Abstract

We assessed current strategies and built an infrastructure informed by historical studies demonstrating effective engagement of diverse participants to improve recruitment. Our objective was to increase enrollment of an inpatient health equity study experiencing food insecurity and diabetes mellitus (DM). This scalable model focused on supporting clinical integration for the development of a long-term, sustainable nutrition program.

This randomized control study included patients with a history of DM. The nursing research team screened patients using the validated, Hunger Vital Sign™ tool to assess for food insecurity. Using an evidence-based multifactorial approach, the implementation plan uses best practices to support socioeconomic participants.

Strategies included: 1) collaborating and engaging stakeholders—including physicians, nursing, social work, nutrition, and interpretation services—to ensure culturally competency and regulatory compliance, 2) utilizing electronic health records and hospital-based messaging platforms to screen and reach patients with DM per inclusion criteria, and 3) integrating efficient workflows and linguistically appropriate screening tools and material into routine patient care, aligned with Good Clinical Practices (GCP).

From March 2024 to current, the research nursing team prescreened 1,182 patients and enrolled a total of 137 participants, who identified as 59% Hispanic, 17% Non-Hispanic White, 11% Black, 4% Asian, 9% Other, and 1% Unknown. We improved recruitment methods by streamlining the initial screening method by 70%, adding 100 plus participants, and translating informed consents, flyers, and questionnaires in four, non-English languages to ensure fairness and equity. Consented participants accounted for 17% of overall patients screening positive for food insecurity advancing health equity. Interpreter services reached approximately 21% of individuals, who are non-native English speakers. The clinical workflow integration improved from one physician researcher placing consultations to each patient’s primary care team adopting the workflow with 98% accuracy.

This model shows that infrastructure and equity-driven design, incorporated in clinical workflows, drive success in research while removing barriers to participation. Findings suggest that patient-centered screening in diverse and vulnerable patient populations can be applied to other chronic conditions to reduce health iniquities.

Notes

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References:

Clark, J.M., Maw, M.T.T., Pettway, K. et al. Impact of Medically Tailored Meals on Clinical Outcomes Among Low-Income Adults with Type 2 Diabetes: A Pilot Randomized Trial. J GEN INTERN MED 40, 1711–1719 (2025).

de Tantillo L, McCabe BE, Zdanowicz M, Ortega J, Gonzalez JM, Chaparro S. Implementing Strategies to Recruit and Retain a Diverse Sample of Heart Failure Patients. Hisp Health Care Int. 2025;23(1):9-17.

Ganatra S, Khadke S, Kumar A, et al. Standardizing social determinants of health data: a proposal for a comprehensive screening tool to address health equity—a systematic review. Health Aff Scholar. 2024;2(12):qxae151.

Houghtaling, B., Short, E., Shanks, C. et al. Implementation of food is medicine programs in healthcare settings: A narrative review. J GEN INTERN MED 39, 2797–2805 (2024).

Rangachari, P., Thapa, A. Impact of hospital and health system initiatives to address Social Determinants of Health (SDOH) in the United States: a scoping review of the peer-reviewed literature. BMC Health Serv Res 25, 342 (2025).

Description

We developed an equity-focused, research infrastructure model to improve recruitment and retention in an inpatient study for patients with diabetes and food insecurity.

Author Details

Elidia V. Tafoya, MPH1; Keith Henri Salvado, BSN, RN, BSBioE1; Latanya Dean, Pharm D, MBA, BCOP1, Pamela Josue, BA1, Briana Williams, BS1, Grissel Hernandez, PhD, MPH, RN, HNB-BC, NPD-BC, SGAHN1, and Neera Ahuja, MD, FACP, SFHM2

Center for Education, Research, and Professional Development, Stanford Health Care1, Stanford University2 Stanford, California, USA

Sigma Membership

Alpha Alpha Lambda at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Randomized Controlled Trial

Research Approach

Quantitative Research

Keywords:

Academic-Clinical Partnership, Implementation Science, Testing Strategies, Diabetes, Food Security, Nursing Research, Clinical Medicine Research

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-24

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Building Research Infrastructure to Advance Recruitment and Retention of Diabetes Mellitus Patients

Toronto, Ontario, Canada

We assessed current strategies and built an infrastructure informed by historical studies demonstrating effective engagement of diverse participants to improve recruitment. Our objective was to increase enrollment of an inpatient health equity study experiencing food insecurity and diabetes mellitus (DM). This scalable model focused on supporting clinical integration for the development of a long-term, sustainable nutrition program.

This randomized control study included patients with a history of DM. The nursing research team screened patients using the validated, Hunger Vital Sign™ tool to assess for food insecurity. Using an evidence-based multifactorial approach, the implementation plan uses best practices to support socioeconomic participants.

Strategies included: 1) collaborating and engaging stakeholders—including physicians, nursing, social work, nutrition, and interpretation services—to ensure culturally competency and regulatory compliance, 2) utilizing electronic health records and hospital-based messaging platforms to screen and reach patients with DM per inclusion criteria, and 3) integrating efficient workflows and linguistically appropriate screening tools and material into routine patient care, aligned with Good Clinical Practices (GCP).

From March 2024 to current, the research nursing team prescreened 1,182 patients and enrolled a total of 137 participants, who identified as 59% Hispanic, 17% Non-Hispanic White, 11% Black, 4% Asian, 9% Other, and 1% Unknown. We improved recruitment methods by streamlining the initial screening method by 70%, adding 100 plus participants, and translating informed consents, flyers, and questionnaires in four, non-English languages to ensure fairness and equity. Consented participants accounted for 17% of overall patients screening positive for food insecurity advancing health equity. Interpreter services reached approximately 21% of individuals, who are non-native English speakers. The clinical workflow integration improved from one physician researcher placing consultations to each patient’s primary care team adopting the workflow with 98% accuracy.

This model shows that infrastructure and equity-driven design, incorporated in clinical workflows, drive success in research while removing barriers to participation. Findings suggest that patient-centered screening in diverse and vulnerable patient populations can be applied to other chronic conditions to reduce health iniquities.