Abstract
BackgroundThe recruitment of participants into community-based randomized controlled trials studying childhood obesity is often challenging, especially from low-income racial/ethnical minorities and when long-term participant commitments are required. This paper describes strategies used to recruit and enroll predominately low-income racial/ethnic minority parents and children into the Childhood Obesity Prevention and Treatment Research (COPTR) consortium.MethodsThe COPTR consortium has run four independent 3-year, multi-level (individual, family, school, clinic, and community) community-based randomized controlled trials. Two were prevention trials in preschool children and the other two were treatment trials in pre-adolescents and adolescent youth. All trials reported monthly participant recruitment numbers using a standardized method over the projected 18–24 months of recruitment. After randomization of participants was completed, recruitment staff and investigators from each trial retrospectively completed a survey of recruitment strategies and their perceived top three recruitment strategies and barriers.ResultsRecruitment was completed in 15–21 months across trials, enrolling a total of 1745 parent-child dyads- out of 6314 screened. The number of children screened per randomized child was 4.6 and 3.5 in the two prevention trials, and 3.1 and 2.5 in the two treatment trials. Recruitment strategies reported included: (1) careful planning, (2) working with trusting community partners, (3) hiring recruitment staff who were culturally sensitive, personality appropriate, and willing to work flexible hours, (4) contacting potential participants actively and repeatedly, (5) recruiting at times and locations convenient for participants, (6) providing incentives to participants to complete baseline measures, (7) using a tracking database, (8) evaluating whether participants understand the activities and expectations of the study, and (9) assessing participants’ motivation for participating. Working with community partners, hiring culturally sensitive staff, and contacting potential participants repeatedly were cited by two trials among their top three strategies. The requirement of a 3-year commitment to the trial was cited by two trials to be among the top three recruitment barriers.ConclusionsComprehensive strategies that include community partnership support, culturally sensitive recruitment staff, and repeated contacts with potential participants can result in successful recruitment of low-income racial/ethnic minority families into obesity prevention and treatment trials.Trial registrationNET-Works trial: ClinicalTrials.gov, NCT01606891. Registered on 28 May 2012.GROW trial: ClinicalTrials.gov, NCT01316653. Registered on 16 March 2011.GOALS trial: ClinicalTrials.gov, NCT01642836. Registered on 17 July 2012.IMPACT trial: ClinicalTrials.gov, NCT01514279. Registered on 23 January 2012.
Highlights
The recruitment of participants into community-based randomized controlled trials studying childhood obesity is often challenging, especially from low-income racial/ethnical minorities and when long-term participant commitments are required
The number of children screened per randomized child was 4.6 and 3.5 in the two prevention trials, and 3.1 and 2.5 in the two treatment trials
Recruitment strategies reported included: (1) careful planning, (2) working with trusting community partners, (3) hiring recruitment staff who were culturally sensitive, personality appropriate, and willing to work flexible hours, (4) contacting potential participants actively and repeatedly, (5) recruiting at times and locations convenient for participants, (6) providing incentives to participants to complete baseline measures, (7) using a tracking database, (8) evaluating whether participants understand the activities and expectations of the study, and (9) assessing participants’ motivation for participating
Summary
The recruitment of participants into community-based randomized controlled trials studying childhood obesity is often challenging, especially from low-income racial/ethnical minorities and when long-term participant commitments are required. Contemporary community-based interventions often focus on economically disadvantaged, racially/ethnically diverse populations [1] Recruitment of these populations requires an understanding of the challenges faced by potential participants, such as feelings of mistrust of medical care and medical research [1,2,3,4], family stressors including high mobility and financial distress [5], lack of a working phone to communicate with research staff [5], inflexible work hours or lack of time due to working several jobs [5], lack of childcare or transportation [6], low literacy skills [5], and limited understanding of research purposes and processes [1]. Parents, especially low-income parents, may not prioritize obesity as an important health problem for their children, given a host of more immediate stressors and challenges they may face [18, 19]
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