Contact Attempts Research Articles

Caregiver-reported satisfaction with pediatric movement disorder surgery.

Patient- and surrogate-reported outcomes are increasingly recognized as important and historically limited dimensions of satisfaction with medical care. Evaluating caregiver satisfaction for cerebral palsy (CP) patients with pediatric movement disorders (PMDs) remains undefined, limited by a lack of appropriate tools and the heterogeneity of the patient population. The authors identified caregiver satisfaction with the neurosurgical management of PMDs as a key quality metric and report their results across an institutional experience. A retrospective single-institution survey study was performed on caregivers of consecutive children who underwent PMD surgery from March 2022 to December 2023. The authors designed a brief 4-question satisfaction survey with dichotomous yes/no answers. The telephone survey solicited answers from primary caregivers, and contact attempts were made 3 times before labeling a nonresponder. Non-English speakers were included. The survey answers were correlated with demographic characteristics, clinical data, and complications. Descriptive statistics were performed using Excel. Seventy patients were identified in the study period with 50 associated caregivers voluntarily responding to the questionnaire (50/70 [71.4%]). Forty-six male and 24 female patients with a mean (range) age of 13.1 (2-34) years and a follow-up range of 3-20 months were included. All 50 caregivers reported satisfaction with the surgical care their child received: 100% confirmed they would refer others to the program and 94% confirmed that they would have the surgery again in retrospect. Ten caregivers (10/50 [20%]) recalled complications, but only 5 (5/50 [10%]) surgical complications resulted in hospital readmission. Caregivers were overwhelmingly satisfied with the neurosurgical care for PMDs and would recommend the functional pediatric neurosurgery program to others. A large percentage would again submit to the surgery. There is a perception disparity between caregiver- and hospital-identified complications; it may be beneficial to emphasize expected adverse effects with caregivers prior to surgery. Caregiver satisfaction remains an important quality dimension and future research may benefit from more objective metrics.

A Pilot Project to Implement a Pharmacist-Managed Remote Blood Pressure Monitoring Service

Background: Clinicians often hesitate to adjust antihypertensive medications based solely on clinic blood pressure (BP) readings. Limitations to obtaining home readings include access to sphygmomanometers and ability to provide accurate, reliable readings upon follow-up. Objective: This study examined whether an online platform linked to remote BP monitoring improved BP management and facilitated effective clinical interventions by pharmacists. Methods: Thirty patients with uncontrolled hypertension were enrolled and provided a remote BP monitor for home use. BP data downloaded to an online platform were monitored by two clinic pharmacists. Daily BP checks were requested (up to twice daily), and pharmacists called patients approximately weekly for 6 months. Through approved protocols, pharmacists individualized interventions to improve patient care. Descriptive statistics were used for demographic and clinical data. Results: The average systolic BP reduction was 39 mmHg (IQR = 17-52.5) for the 21 patients included in analysis. A target BP <140/<90 was achieved by 67%, and 76% had improved BP control. Patients utilized the cuff 2-4 times (n = 10) or >5 times weekly (n = 11). Through 261 patient contact attempts, the pharmacists requested more BP checks (n = 62), changed medications (n = 57), or provided non-pharmacologic counseling (n = 24) most often. Medication changes commonly included dose increases (n = 35) and additional agents (n = 17) for BP control. Spironolactone (n = 5) and thiazide diuretics (n = 5) were the most added medications. Conclusions: Most patients were willing to check their BP when provided with devices. The majority achieved a clinically significant decrease in home BP readings, demonstrating that pharmacist-driven home-monitoring programs can improve the optimization of hypertension regimens.

Recruiting people with selected citizenships for the health interview survey GEDA Fokus throughout Germany: evaluation of recruitment efforts and recommendations for future research

