Abstract
BackgroundMany investigators are interested in recruiting veterans from recent conflicts in Afghanistan and Iraq with Traumatic Brain Injury (TBI) and/or Post Traumatic Stress Disorder (PTSD). Researchers pursuing such studies may experience problems in recruiting sufficient numbers unless effective strategies are used. Currently, there is very little information on recruitment strategies for individuals with TBI and/or PTSD. It is known that groups of patients with medical conditions may be less likely to volunteer for clinical research. This study investigated the feasibility of recruiting veterans returning from recent military conflicts— Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) - using a population-based sampling method.MethodsIndividuals were sampled from a previous epidemiological study. Three study sites focused on recruiting survey respondents (n = 445) who lived within a 60 mile radius of one of the sites.ResultsOverall, the successful recruitment of veterans using a population-based sampling method was dependent on the ability to contact potential participants following mass mailing. Study enrollment of participants with probable TBI and/or PTSD had a recruitment yield (enrolled/total identified) of 5.4%. We were able to contact 146 individuals, representing a contact rate of 33%. Sixty-six of the individuals contacted were screened. The major reasons for not screening included a stated lack of interest in the study (n = 37), a failure to answer screening calls after initial contact (n = 30), and an unwillingness or inability to travel to a study site (n = 10). Based on the phone screening, 36 veterans were eligible for the study. Twenty-four veterans were enrolled, (recruitment yield = 5.4%) and twelve were not enrolled for a variety of reasons.ConclusionsOur experience with a population-based sampling method for recruitment of recent combat veterans illustrates the challenges encountered, particularly contacting and screening potential participants. The screening and enrollment data will help guide recruitment for future studies using population-based methods.
Highlights
Many investigators are interested in recruiting veterans from recent conflicts in Afghanistan and Iraq with Traumatic Brain Injury (TBI) and/or Post Traumatic Stress Disorder (PTSD)
Clinical studies utilizing population-based sampling methods are challenging in this regard as they rely upon the cooperation of a predetermined sample, members of which have no knowledge of the study prior to the first contact
The findings revealed that those who deployed to Afghanistan, Iraq, and other countries had higher estimated prevalence of TBI, PTSD, and cooccurring TBI/PTSD than those who were not deployed
Summary
Many investigators are interested in recruiting veterans from recent conflicts in Afghanistan and Iraq with Traumatic Brain Injury (TBI) and/or Post Traumatic Stress Disorder (PTSD) Researchers pursuing such studies may experience problems in recruiting sufficient numbers unless effective strategies are used. Population-based sampling methods offer the potential for high external validity such that the results can be applied directly to the defined population [7] Use of techniques such as random selection of population members and invitation of greater proportions of high-interest subgroups, for example, increase the potential representativeness of such a sample. For these reasons, studies which estimate prevalence rates in the reference population and identify trends or risk factors frequently utilize this method. The initial random selection in a population-based sample may offer some preliminary protection from bias, responses may still be systematically biased, posing a threat to external validity with weaknesses that may rival convenience based sampling strategies
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