LatAm‐FINGERS: Navigating Diversity in the Engagement of a Subcontinental Trial for Dementia Prevention

Abstract Background LatAm‐FINGERS is the first non‐pharmacological multicenter randomized clinical trial aimed at preventing cognitive impairment in Latin America. It encompasses twelve countries that collectively represent 45% of the territory in the Americas. Its objective is to reach populations that, despite sharing commonalities such as language, are culturally and economically diverse. Above all, these populations have different perspectives on goals related to healthy aging, access to healthcare, and participation in clinical trials. The challenge is twofold: on one hand, achieving commitment across all centers to ensure recruitment and adherence; on the other hand, utilizing these strategies to instill awareness in society about the scourge of dementia and the possibility of its prevention. Methods Our aim is to describe the recruitment strategies and their effectiveness in the design and implementation of the initial phases of the trial. The most relevant strategies included: a) decentralized design, where the 12 site principal investigators collaborated across all phases of the trial design rather than merely implementing it. They were asked to present solutions and barriers based on the idiosyncrasies of their target population and share them with the rest. b) assess cultural beliefs about clinical trials, c) disseminate information about dementia prevention strategies, d) collaborate with community partners in outreach and recruitment. Results The most utilized strategies included 1) assess population with cognitive complaints or concern for prevention (for centers with clinical setting) and 2) community dissemination for universities and research centers. A total of 1,877 candidates were evaluated, of which 1,232 were included. Pre‐screening strategies were implemented to reduce staff burden at most centers. Conclusions Our results demonstrate that, despite the diversity present in Latin America, it is possible to conduct a unified trial with successful recruitment. Carefully designed strategies that respect local culture, coupled with knowledge of local stakeholders, hold the key to success. Moreover, it highlights that a clinical trial, in addition to being a tool to test treatment effectiveness, can serve as a catalyst for awareness campaigns.