BackgroundGermany is the second most common country of immigration after the US. However, people with own or familial history of migration are not represented proportionately to the population within public health monitoring and reporting. To bridge this data gap and enable differentiated analyses on migration and health, we conducted the health interview survey GEDA Fokus among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship living throughout Germany. The aim of this paper is to evaluate the effects of recruitment efforts regarding participation and sample composition.MethodsData collection for this cross-sectional and multilingual survey took place between 11/2021 and 5/2022 utilizing a sequential mixed-mode design, including self-administered web- and paper-based questionnaires as well as face-to-face and telephone interviews. The gross sample (n = 33436; age range 18–79 years) was randomly drawn from the residents’ registers in 120 primary sampling units based on citizenship. Outcome rates according to the American Association for Public Opinion Research, the sample composition throughout the multistage recruitment process, utilization of survey modes, and questionnaire languages are presented.ResultsOverall, 6038 persons participated, which corresponded to a response rate of 18.4% (range: 13.8% for Turkish citizenship to 23.9% for Syrian citizenship). Home visits accounted for the largest single increase in response. During recruitment, more female, older, as well as participants with lower levels of education and income took part in the survey. People with physical health problems and less favourable health behaviour more often took part in the survey at a later stage, while participants with symptoms of depression or anxiety more often participated early. Utilization of survey modes and questionnaire languages differed by sociodemographic and migration-related characteristics, e.g. participants aged 50 years and above more often used paper- than web-based questionnaires and those with a shorter duration of residence more often used a translated questionnaire.ConclusionMultiple contact attempts, including home visits and different survey languages, as well as offering different modes of survey administration, increased response rates and most likely reduced non-response bias. In order to adequately represent and include the diversifying population in public health monitoring, national public health institutes should tailor survey designs to meet the needs of different population groups considered hard to survey to enable their survey participation.

Characteristics of People Who Do Not Complete a Public Health Interview: An Assessment of Colorado Enteric Disease Surveillance Data.

Although enteric disease case interviews are critical for control measures and education, not all case-patients are interviewed. We evaluated systematic differences between people with an enteric disease in Colorado who were and were not interviewed to identify ways to increase response rates and reduce biases in the surveillance data used to guide public health interventions. We obtained data from the Colorado Electronic Disease Reporting System from March 1, 2017, through December 31, 2019. Among case-patients not interviewed and interviewed, we used univariate analyses to describe sociodemographic characteristics, timing of contact attempts, and effect of additional funding. As compared with case-patients who were interviewed, case-patients who were not interviewed were significantly more likely to be aged 18 to 39 years (35.7% vs 31.7%; P < .001); identify as male, Hispanic, or Black; be experiencing homelessness or hospitalization; reside in rural/frontier areas or an institution; or live in areas with lower levels of education, life expectancy, and income. Time to first contact attempt was longer for case-patients who were not interviewed than for those who were (mean days from specimen collection to first contact attempt, 9.8 vs 6.8; P < .001). Residing in a jurisdiction with additional funding for interviewing was associated with increased interview rates (87.7% vs 68.8%) and timeliness of public health report and first contact attempt (2.3 vs 4.4 days; P < .001). Findings can guide efforts to improve response rates in groups least likely to be interviewed, resulting in reduced biases in surveillance data, better disease mitigation, and increased efficiency in case investigations. Timeliness of case interviews and additional funding to conduct case investigations were factors in increasing response rates.

Quadriceps Tendon Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients: 3-Year Clinical and Patient-Reported Outcomes.

The rate of anterior cruciate ligament (ACL) rupture in active, skeletally immature patients is increasing. Although hamstring tendon autograft (HTA) was previously deemed the gold standard, recent studies have shown HTA to have a high failure rate in this high-risk population of young competitive athletes, and quadriceps tendon autograft (QTA) has yielded excellent preliminary outcomes in some studies examining this population. To evaluate 3-year clinical and patient-reported functional outcomes of primary ACL reconstruction (ACLR) with soft tissue QTA in skeletally immature patients. Case series; Level of evidence, 4. Skeletally immature patients who underwent ACLR with a full-thickness soft tissue QTA were included. Preoperative patient and surgical data were collected. The ACLR technique was selected predicated upon skeletal age and included all-epiphyseal and complete transphyseal techniques. Patients were followed for a minimum of 2 years with successive clinical visits or were contacted via telephone. Patients who did not have minimum 2-year follow-up after 3 contact attempts via telephone were excluded. Information regarding return to sports (RTS) and concomitant or subsequent surgical procedures was collected. Pediatric International Knee Documentation Committee (Pedi-IKDC), Hospital for Special Surgery Functional Activity Brief Scale (HSS Pedi-FABS), and Single Assessment Numeric Evaluation (SANE) scores were collected. Of 85 adolescent patients aged 11.1 to 17.6 years (mean age, 14.1 ± 1.2 years), 2 patients were determined to be lost to follow-up after 3 failed contact attempts. Of the patients included in this study (N = 83), 26 patients (31%) underwent all-epiphyseal and 57 patients (69%) underwent complete transphyseal ACLR. Additionally, 48 patients (58%) underwent concomitant lateral extra-articular tenodesis using the iliotibial band with a modified Lemaire technique. The mean follow-up time was 3.7 ± 1.2 years (range, 2-7 years). Twenty (24%) patients had subsequent surgical procedures, of which 3 (4%) were due to graft failures. At a mean 3-year follow-up, the mean Pedi-IKDC, HSS Pedi-FABS, and SANE scores were 90, 23, and 94 respectively; the RTS rate was 100%; and the rate of RTS at the previous level of performance was 93%. Use of a soft tissue QTA for ALCR in a high-risk skeletally immature population of athletes resulted in excellent postoperative outcomes with low rates of graft failure and high return to sport rates.

