BACKGROUND
•Transportation barriers such as distance to trial sites, cost and reliable options reduce access, delay recruitment and increase dropout in Alzheimer’s disease (AD) studies1.
•Direct, pre-arranged and centrally-supported transportation services may streamline options across sites, increasing participant access to preclinical AD trials.
•The Alzheimer’s Clinical Trials Consortium (ACTC) Recruitment, Engagement, and Retention (RER) Unit implemented a centrally-supported, site-coordinated, on-demand rideshare transportation option to support recruitment and retention for AHEAD 3-45, a large multisite preclinical AD trial for adults ages 55-802.
OBJECTIVE
Goal: To preliminarily evaluate over a 12-month time period, the utilization, cost, and regional variation of a centrally-supported rideshare program across a multisite preclinical AD trial.
METHODS
•Design: Analysis of rideshare use in AHEAD3-45 during October 2023 - October 2024, corresponding with the final year of study enrollment.
•Data: Monthly ride volume and cost from centralized invoices.
•Analysis: Trends over time and by United States census regions (Midwest, Northeast, South, and West), reported as absolute use and cost.
RESULTS
Utilization
•36 of 71 AHEAD 3-45 US sites (51%) utilized (5 Midwest; 6 Northeast; 10 West; 15 South)
•4,727 rides scheduled; 98% completed
•364 monthly study-averaged rides/month
Cost
•Total: US 236,481.00
•Monthly average: US 18,190
Trends Over Time (Figures 1 and 2)
•Utilization and cost increased over time
•Highest use toward the end of enrollment
Regional Variation (Figures 3 and 4)
•Highest use: West region
•Highest cost: Northeast region
•Lowest use and cost: Midwest region
INTERPRETATION AND CONCLUSION
Interpretation
•AHEAD 3-45 participants and study partners are provided the opportunity of central transportation support through ride-share service, at no-cost.
•Regional variation may reflect differences in site implementation practices, ride-share availability, or participant geography (i.e. rurality).
•Increasing use over time might reflect growing site familiarity with the service, integration into workflow, and study need.
Conclusion
•Centralized rideshare support is a viable strategy to streamline participant transportation for AD trials, with regional differences observed in these analyses.
•RER funding strategies may consider the utility of centralized on-demand rideshare options for participants and study partners in future multisite preclinical AD trials.
•The ACTC RER Unit has added rideshare as one of the standard transportation tools available to sites for ACTC trials.
•Future analyses may evaluate associations with participant recruitment, retention, visit adherence, and additional site-level feedback.
ACKNOWLEDGEMENTS
•AHEAD 3-45 is a public-private partnership between the ACTC (NIA U24 AG057437), NIH (R01AG095009;R01AG061848) and Eisai and Co, with additional support provided by Alzheimer’s Association, GHR Foundation, and philanthropic organizations.
•The authors would like to thank the site principal investigators, site staff, and especially participants and their families for their contributions in this study.
