Experience and lessons learned from multi-modal internet-based recruitment of U.S. Vietnamese into research.

BACKGROUND: Asian-Americans are one of the most understudied racial/ethnic minority populations. To increase representation of Asian subgroups, researchers have traditionally relied on data collection at community venues and events. However, the COVID-19 pandemic has created serious challenges for in-person data collection. In this case study, we describe multi-modal strategies for online recruitment of U.S. Vietnamese parents, compare response rates and participant characteristics among strategies, and discuss lessons learned. METHODS: We recruited 408 participants from community-based organizations (CBOs) (n = 68), Facebook groups (n = 97), listservs (n = 4), personal network (n = 42), and snowball sampling (n = 197). Using chi-square tests and one-way analyses of variance, we compared participants recruited through different strategies regarding sociodemographic characteristics, acculturation-related characteristics, and mobile health usage. RESULTS: The overall response rate was 71.8% (range: 51.5% for Vietnamese CBOs to 86.6% for Facebook groups). Significant differences exist for all sociodemographic and almost all acculturation-related characteristics among recruitment strategies. Notably, CBO-recruited participants were the oldest, had lived in the U.S. for the longest duration, and had the lowest Vietnamese language ability. We found some similarities between Facebook-recruited participants and those referred by Facebook-recruited participants. Mobile health usage was high and did not vary based on recruitment strategies. Challenges included encountering fraudulent responses (e.g., non-Vietnamese). Perceived benefits and trust appeared to facilitate recruitment. CONCLUSIONS: Facebook and snowball sampling may be feasible strategies to recruit U.S. Vietnamese. Findings suggest the potential for mobile-based research implementation. Perceived benefits and trust could encourage participation and may be related to cultural ties. Attention should be paid to recruitment with CBOs and handling fraudulent responses.

The acute stone clinic model: Improving waiting times and patient care in a public funded health care system

Introduction & Objective: The management of patients with ureteric stones can be logistically challenging in large volume centres with long waits for outpatient clinics and definitive interventions. Many units in publicly funded health systems resort to temporising obstructed kidneys with stent insertion and a subsequent plan for elective ureteroscopy at a later date. This can result in unnecessary stent insertions, repeated attendances to the emergency department and an overall poor experience for patients. We aimed to reorganise resources to improve waiting times for definitive intervention, reduce the need for pre-stenting, reduce emergency department re-attendance and improve the overall patient experience. Methods: All patients diagnosed with ureteric stones between March-September 2017 were collected as baseline data. Time to clinic review and definitive treatment were measured. By collaborating with the emergency department, radiology and operation schedulers, our intervention for improvement where a consultant led acute stone clinic (ASC) with a pathway for primary ureteroscopy was implemented and a second cycle was performed June 2018-January 2019. Further data was collected January-October 2020 to assess performance during the COVID-19 pandemic. Results: After implementing the ASC model, median time from diagnosis to clinic consultation reduced from 77 to 9 days. Median time to definitive procedure reduced from 56 to 25 days. Emergency ureteric stent insertion reduced from 69.1% to 27.9%. Reattendance to the emergency department reduced from 3.0 to 1.6 episodes/month. Primary definitive treatment increased from 31.0% to 72.1%. Patients receiving definitive treatment within 4 weeks improved from 26.2% to 51.2% post intervention and sustained at 54.5% during the pandemic period. Conclusions: Implementation of the ASC model has led to a reduced time from diagnosis to clinic review and from diagnosis to definitive treatment. Further improvement is limited by the lack of extra operating lists to reduce the waiting times for ureteroscopy. The ASC model can provide a blueprint for other hospitals to improve outcomes and care of patients with acute ureteric stones.