Implementing financial toxicity and health-related social risks screening and referral.

11006 Background: Financial toxicity (FT), or cancer-related economic hardship, is associated with delayed/skipped care, reduced quality of life, and worse mortality. Screening for FT and health-related social risks (HRSR) as part of assessment for social determinates of health is currently being integrated into clinical care, but there is limited research on outcomes after patients screen positive for FT or HRSR. Methods: We conducted FT and HRSR screening for patients receiving treatment for breast, gynecologic, gastrointestinal, or thoracic cancer at an urban comprehensive cancer center. Screening included the 11-item Comprehensive Score for Financial Toxicity (COST) tool (scored 0-44, lower scores = worse FT) and a HRSR checklist to identify food, housing, medicine, and transportation insecurity. A COST score ≤20 or any endorsed HRSR was considered a positive screen, and financial/assistance counseling referral was offered. Multivariable logistic regression assessed associations of accepting referral, after controlling for demographic and clinical characteristics. Data were collected 09/2022-08/2023. Results: 28,606 patients completed screening, of which 32% (n = 9106) screened positive. Median COST was 16.0. Identified HRSR were: 23% food, 25% housing, 21% medicine, and 24% transportation insecurity. Of positive screens, 51% (n = 4683) requested some form of financial counseling. Associations with accepted referral include: higher FT (β = 1.15, 95% CI: 1.13, 1.16), younger age (β = 1.01, 95% CI: 1.008, 1.02), more essential needs (β = 1.19, 95% CI: 1.13, 1.25), non-White race/ethnicity (β = 1.70, 95% CI: 1.49, 1.93), and stage 3 (β = 1.29, 95% CI: 1.08, 1.53) or stage 4 (β = 1.26, 95% CI: 1.07, 1.49) diagnoses (vs. stage 0/1). Needs of patients who requested counseling included concerns relating to out-of-pocket expenses (68%), non-medical expenses (39%), health insurance coverage (23%), and paying for prescription medication (18%; not mutually exclusive). Of financial counseling sessions with available dispositions (n = 2336/4683, 50%), outcomes (not mutually exclusive) included general counseling (29%), referral to specific assistance programs (e.g., copay assistance, reduced cost care program; 15%), and insurance navigation (15%). One-third of patients requesting counseling did not respond to contact attempts; 21% reported no longer being interested in counseling upon contact. Conclusions: Screening for FT and HRSR was feasible, and one-third of patients were identified as at risk for FT or having an unmet essential need. Patients known to have worse FT outcomes (those with later-stage disease, younger age, higher FT, minoritized groups) were more likely to accept financial counseling; however, only one-half of those at risk accepted help. Future work will focus on improving workflows to ensure assistance meets patient needs, including addressing patient stigma around requesting help.

#2609 Comparison of baseline patient characteristics of the CONVINCE randomized controlled trial with existing trial and registry populations

