 11.


Background: Recruiting participants with cardiovascular disease into research during the COVID-19 pandemic was challenging, particularly those at risk of health disparities.

Objective: During the pandemic, 12 cohorts of older women with cardiovascular disease were recruited from cardiology clinics into a lifestyle intervention trial to prevent cognitive decline. Objectives were to ( a ) describe the results of modified recruitment/screening strategies to overcome pandemic-related challenges and ( b ) evaluate differences in age, race, and ethnicity between patients recruited/randomized, recruited/not randomized (entered recruitment but not randomized because of being ineligible or not interested), and not recruited (clinic patients who met preliminary criteria but did not enter recruitment).

Methods: This was a cross-sectional descriptive analysis. In-person study strategies proposed before the COVID-19 pandemic were modified before study onset (September 2020). Women 65 years or older with cardiovascular disease were recruited from cardiology clinics by clinicians, posted flyers, and letters mailed to patients randomly selected from electronic health record data extractions. Patients were classified as recruited/randomized, recruited/not randomized, and not recruited.

Results: Of 5719 patients potentially eligible, 1689 patients entered recruitment via referral (49.1%), posted flyers (0.5%), or mailed letters (50.3%), and 253 patients were successfully recruited/randomized. Recruited/randomized participants were, on average, 72.4 years old (range, 65-90 years old), non-Hispanic White (54.2%), non-Hispanic Black (38.3%), Hispanic/Latinx (1.6%), and other/not reported (5.1%). The recruited/randomized group was significantly younger with fewer patients of Hispanic/Latinx ethnicity compared with those not recruited.

Conclusions: During the pandemic, all recruitment/screening goals were met using modified strategies. Differences in sociodemographic representation indicate a need for tailored strategies.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Cardiovascular Diseases* / ethnology
  • Cardiovascular Diseases* / prevention & control
  • Cognitive Dysfunction* / prevention & control
  • Cross-Sectional Studies
  • Female
  • Humans
  • Life Style
  • Mass Screening
  • Pandemics
  • Patient Selection*