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.
American journal of preventive medicine. 2026 Jun 17 [Epub ahead of print]
Siobhan Sutcliffe, Chloe Falke, Kyle D Rudser, Gerald McGwin, Cynthia S Fok, Cecilia Hardacker, Aimee S James, Emily S Lukacz, Julia Maki, Alayne D Markland, Ratna Pakpahan, Sara Putnam, Leslie M Rickey, Jean F Wyman, Linda Brubaker, Ariana L Smith, Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
Division of Public Health Sciences, Department of Surgery; and the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO. Electronic address: ., Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN. Electronic address: ., Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN. Electronic address: ., Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL. Electronic address: ., Department of Urology and the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology and Women's Health; University of Minnesota School of Medicine, Minneapolis, MN. Electronic address: ., Howard Brown Health, Chicago, IL. Electronic address: ., Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address: ., Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, La Jolla, CA. Electronic address: ., Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address: ., Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT; Geriatric Research, Education, and Clinical Center at the Birmingham Veterans Affairs Health Care System; Birmingham, AL. Electronic address: ., Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address: ., Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN. Electronic address: ., Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences; Yale School of Medicine, New Haven, CT. Electronic address: ., School of Nursing, University of Minnesota, Minneapolis, MN. Electronic address: ., Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, La Jolla, CA. Electronic address: ., Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address: .