Abstract Background and Aims The generalizability of randomized controlled trials (RCTs) results is based on representativeness of the population involved. Trial populations may have different baseline characteristics compared to the general population that could benefit from the intervention. We compare the baseline characteristics of patients involved in the CONVINCE trial with those involved in all previous RCTs and representative registries of patients receiving hemodialysis as renal replacement therapy. Method Based on world class methods for systematic reviews, we identified all RCTs comparing hemodiafiltration (HDF) with hemodialysis (HD) published up to January 2024 and extracted data on baseline patient characteristics. Where data were missing, authors have been contacted and data so far obtained were included in this analysis (Fig. 1). Additional contact attempts are being performed. In addition, a comprehensive search was conducted to identify renal registries from all geographic regions. Those without information in English, without information on HDF and registries focusing on special patient groups (e.g. transplantation only) were excluded. This registry data will not be analyzed in this abstract as we are in progress of extracting the patient data from the latest registry annual reports available up to January 2024 for further analysis. Results We have selected 11 RCTs for further analysis, with the selection criteria and outcomes presented in Fig. 1. Key patient characteristics from RCTs were compared with those of patients in the CONVINCE trial using descriptive statistics and forest plots (Fig. 1). Comparison of differences was analyzed with the Kruskal-Wallis-Test. Interpretation of the results are as follows: • Age: Mean age of 76.5 years noted in Morena et al. (2017) because study inclusion criterion was ≥65 years. Other RCTs ranged from 54.1 to 68 years, which is consistent with 62.4 years in the CONVINCE trial (χ2 = 10, df = 10, p = 0.44). • Sex: 16.7% and 50% female noted in Selby et al. (2006) and Meert et al. (2009) respectively probably due to limited sample size (12 patients and 14 patients respectively). Other RCTs ranges from 30.4% to 42.5%, which is consistent with 36.0% in the CONVINCE trial (χ2 = 11, df = 11, p = 0.44). • Diabetes comorbidities: Ranges from 17.8% to 45%. CONVINCE trial is 35.0% (χ2 = 6, df = 6, p = 0.42). • Cardiovascular diseases comorbidities: Range from 26.4% to 45%. CONVINCE trial is 45% (χ2 = 3, df = 3, p = 0.39). • AVF as vascular access: value of 100% in Pedrini et al. (2011) because it was an inclusion criterion. Other RCTs ranged from 79.4% to 90%, which is consistent with 82% in the CONVINCE trial (χ2 = 7, df = 7, p = 0.43). There were no significant differences between CONVINCE and other RCTs data regarding all 5 patient baseline characteristics. Conclusion Our analysis showed the CONVINCE trial has no significant differences in patient baseline characteristics compared to previous RCTs. For a more comprehensive evaluation of representativeness of the trial's population, we are currently retrieving missing data from the trial authors and analyzing data from hemodialysis registries.

Development of a Medication Refill System - A Collaboration Between Telemedicine and Pharmacy Departments

Background: The Saturday Clinic for the Uninsured (SCU) has an on-site dispensary that provides free medications to patients. Many patients request urgent refills when they run out leaving them without medications prior to their appointments. A prior study showed a reminder phone call can effectively assist with medication refills.1 However, little data exists for how to develop such a system at a free clinic. Our team implemented this methodology utilizing a system where patients were contacted before their medications ran out to arrange refills and analyzed its effectiveness. Methods: All clinic patients receiving medications from the on-site dispensary had their expected refill date logged. Patients 3 weeks away from needing a refill had their chart reviewed to determine if they should be contacted. When indicated, patients were contacted one time via telephone by students to assess their needs and schedule refills. System outcomes were gathered over 18 weeks and analyzed to determine the number of potential medication gaps prevented and system success rate. Results: 131 patient charts were reviewed for potential follow-up. 58 patients were contacted, of which 32 patients were reached and spoken with resulting in 32 refills scheduled. The system prevented 24.4% of potential medication gaps with a system success rate of 55.2%. Conclusion: This system successfully reduced medication gaps among patients. The most and least effective methods for scheduling refills were by directly speaking with patients and leaving voicemails respectively. A trend observed was a decrease in urgent patient calls regarding medication gaps. Future directions include making multiple contact attempts, using multiple contact methods including texts and emails, and evaluating adherence.

Design, Methods, and Participation in Riksmaten Young Children—A Swedish National Dietary Survey

BackgroundNational dietary surveys provide essential data for risk benefit assessments of foods and nutrients, for management and policy development. Physical activity measurement and biomonitoring can provide important complementary data but are less commonly included. ObjectivesThis study aimed to describe the study design and methods of the cross-sectional Swedish national dietary survey Riksmaten Young Children (Riksmaten småbarn), of children aged 9 mo, 18 mo, and 4 y. Participation/dropout rates for the 2 older age groups are also presented. The impact of different recruitment strategies is discussed. MethodsChildren (N = 16,655) were randomly selected from the population register; invitations to guardians were sent by post and where possible, followed up by telephone. Food intake was assessed by a 2-d food diary and/or questionnaire. Height and weight were reported after measurement. Physical activity (accelerometery, 7 d) and stool, blood, and urine samples were assessed in subgroups. ResultsFood consumption data were collected in 1828 children (11% of the invited; 18 mo: n = 1078, and 4 y: n = 750). Of participants also in subgroups, 71% provided physical activity data (n = 1307), 60% stool samples (n = 630), and 51% blood and/or urine samples (n = 593). The study population represented all geographic regions and types of municipalities in Sweden, but participating households had both higher education level and higher income than the target population. Only minor differences were seen in participation rates between recruitment via post and telephone compared with those through post only (12% compared with 10%). Repeated contact attempts were needed for the majority of participants (65%). Despite the low-participation rate, 99% of the participants completed the study once started. ConclusionsAlthough it was a challenge to recruit participants, Riksmaten Young Children provides a substantial amount of information at national level, representative in terms of sex, geography, and family structure. The underrepresentation of households with lower socioeconomic position must be considered when generalizing results.

