Overcoming Challenges to Implementing Randomized Controlled Trials with Underserved Populations in Community-Based Settings

Social workers who practice and conduct research with underserved and vulnerable populations are often faced with challenges when implementing behavioral randomized controlled trials (RCT) in real world settings. This roundtable discussion will provide lessons learned from three social workers who have conducted behavioral RCT with vulnerable populations (i.e., current and former prisoners, child victims of violence, and unemployed adults with social anxiety). Several of the RCTs to be discussed have been funded by the National Institute of Mental Health. Each discussant will provide a brief overview of one or two RCTs that have been conducted or that are underway, and will share their unique perspective on six challenges to executing a RCT with underserved populations in community-based settings. After each challenge is discussed, participants will have an opportunity to ask questions and join in the dialogue.

The six challenges posed by behavioral RCTs to be discussed are: (1) developing and maintaining active community partnerships; (2) delineating inclusion and exclusion criteria that are flexible for community practice yet appropriate for conducting a RCT; (3) actively engaging in recruitment to meet sample size requirements; (4) increasing retention and minimizing dropout; (5) balancing assessment protocols and utilizing various assessment methods to obtain needed data and limit participant burden; and (6) ensuring treatment fidelity and consistency across sites.

The lead discussant will facilitate the roundtable discussion to assure that different perspectives and methods are highlighted. In addition to the six methodological challenges noted, presenters will link their work on RCTs to the conference theme of achieving equal opportunity, equity and justice. For example, the first discussant will discuss how systems related to child abuse and neglect influence successful participation in trauma-focused clinical trials. The second discussant will discuss how current and former prisoners are often faced with social stigma and how stigma and other injustices may influence participation in RCTs. Lastly, the third discussant will discuss the use of cognitive behavioral therapy with underserved populations, including a current NIMH RCT with unemployed persons with social anxiety. Participants will learn some current research method and strategies being used in behavioral RCTs, and will have the opportunity to ask questions related to social work practice with these vulnerable populations, and to conducting behavioral RCT with vulnerable populations.