Background/Purpose: The LIMIT-JIA trial aims to study if early abatacept treatment can prevent disease extension in children with recent-onset, uncomplicated, and oligoarticular or limited JIA. Barriers to recruitment identified in the first trial phase included 1) families expressed concern over being diagnosed with JIA, 2) confusion about usual treatment of JIA, and 3) fear around administering injections to their children. When LIMT-JIA enrollment reopened in the new COVID-19 environment, these pre-COVID barriers were amplified. Qualifying patients and families were more hesitant to pursue treatment that might be labeled as immune-suppressing. We sought to identify and implement COVID-friendly strategies to minimize these recruitment barriers.

Methods: A group of stakeholders (JIA parents, a pediatric rheumatologist, an experienced interviewer, and an adult JIA patient) met weekly throughout the summer of 2021 to determine target groups to interview, how to best gather video footage, and the look of the final products. As COVID-19 cases spiked again, plans were modified from in-person recorded interviews to recorded marketing-style zoom interviews. Interviewees included 3 parent members from the LIMIT-JIA Stakeholder Advisory Committee, 3 young adult patients 20-25 y.o., and 4 children 8-12 y.o. Interviewees were asked about their experience with JIA and described their own hesitation and experience with their first injection. Interviews were transcribed with key phrases or points of each interview flagged for editing purposes.

Results: Patient and families were familiar with use of Zoom/Teams/Webex style platforms for communicating and hearing information from Tik-Tok, Instagram stories, and reels. This suggested more dynamic resources were needed in a digital format, and several videos were created to address the needs expressed by patient families and clinic staff. To date, 8 video clips have been developed for our patient-facing website, covering topics around injection preparation, diagnosis journey, and JIA. The videos were made available on the

www.limitjia.com website as part of a new recruitment packet. Study is ongoing to determine whether the patient-facing websites and video clips were effective recruitment tools.

Conclusion: Ethnographic interviews of patients, families, and clinical staff informed peer-to-peer recruitment strategies. Casual, low-fidelity video capture is more acceptable and relatable today than highly edited and directed film. Our study team felt this worked to our advantage and allowed us to develop cost-efficient digital tools to address the needs of families and clinic staff. We were able to use creative approaches to address barriers to patient and site engagement amplified by the COVID pandemic.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/facilitating-peer-to-peer-conversations-around-key-clinical-trial-recruitment-barriers-in-the-limit-jia-trial-using-low-fidelity-video-capture/