Evaluating the Reach of a Patient Navigation Program for Follow-up Colonoscopy in a Large Federally Qualified Health Center.

Patient navigation (PN) has been shown to improve participation in cancer screening, including colorectal cancer screening, and is now a recommended practice by the Community Preventive Services Task Force. Despite the effectiveness of PN programs, little is known about the number of contacts needed to successfully reach patients or about the demographic and healthcare utilization factors associated with reach. PRECISE was an individual randomized study of PN versus usual care conducted as a partnership between two large health systems in the Pacific Northwest. The navigation program was a six-topic area telephonic program designed to support patients with an abnormal fecal test result to obtain a follow-up colonoscopy. We report the number of contact attempts needed to successfully reach navigated patients. We used logistic regression to report the demographic and healthcare utilization characteristics associated with patients allocated to PN who were successfully reached. We identified 1,200 patients with an abnormal fecal immunochemical test result, of whom 970 were randomized into the study (45.7% were female, 17.5% were Spanish-speaking, and the mean age was 60.8 years). Of the 479 patients allocated to the PN intervention, 382 (79.7%) were reached within 18 call attempts, and nearly all (n = 356; 93.2%) were reached within six contact attempts. Patient characteristics associated with reach were race, county of residence, and body mass index. Our findings can guide future efforts to optimize the reach of PN programs. Prevention Relevance: The findings from this large study can inform clinic-level implementation of future PN programs in Federally Qualified Health Centers to improve the reach of patients needing cancer screenings, optimize staff resources, and ultimately increase cancer screenings.

Does it Pay to Send Multiple Pre-Paid Incentives? Evidence from a Randomized Experiment

To encourage survey participation and improve sample representativeness, the Survey of Consumer Finances (SCF) offers an unconditional pre-paid monetary incentive and separate post-paid incentive upon survey completion. We conducted a pre-registered between-subject randomized control experiment within the 2022 SCF, with at least 1,200 households per experimental group, to examine whether changing the pre-paid incentive structure affects survey outcomes. We assess the effects of: (1) altering the total dollar value of the pre-paid incentive (“incentive effect”), (2) giving two identical pre-paid incentives holding the total dollar value fixed (“reminder effect”), and (3) offering multiple pre-paid incentives of different amounts holding the total dollar value fixed (“slope effect”) on survey response rates, interviewer burden, and data quality. Our evidence indicates that a single $15 pre-paid incentive increases response rates and maintains similar levels of interviewer burden and data quality, relative to a single $5 pre-paid incentive. Splitting the $15 into two pre-paid incentives of different amounts increases interviewer burden though lengthening time in the field without improving response rates, reducing the number of contact attempts needed for a response, or improving data quality, regardless of whether the first pre-paid is larger or smaller than the second.

Personalised versus standard text message prompts for increasing trial participant response to telephone follow-up: an embedded randomised controlled retention trial

BackgroundImproving retention within randomised controlled trials is important. The effectiveness of different strategies can be assessed using a Study Within A Trial (SWAT). Previous research has shown personalised text message reminders improve clinic attendance rates; however, the results are mixed on improving postal questionnaire return. This SWAT aims to assess whether personalised text message reminders improve completion rates for scheduled telephone follow-ups.MethodsThis SWAT is a two-arm, multi-centre randomised controlled trial with equal allocation. The host trial was the Melatonin for Anxiety prior to General anaesthesia In Children trial (ISRCTN 18296119), where the child’s caregiver was to answer a scheduled telephone follow-up 14 days post-surgery; participants for the SWAT were therefore the caregiver. Text messages were sent 24–48 h before the scheduled call and the personalised version contained the first name of the caregiver which was omitted in the non-personalised version. The primary outcome was questionnaire completion rate, defined as the proportion of caregivers successfully contacted, and completed any of the questionnaires, over the telephone within the follow-up window (day 14 + 7 days).ResultsThe SWAT included 100 of the 110 (91%) participants randomised into the host trial. Randomisation within the SWAT was equal between non-personalised (n = 50) and personalised (n = 50) interventions. The overall questionnaire response rate was 73% with a difference between the two interventions of 68% in the non-personalised text message arm and 78% in the personalised text message arm. The adjusted absolute risk difference was 7.1% (95% confidence interval = −10.2%, 24.4%). There was no difference in either the time to response or the number of contact attempts between the two interventions.ConclusionsThere is some evidence that personalised text messages could be effective at increasing response rates when data is collected via telephone and in a population of caregivers for paediatric trial participants. However, similar SWATs have shown mixed results. Given the low-cost and low risks associated with personalising text message reminders, this SWAT could be implemented easily in other RCTs scheduling telephone follow-up appointments.Trial RegistrationISRCTN 18296119, SWAT 35 (MRC Northern Ireland Network for Trials Methodology Network).

