All of Us Motivations Study

The Motivations Study:
Understanding “Engagement” in the All of Us Research Program

Funder: National Human Genome Research Institute & Office of the Director, National Institutes of Health (R21)

The Motivations study will map the contours of why people, especially racialized minorities, decline, enroll, or stay engaged in the All of Us Research Program. All of Us is an initiative led by the National Institutes of Health to amass health, genetic, and environmental data from one million people living in the United States. These data will be used to create a biobank (a library of biological samples). Biobanks are a crucial tool in the development of precision medicine therapies and interventions targeting the underlying genetic and/or environmental causes of disease. All of Us seeks to diversify health research and reduce health disparities by enrolling people from populations that have been historically underrepresented in biomedical research and thus left out of advances in precision medicine to date. The initial genomic dataset from All of Us was published in March 2022.

Six FQHCs around the country received initial All of Us funding to recruit and engage their patients in the research program. Participants are also offered the option to receive genetic information. 

The Motivations study seeks to understand:

  • What motivates patients at FQHCs to enroll, decline, or continue to participate in All of Us
  • The extent to which people’s motivations to enroll or decline to enroll in All of Us match expected outcomes

This project will contribute to advancing diverse participation in precision medicine research, identify new strategies to meaningfully engage underrepresented populations in All of Us,  and ensure that these strategies are attentive to participants’ values and expectations.

Methods

Motivations is a qualitative study of recruitment and retention into All of Us at one FQHC that is part of the All of Us recruitment program. The study collected in-depth qualitative data, via interviews with key staff and both enrollees in and decliners to the All of Us Research Program. It took place form September 1, 2019-August 31, 2023.

Supplement

Key informant interviews conducted in early 2020 (pre-pandemic) yielded the insight that FQHC staff are concerned about the barriers that patients who are participants will face when All of Us returns medically relevant genomic information, such as information about increased risk of cancer or heart disease. These early findings led to a supplemental study. See here: “Meeting the Follow-up Needs of All of Us Participants from Federally Qualified Health Centers.”

Publications

Experiences at a Federally Qualified Health Center Support Expanded Conception of the Gifts of Precision Medicine

Special Considerations When Research is Embedded within Community Health Centers

Project Team

Carolyn Neuhaus, PhD

Principal Investigator

Research Scholar, The Hastings Center
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​Johanna Crane, PhD

Principal Investigator

Associate Professor, Alden March Bioethics Institute, Albany Medical College
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Danielle Pacia, MBE

Project Manager

Project Manager-Research Assistant, The Hastings Center
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Camila Salvagno, MFA

Research Assistant

Research Assistant,
RIP Medical Debt

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