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Ethn Health. 2017 Aug;22(4):361-371. doi: 10.1080/13557858.2016.1244626. Epub 2016 Oct 21.

Care transitions among Latino diabetics: barriers to study enrollment and transition care.

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a Department of Family Medicine, Keck School of Medicine , University of Southern California , Alhambra , CA , USA.
b HealthCore, Inc. , Andover , MA , USA.
c School of Social Work , University of Southern California , Los Angeles , CA , USA.
d Kaiser Permanente , Pasadena , CA , USA.
e Davis School of Gerontology , University of Southern California , Los Angeles , CA , USA.



Latinos are disproportionately affected by diabetes and people with diabetes experience frequent hospital admissions and readmissions. Care transition interventions can help reduce rates of readmission; however, there are many barriers to recruiting Latinos for participation in intervention research. Exploring reasons for study refusal furthers understanding of low research participation rates to help researchers address barriers.


This study presents a cross-sectional, descriptive analysis of reasons for study refusal and attrition drawing from data collected as part of a randomized controlled trial conducted to test the effectiveness of a transitions intervention for diabetic Latino discharged from the hospital to home. Reasons for refusal were elicited from participants, transcribed, and coded. Descriptive statistics and bivariate analyses were used to compare those who completed the study and those who did not complete the study.


Reasons for study enrollment refusal and loss to follow-up ranged from difficulty locating the patient to homelessness to patient reluctance to having providers in the home. Study completers were more likely than non-completers to reside with family members (pā€‰=ā€‰.03) and have a spouse as a primary caregiver (pā€‰=ā€‰.08).


Inner city, monolingual Latinos may be difficult to enroll and engage in home-based interventions. Although not representative of all Latino populations, barriers encountered highlight the need for targeted research to improve transitional care among Latinos. Researchers and clinicians should take into consideration the unique barriers that Latinos face in participating in research and intervention studies.


Latinos; attrition; barriers; care transitions; diabetes

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