Privacy and confidentiality in Massachusetts' post-overdose outreach programs: Mixed methods analysis of outreach staff surveys and interviews

BackgroundPublic health-public safety partnerships for post-overdose outreach have emerged in many communities to prevent future overdose events. These efforts often identify overdose survivors through emergency call data and seek to link them with relevant services. The aim of this study was to describe how post-overdose outreach programs in Massachusetts manage the confidentiality of identifiable information and privacy of survivors. MethodsIn 2019, 138 Massachusetts programs completed surveys eliciting responses to questions about program operations. Descriptive statistics were calculated from the closed-ended survey responses. Thirty-eight interviews were conducted among outreach staff members during 2019–2020. Interview transcripts and open-ended survey responses were thematically analyzed using deductive and inductive approaches. ResultsOf programs that completed the survey, 90 % (n = 124/138) reported acting to protect the privacy of survivors following overdose events, and 84 % (n = 114/135) reported implementing a protocol to maintain the confidentiality of personal information. Interviews with outreach team members indicated substantial variation in practice. Outreach programs regularly employed discretion in determining actions in the field, sometimes undermining survivor privacy and confidentiality (e.g., by disclosing the overdose event to family members). Programs aiming to prioritize privacy and confidentiality attempted to make initial contact with survivors by phone, limited or concealed materials left behind when no one was home, and/or limited the number of contact attempts. ConclusionsDespite the establishment of privacy and confidentiality protocols within most post-overdose outreach programs, application of these procedures was varied, discretionary, and at times viewed by staff as competing with engagement efforts. Individual outreach overdose teams should prioritize privacy and confidentiality during outreach to protect overdose survivors from undesired exposure. In addition to individual program changes, access to overdose survivor information could be changed across all programs to bolster privacy and confidentiality protocols. For example, transitioning the management of overdose-related information to non-law enforcement agencies would limit officers’ ability to disseminate such information at their discretion.

CONECTAR: A MINDSET TO INCREASE HISPANIC ENGAGEMENT IN DIGITAL TECHNOLOGY RESEARCH

Abstract In-home digital technology affords the opportunity for more precise and ecologically valid assessments of daily activity engagement. However, concerns about loss of privacy can hinder recruitment, especially within communities already underrepresented in research. Literature on effective, culturally tailored recruitment strategies is limited. Herein, we describe strategies employed for an in-home digital technology study with 100% Mexican American representation. Hispanic participants were recruited from the greater San Antonio area. Direct recruitment strategies conducted in both English and Spanish included community outreach events, a participant repository, cross-enrollment with other research studies, and by word of mouth. Mass recruitment strategies included flyer dissemination, newsletters, and digital announcements through community organizations (i.e., Salud America!) and national (i.e., Research Match) and institutional websites. Between September 2022 and February 2023, 31 participants were enrolled out of 154 individuals who were contacted. Of these, 29% were recruited from community events, 22.6% from word of mouth, 19.4% from cross-enrollment, 12.9% from the research repositories, and 16.1% from mass recruitment strategies. The most common reasons for non-enrollment included lack of interest (n=49), screen failure (n=29), and privacy concerns (n=12).Direct recruitment efforts achieved higher rates of enrollment, while mass media campaigns yielded lower responses and resulted in more unsuccessful contact attempts. Understanding the relationship between social networks and research beliefs may be particularly relevant given the Hispanic culture’s collectivist and family-oriented nature. Hence, social network theories, combined with a diffusion of innovation framework, may be advantageous for increasing trust and may consequently improve representation of diverse groups in research.

RECRUITMENT AND RETENTION AMONG A LONGITUDINAL COHORT OF AGING ADULTS: EXPERIENCES OF THE WOODLAWN STUDY

Abstract Minimizing participant attrition is critical to the success of longitudinal studies, but locating and retention is challenging when assessments occur decades apart. This poster will describe efforts to locate participants from the Woodlawn Study, a longitudinal cohort of 1,242 Black Americans followed since 1966 who were assessed at ages 6, 16, 32, and 42. In 2021-2023, two decades since the last assessment, we attempted to locate 1038 participants still thought to be alive to complete an Age 62 interview. Key sources for locating were online contact information databases, genealogical records, and public property records. Deceased participants were identified via National Death Index records. Strategies to encourage participation included monetary incentives, flexible scheduling options, and sharing results from previous assessments. To date, 90.8% have been located, 2.5% are unlocatable, and 6.6% have been identified as newly deceased. Although the cohort originated in Chicago, participants were located in more than 25 states. Interviews were completed with 45.7% of located participants. Approximately one-third (37.7%) did not respond to contact attempts, 6.4% were hard refusals, and 10.3% were soft refusals. Mailed letters and phone calls were the most successful contact methods; social media and email were not fruitful. Interview completion rates were highest for participants who participated at Age 42 (51.4%) and lowest among participants not reached since Age 6 (5.3%). Recruitment challenges included non-response to phone calls, suspicion about scams, and unknown accuracy of locating information. Implications for locating and maintaining aging cohort members will be presented.

