Abstract
BackgroundA primary challenge for behavior change strategies is ensuring that interventions can be effective while also attracting a broad and representative sample of the target population. The purpose of this case-study was to report on (1) the reach of a randomized controlled trial targeting reduced sugary beverages, (2) potential participant characteristic differences based on active versus passive recruitment strategies, and (3) recruitment strategy cost.MethodsDemographic and recruitment information was obtained for 8 counties and for individuals screened for participation. Personnel activities and time were tracked. Costs were calculated and compared by active versus passive recruitment.ResultsSix-hundred and twenty, of 1,056 screened, individuals were eligible and 301enrolled (77% women; 90% white; mean income $21,981 ± 16,443). Eighty-two and 44% of those responding to passive and active methods, respectively, enrolled in the trial. However, active recruitment strategies yielded considerably more enrolled (active = 199; passive = 102) individuals. Passive recruitment strategies yielded a less representative sample in terms of gender (more women), education (higher), and income (higher; p’s <0.05). The average cost of an actively recruited and enrolled participant was $278 compared to $117 for a passively recruited and enrolled participant.ConclusionsThough passive recruitment is more cost efficient it may reduce the reach of sugary drink reduction strategies in lower educated and economic residents in rural communities.Trial registrationClinicaltrials.gov; ID: NCT02193009, July 2014, retrospectively registered.
Highlights
A primary challenge for behavior change strategies is ensuring that interventions can be effective while attracting a broad and representative sample of the target population
The degree to which passive versus active strategies produce more representative samples, and at what cost, is less clear in that only a small proportion of studies report on these factors [13]. In those that have examined representativeness, the findings suggest that active recruitment strategies engage a sample that more closely aligns with the characteristics of the target population [3, 9, 15, 17, 20, 21]
The goal of the overall study recruitment strategy was to accrue the necessary number of participants per county while explicitly focusing on strategies that would increase the likelihood of a representative sample—all while engaging community organizations or settings that could potentially be involved in taking an Sugar sweetened beverages (SSB) intervention to scale
Summary
A primary challenge for behavior change strategies is ensuring that interventions can be effective while attracting a broad and representative sample of the target population The purpose of this case-study was to report on (1) the reach of a randomized controlled trial targeting reduced sugary beverages, (2) potential participant characteristic differences based on active versus passive recruitment strategies, and (3) recruitment strategy cost. Other factors are salient such as the cost of recruitment and the representativeness of participants that are engaged through different recruitment strategies to ensure key subgroups in the population are not under-represented (e.g., those from lower SES, less educated, and minority groups [9,10,11]) This is not an insignificant point for those interested in eliminating health disparities. Designing and testing interventions that systematically (though likely unintentionally) exclude participants from sub-populations that experience disparities could result in interventions that are effect for those that need them the least, and worse, are ineffective for those that need them the most—further exacerbated existing disparities
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