Underrepresentation of Participants From Marginalized Racial and Ethnic Groups: A Secondary Analysis of the Cognitive Rehabilitation Literature
Abstract
Objective To examine the inclusion of people with brain injury from racially and ethnically marginalized groups in cognitive rehabilitation clinical trials. Data Sources We conducted a secondary analysis of the Cicerone et al (2019) cognitive rehabilitation review. Study Selection Of the originally included studies, we excluded those not conducted in the United States, along with case studies and case series studies. Data Extraction We extracted data on the racial and ethnic demographics of the study samples, along with eligibility criteria and recruitment and sampling strategies. We examined demographic data descriptively (frequencies and percentages) and examined other study methods thematically. Data Synthesis Sixty-five studies met criteria for inclusion in this secondary analysis. Of these, only 27 reported on the racial and ethnic demographics of the study samples. In all but 8, White non-Hispanic participants were overrepresented. We identified several frequently employed recruitment strategies and eligibility criteria that may disproportionately exclude participants from minoritized racial and ethnic groups, including English language, literacy, and baseline education requirements, exclusion based on comorbid conditions, and recruitment of participants from existing clinic patient pools. Conclusions We found notable underrepresentation of people with traumatic brain injury (TBI) from racially and ethnically marginalized groups in cognitive rehabilitation clinical…
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Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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