Abstract
BackgroundRecruitment is a challenge in developing population-representative pregnancy and birth cohorts.MethodsWe developed a collaborative recruitment infrastructure (CRI) to recruit pregnant women for 4 pregnancy cohorts using: faxes from obstetrical offices, in-clinic recruiters, university and funder-driven free-media events, paid-media, and attendance at relevant tradeshows. Recruitment rates and demographic differences were compared between recruitment methods.ResultsWe received 5008 referrals over 40 months. Compared to fax, free-media referrals were 13 times more likely to be recruited (OR 13.0, 95% CI 4.2, 40.4: p < 0.001) and paid-media referrals were 4 times more likely to be recruited (OR 4.6, 95% CI 2.1, 10.3: p < 0.001). Among paid-media advertisements, free-to-read print (e.g. Metro) was the most effective (OR 3.3, 95% CI 2.3, 4.5: p < 0.05). Several demographic differences were identified between recruitment methods and against a reference population. Between recruitment methods, media recruits had a similar proportion families with incomes ≥ $40,000 (paid-media: 94.4%; free-media: 93.3%) compared to fax recruits (95.7%), while in-clinic recruits were less likely to have family incomes ≥ $40,000 (88.8%, p < 0.05). Maternal recruits from fax and in-clinic were more likely to attend university (Fax: 92.6%, in-clinic 89.8%) versus the reference population (52.0%; p < 0.05 for both) and both were less likely to smoke (Fax: 6.8%, in-clinic 4.2%) versus reference (18.6%; p < 0.05 for both). However, while fax referrals were more likely to be Caucasian (85.9% versus reference 77.5%; p < 0.05), in-clinic referrals were not significantly different (78.2%; P > 0.05).ConclusionRecruitment methods result in different recruitment rates and participant demographics. A variety of methods are required to recruit a generalizable sample.
Highlights
Recruitment is a challenge in developing population-representative pregnancy and birth cohorts
Recruitment methods Results for each recruitment method are presented in the following order 1) any significant demographic differences in referrals compared to fax referrals, 2) any significant difference in recruitment rate compared to fax referrals, 3) any significant demographic difference in recruits compared to fax referrals
For the recruits that identified themselves of first-nations origin, there were no significant difference between the fax recruits (3.5% identifying themselves as first-nation) compared to the reference population (3.7%, p > 0.05)
Summary
Recruitment is a challenge in developing population-representative pregnancy and birth cohorts. There is a renewed interest in large, populationrepresentative pregnancy and birth cohort studies. The UK government recently announced a 90,000 longitudinal pregnancy/birth cohort project [1]. The USA National Children’s Study (NCS) plans to recruit 100,000 children [2]. One of the biggest challenges in developing these studies is participant recruitment [3,4]. The NCS originally proposed a pre-conception cohort and estimated that 10–40 households would need participants from each strategy (45000/45000/10000) [8]. Between 2008 and 2012, there were four pregnancy cohort studies recruiting at the University of Alberta. We developed a collaborative recruitment infrastructure (CRI) that recruited for all four studies simultaneously.
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