{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:02:40Z","timestamp":1781262160885,"version":"3.54.1"},"reference-count":0,"publisher":"Project MUSE","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["hpu"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p xml:lang=\"en\">Abstract: Objective. To be effective and generalizable, research must include diverse populations representative of the intended beneficiaries. Among women with low income in the United States, 74.9% initiate breastfeeding, but only 47.5% continue to six months. This analysis examined how structural inequities, indicated by income, race, and ethnicity, affect participant retention in a breastfeeding intervention. Methods. Participants (N=250) enrolled in PROMPT, a longitudinal randomized text-based breastfeeding self-management intervention trial. Cox proportional hazards models were used to analyze retention over 24 weeks. Results. Overall retention was 72%. Dropout risk was significantly higher among Hispanic and non-Hispanic Black participants (HR 2.86, p&lt;.001), and among those with lower income (HR 2.61, p&lt;.001). A three-factor model (including income, race\/ethnicity, and age) was statistically significant overall (p=.0001), though individual predictors were not. Conclusion. Structural inequities may contribute to differential retention in breastfeeding trials, highlighting the need for equity-focused recruitment and retention strategies.<\/jats:p>","DOI":"10.1353\/hpu.2026.a992136","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:46:17Z","timestamp":1781261177000},"page":"673-691","source":"Crossref","is-referenced-by-count":0,"title":["Retention and Structural Inequities in Clinical Research: Insights from a Breastfeeding Intervention Study"],"prefix":"10.1353","volume":"37","author":[{"given":"Helen Wilde","family":"LaPlant","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayna","family":"Cunningham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Confidence","family":"Franics-Edoziuno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwag","family":"Alhabodal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana Marie","family":"Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Marshall-Crim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idelisa","family":"Freytes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Walsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"147","container-title":["Journal of Health Care for the Poor and Underserved"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:46:27Z","timestamp":1781261187000},"score":1,"resource":{"primary":{"URL":"https:\/\/muse.jhu.edu\/article\/992136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1353\/hpu.2026.a992136","relation":{},"ISSN":["1548-6869"],"issn-type":[{"value":"1548-6869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}