STRIVING FOR DIVERSITY IN POPULATION-BASED RESEARCH: STRATEGIES AND OUTCOMES IN THE RISE FOR HEALTH STUDY.

Abstract

Broad demographic representation is important in population-based research to enhance generalizability. The purpose of this manuscript is to describe strategies used to promote broad representation in the RISE FOR HEALTH study (RISE), consistent with its prioritized representation goals; and to compare participants to American women to gauge the success of these strategies. RISE was a large population-based cohort study of community-dwelling women selected by probability sampling of adult female residents of 57 geographically dispersed U.S. counties. Participation entailed completing self-administered surveys and an optional in-person assessment. Diversity goals and associated strategies were to: 1) ensure representation by race, ethnicity, and age similar to the U.S. population (by stratified probability sampling from a large marketing database); 2) remove barriers to participation by preferred Spanish language speakers (cultural adaptation, linguistic translation, bilingual mailings); and 3) promote diversity more broadly (marketing-style materials, community engagement). In 2024-2025, participant characteristics were compared to those of American women, using data from two national surveys (American Community Survey, National Health and Nutrition Examination Survey). 3,400 participants (of 50,367 invited) completed the baseline survey from 2022-2023 and were eligible. Consistent with the stratified sampling plan, participants were similar to the U.S. population with respect to race, ethnicity, and age. In contrast, they differed by Spanish as a primary language spoken (4.4% versus 12.9% in the U.S.) and completion of a high school degree or less (13.8% versus 35.9%). Strategies designed to promote diversity were variably successful in RISE, offering insight for future population-based research.