Integration of community-engaged research technology and methods to guide tobacco regulatory science in rural communities

Objective: This study aims to build a rural Appalachian cohort to examine how US Food and Drug Administration (FDA) Center for Tobacco Products (CTP) regulatory policies influence tobacco and nicotine product use across levels of rurality. Methods: The AppalTRUST (Appalachian Tobacco Regulatory Science Team) Cohort integrates four inter-connected Community-engaged Research + Technology (CEnRT) elements to support recruitment and retention: (1) building trust and cultural relevance; (2) addressing barriers to participation in research; (3) focusing on ethics and confidentiality; and (4) fostering ongoing and consistent collaboration between the scientific and field teams. The study uses a dual sampling design to recruit 1,000 quota-based non-probability sample participants and 1,000 address-based probability sample participants. Eligible adults (ages 18+) are recruited from two Appalachian Kentucky catchments spanning rural and peri-urban counties. A local field team combines culturally relevant engagement strategies with technology-enabled procedures, including virtual consent and participant tracking, to foster trust and relevance with an underserved population. Anticipated results: Recruitment is ongoing. Feasibility indicators include enrollment of 985 non-probability sample participants and 209 probability sample participants, a 16% direct-mail response rate, and a 62% participant preference for text-based consent and survey reminders. Expected outcomes include guidance for applying CEnRT approaches in underserved populations, characterization of tobacco and nicotine use trends across the rural-peri-urban continuum, and description of marketing exposure and consumer choice among subgroups of young adults and daily users in Appalachia. Findings will inform FDA CTP regulatory decision-making in rural Appalachian communities. Discussion: This integrated CEnRT approach shows promise for recruiting and retaining rural Appalachian adults by centering community voice, trust, confidentiality, and practical engagement strategies.