Practical issues regarding implementing a randomized clinical trial in a homeless population: strategies and lessons learned
Practical issues regarding implementing a randomized clinical trial in a homeless population: strategies and lessons learned
Although the Homeless Hub works tirelessly to bring current and up to date content to our site, access to many journal articles is constrained by the subscription restrictions imposed by publishing companies. While the Homeless Hub cannot afford to buy access to the innumerable proprietary journals we link to, we do strive, at least, to bring the knowledge of this content to our users.
Furthermore, the Homeless Hub is committed to the principles of open access and we provide free access to all original Homeless Hub content, thus offering our users the ability to re-use and re-distribute scholarly works as long as there is proper attribution to the author. We feel strongly that this serves the broader community by greatly improving the dissemination, visibility, and impact of research findings.
We will endeavour to improve upon our open access principles in order to continue to provide our users with access to the best and most current research available.
There is a critical need for objective data to guide effective health promotion and care for homeless populations. However, many investigators exclude homeless populations from clinical trials due to practical concerns about conducting research with this population. This report is based on our experience and lessons learned while conducting two large NIH-funded randomized controlled trials targeting smoking cessation among persons who are homeless. The current report also addresses challenges when conducting clinical trials among homeless populations and offers potential solutions. Homeless individuals face several challenges including the need to negotiate daily access to food, clothing, and shelter. Some of the critical issues investigators encounter include recruitment and retention obstacles; cognitive impairment, mental health and substance abuse disorders; transportation and scheduling challenges; issues pertaining to adequate study compensation; the need for safety protocols for study staff; and issues related to protecting the wellbeing of these potentially vulnerable adults. Anticipating realistic conditions in which to conduct studies with participants who are homeless will help investigators to design efficient protocols and may improve the feasibility of conducting clinical trials involving homeless populations and the quality of the data collected by the researchers.