Effect of Automated and Personalized Outreach Messages on Well-Child Visit Catch Up: A Randomized Clinical Trial

ObjectiveTo determine the effectiveness of text/telephone outreach messages and personal contact attempts on well-child care (WCC) scheduling and completion and measles, mumps, and rubella (MMR) vaccine receipt. MethodsWe conducted an intent-to-treat, 2 × 2 factorial randomized clinical trial with 3 replications at 3 academic pediatric primary care practices from September 27, 2020 to August 6, 2021. We randomized participants to 1 of 4 groups: 1 automated message (group 1), 2 automated messages (group 2), 1 automated message plus personal contact attempts (group 3), or 2 automated messages plus personal contact attempts (group 4). Outcomes included: 1) scheduled WCC within 2 weeks (secondary outcome), 2) completed WCC within 8 weeks (secondary outcome), 3) receipt of first MMR by 15 months of age or second MMR within 3 months of first message for 4-year-olds (primary outcome). ResultsWe randomized 1312 patients (mean [SD] age = 38.8 [19.3] months, 53.5% male, 72.8% non-Hispanic Black, 86.9% Medicaid-enrolled). Scheduling rates were significantly higher in groups with personal contact attempts compared to those without (1 = 15.2%, 2 = 12.5%, 3 = 29.3%, and 4 = 31.5%). WCC completion rates also differed across groups: 1 = 27.4%, 2 = 22.3%, 3 = 32.0%, and 4 = 29.4%, with groups 3 and 4 having significantly higher rates than group 2. Similarly, groups 3 (30.2%) and 4 (31.8%) had significantly higher rates of receiving the MMR vaccine compared to group 2 (23.5%) but not group 1 (28.0%). ConclusionsOutreach messages that were followed by personal contact attempts increased the rates of scheduling and completing WCCs and receiving the MMR vaccine, providing a useful tool to re-engage at-risk populations.

Responsive and Adaptive Designs in Repeated Cross-National Surveys: A Simulation Study

AbstractCross-national surveys run the risk of differential survey errors, where data collected vary in quality from country to country. Responsive and adaptive survey designs (RASDs) have been proposed as a way to reduce survey errors, by leveraging auxiliary variables to inform fieldwork efforts, but have rarely been considered in the context of cross-national surveys. Using data from the European Social Survey, we simulate fieldwork in a repeated cross-national survey using RASD where fieldwork efforts are ended early for selected units in the final stage of data collection. Demographic variables, paradata (interviewer observations), and contact data are used to inform fieldwork efforts. Eight combinations of response propensity models and selection mechanisms are evaluated in terms of sample composition (as measured by the coefficient of variation of response propensities), response rates, number of contact attempts saved, and effects on estimates of target variables in the survey. We find that sample balance can be improved in many country-round combinations. Response rates can be increased marginally and targeting high propensity respondents could lead to significant cost savings associated with making fewer contact attempts. Estimates of target variables are not changed by the case prioritizations used in the simulations, indicating that they do not impact nonresponse bias. We conclude that RASDs should be considered in cross-national surveys, but that more work is needed to identify suitable covariates to inform fieldwork efforts.

Challenges in recruiting frequent users of ambulance services for a community paramedic home visit program

