Recruitment and Retention for an Acupuncture Trial in an Underrepresented 65 and Older Population With Chronic Low Back Pain.

Researchers successfully recruited older adults from underserved communities in New York City to participate in a large study on acupuncture for chronic low back pain. The BackInAction study enrolled 123 participants at one site serving predominantly low-income patients, with impressive diversity: 39% Hispanic, 35.6% Black, and 22% White non-Hispanic participants, including many Spanish speakers. The study focused on adults 65 and older who had been living with chronic low back pain. What makes this research noteworthy isn't the acupuncture results themselves, but rather how successfully the team engaged communities that are typically underrepresented in medical research. They achieved this by working closely with primary care doctors who referred patients, using research coordinators as patient navigators to guide participants through the process, and adapting electronic health records to improve communication. Importantly, 88% of participants stayed in the study through completion, with only 12% withdrawing—a strong retention rate that suggests participants found value in their involvement. The study also achieved good follow-up rates, with about 81% of participants completing assessments at the 6-month mark. This success demonstrates that when research teams build trusted relationships within communities, adapt their processes to meet patients where they are, and work within familiar healthcare settings, older adults from diverse backgrounds will participate in acupuncture research. For patients considering acupuncture for chronic low back pain, this study shows that diverse older populations are interested in and can access this treatment option. If you're considering acupuncture, seek a licensed acupuncturist with experience treating older adults and chronic pain conditions.

This methodological report describes successful recruitment and retention strategies for enrolling underrepresented older adults in the BackInAction trial, a pragmatic multi-site RCT testing acupuncture for chronic low back pain in adults ≥65 years. The Institute for Family Health, a Federally Qualified Health Center in New York City, enrolled 123 participants with notable demographic diversity: 39.0% Hispanic, 35.6% Black, 22.0% White non-Hispanic; 26.8% Spanish-speaking; 62.6% reporting annual household income <$25,000. Key recruitment mechanisms included PCP orientation to trial referrals, research coordinators functioning as patient navigators, and EHR adaptations facilitating communication between acupuncturists and research teams. The site achieved a 12.2% withdrawal rate and 18.7% missingness in 6-month primary endpoint data—strong retention metrics for this population. Clinical takeaway: Integrating acupuncture research within trusted primary care settings serving underrepresented communities, combined with navigation support and streamlined communication systems, enables successful enrollment and retention of diverse older adults in comparative effectiveness trials.