BackgroundThe Community Paramedicine at Home (CP@home) program is a health promotion program where community paramedics conduct risk assessments with frequent 9-1-1 callers in their homes, with a goal of reducing the frequency of 9-1-1 calls in this vulnerable population. The effectiveness of the CP@home program was investigated through a community-based RCT conducted in four regions in Ontario, Canada. The purpose of this current recruitment study is to examine the challenges met when recruiting for a community randomized control trial on high frequency 9-1-1 callers.MethodsEligible participants were recruited from one of four regions participating in the CP@home program and were randomly assigned to an intervention group (n = 1142) or control group (n = 1142). Data were collected during the recruitment process from the administrative database of the four paramedic services. Whether they live alone, their parental ethnicity, age, reason for calling 9-1-1, reason for not participating, contact method, and whether they were successfully contacted were recorded. Statistical significance was calculated using the Chi-Squared Test and Fisher’s Exact Test to evaluate the effectiveness of the recruitment methods used to enroll eligible participants in the CP@home Program.ResultsOf the people who were contacted, 48.0% answered their phone when called and 53.9% answered their door when a home visit was attempted. In Total, 110 (33.1%) of people where a contact attempt was successful participated in the CP@home program. Most participants were over the age of 65, even though people as young as 18 were contacted. Older adults who called 9-1-1 for a lift assist were more likely to participate, compared to any other individual reason recorded, and were most often recruited through a home visit.ConclusionsThis recruitment analysis successfully describes the challenges experienced by researchers when recruiting frequent 9-1-1 callers, which are considered a hard-to-reach population. The differences in age, contact method, and reason for calling 9-1-1 amongst people contacted and participants should be considered when recruiting this population for future research.

Predicting Days to Respondent Contact in Cross-Sectional Surveys Using a Bayesian Approach

Abstract Surveys estimate and monitor a variety of data collection parameters, including response propensity, number of contacts, and data collection costs. These parameters can be used as inputs to a responsive/adaptive design or to monitor the progression of a data collection period against predefined expectations. Recently, Bayesian methods have emerged as a method for combining historical information or external data with data from the in-progress data collection period to improve prediction. We develop a Bayesian method for predicting a measure of case-level progress or productivity, the estimated time lag, in days, between first contact attempt and first respondent contact. We compare the quality of predictions from the Bayesian method to predictions generated from more commonly-used predictive methods that leverage data from only historical data collection periods or the in-progress round of data collection. Using prediction error and misclassification as short- or long- day lags, we demonstrate that the Bayesian method results in improved predictions close to the day of the first contact attempt, when these predictions may be most informative for interventions or interviewer feedback. This application adds to evidence that combining historical and current information about data collection, in a Bayesian framework, can improve predictions of data collection parameters.

1132-P: It Takes 6!—Recruiting Marginalized Youth with T1D for Shared Medical Appointments (SMA) Pilot Study

Introduction: Minority youth are underrepresented in diabetes technology trials. An ongoing pilot study is recruiting 20 publicly insured, insulin pump naive youth ages 8-12 with T1D who identify as NHB or Latinx with recent HbA1c &amp;gt;8% to participate in a study using SMAs to improve T1D self-management and sustained CGM use. We aimed to identify the most successful recruitment strategies. Methods: Potentially eligible youth are identified through weekly review of diabetes appointments. Families are then contacted in-person at a clinic visit, by phone, or text-message. We reviewed the number of in-person, phone, and text-message attempts for all eligible participants, as well as the number of youth who enrolled, refused, or who have not yet been successfully contacted. Results:79 youth were identified as potentially eligible. 56% (n=44, 16±13 contact attempts) have been successfully contacted; 18% (n=14, 6±4 contact attempts) enrolled. 64% (n=9/14) of enrolled and 18% (n=12/65) of non-enrolled were approached at a clinic visit, 14% (n=2/14) of enrolled and 40% (n=26/65) of non-enrolled via phone, and 50% (n=7/14) of enrolled and 46% (n=30/65) of non-enrolled via text-message (p&amp;lt;0.001). 38% (n=6/16) of those who scheduled an enrollment visit after being contacted by phone/text attended the visit versus 63% (n=10/16) contacted at a clinic visit (p&amp;lt;0.001). 38% (n=30, 10±9 contact attempts) refused to participate; 27% (n=9) did not want to travel to the study site, 17% (n=5) refused CGM, and 53% (n=16) declined research participation. 46% (n=35, 12±5 contact attempts) have not yet been successfully contacted. Conclusions: Historically marginalized youth enrolling in this SMA study required an average of 6 contact attempts for study participation. Purposeful in-person recruitment strategies, being mindful of the low rates of technology use among this community and mistrust in the healthcare system, is needed to promote diversity and inclusion in T1D research. Disclosure J.Grundman: Research Support; American Diabetes Association, Dexcom, Inc. S.Majidi: None. A.G.Perkins: Research Support; Tandem Diabetes Care, Inc., Dexcom, Inc. R.Streisand: None. M.Monaghan: Employee; National Institute of Diabetes and Digestive and Kidney Diseases, Research Support; American Diabetes Association. B.E.Marks: Research Support; Tandem Diabetes Care, Inc., Dexcom, Inc., Medtronic. Funding American Diabetes Association (7-21-PDFHD-09 to J.G.)