Successful Recruitment Of Participants Research Articles

Abstract B116: Overcoming barriers in recruiting medically underserved patients with lung cancer: The NutriCare study, a "Food is Medicine" intervention

Abstract Despite recent efforts to expand clinical trial eligibility criteria to involve traditionally underserved patient populations, less than 5% of patients diagnosed with cancer choose to participate in clinical trials (lifestyle, behavioral or pharmaceutical), of which only a small fraction represents underserved or vulnerable populations. The barriers that contribute to these trends are multifactorial. Examining sociodemographic and clinical characteristics may provide insight into successful participant recruitment and retention of underrepresented groups in clinical trials. The NutriCare study (NCT04986670) is a national, multisite, randomized controlled trial evaluating the impact of medically tailored meals plus weekly nutritional counseling on the outcomes of vulnerable patients with treatment-naïve lung cancer initiating treatment. Eligibility criteria defining vulnerability included: ≥65 years of age; underrepresented minority; rural resident; no health insurance; or income ≤130% of federal poverty line. To remain on study, eligible participants also completed a 90-minute baseline assessment within 8 weeks of study consent. A comprehensive list of screened patients was maintained throughout the course of the study, including approach attempts and refusal reasons for participation. Strategies to improve recruitment included obtaining referrals from the treating physician and inclusion of the study dietitian during the informed consent process. Descriptive statistics were used to summarize the recruitment and retention of vulnerable patients. Overall, 438 participants were screened in Phase I of this study at The Ohio State University and MD Anderson (Nov, 2020 – Aug, 2022), of which 116 (26%) participants consented to the study. Of these 116 participants, 76 (66%) were 65 years of age or older, 42 (36%) lived in a rural area, 21 (18%) identified as a racial or ethnic minority, and 27 (23%) met federal poverty levels. As the study progressed, 44 (38%) patients withdrew between baseline to 3-months,18 (16%) patients withdrew between the 3-month to 8-month timepoints, and a total of 54 (47%) participants completed the study. The highest retention rates were identified among those <65 years (58%), males (52%), early-stage lung cancer (69%), racial or ethnic minorities (62%), non-rural residents (50%) and those above the federal poverty line (48%). Barriers to completing the study included rapid decline in performance status among those diagnosed with late/extensive stage lung cancers (16%), treatment impacting taste and appetite (8%), and logistical complications with the meal intervention (3%). Barriers to recruitment and willingness to participate during the NutriCare trial were similar across recruiting sites. Future trials should consider implementation of a crossover study design, local and customized food delivery services, and measurements of time toxicity related to survey completion as an outcome. These efforts may improve clinical trial participation and provide more supportive care needs for vulnerable patients with lung cancer. Citation Format: Hazel M. Antao, Kenneth Kwan Ho Chui, Jade Smith, Pooja Vibhakar, Mary Kathryn Cohen, Jessica Bauman, Saumil Gandhi, Joya Chandra, Lori Pai, Fang Fang Zhang, Colleen Spees, Carolyn Presley. Overcoming barriers in recruiting medically underserved patients with lung cancer: The NutriCare study, a "Food is Medicine" intervention [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B116.

Implementing Patient-Centered Outcomes Research Institute Stakeholder Engagement Principles in Models of Palliative Care Delivery and Advance Care Planning Research.

Given the many challenges of conducting research that addresses the palliative and end-of-life care needs of patients with serious illnesses, stakeholder engagement starting from the moment of study conceptualization and design is critical to ensure successful participant recruitment, data collection, intervention delivery, data analysis, and dissemination. Guided by a conceptual model published by the Patient-Centered Outcomes Research Institute (PCORI) entitled, "Measuring What Matters for Advancing the Science and Practice of Engagement"14 and with the support of a PCORI Engagement Officer, representatives from 9 PCORI-funded study teams formed a working group to survey team members and review, outline, and describe key lessons learned and best practices for promoting stakeholder engagement in palliative care research. Almost all study teams engaged with patients/caregivers, clinicians, researchers, and health care system experts as stakeholder partners. About half the teams also included payers and training institutions as part of their stakeholder advisors as well as a range of content experts. Study teams relied on a variety of support structures and resources, and they employed 10 distinct methods for maintaining engagement. All engagement methods were generally considered to be effective by teams who used the method, though there was some variability in team-rated engagement quality of each method. Nine barriers to stakeholder engagement were identified across the 9 studies as well as 9 strategies (or facilitators) to overcome these barriers. We share examples of how stakeholder engagement impacted studies in all phases, including the preparatory phase, study initiation phase, execution phase, and data analysis/dissemination phase. Teams utilized a variety of resources and support structures as well as capitalized on multiple engagement methods for fostering stakeholder engagement, resulting in a high level of collaboration and integration.

A multidomain lifestyle intervention to maintain optimal cognitive functioning in Dutch older adults—study design and baseline characteristics of the FINGER-NL randomized controlled trial

BackgroundEvidence on the effectiveness of multidomain lifestyle interventions to prevent cognitive decline in older people without dementia is mixed. Embedded in the World-Wide FINGERS initiative, FINGER-NL aims to investigate the effectiveness of a 2-year multidomain lifestyle intervention on cognitive functioning in older Dutch at risk individuals.MethodsMulti-center, randomized, controlled, multidomain lifestyle intervention trial with a duration of 24 months. 1210 adults between 60–79 years old with presence of ≥ 2 modifiable risk factors and ≥ 1 non-modifiable risk factor for cognitive decline were recruited between January 2022 and May 2023 via the Dutch Brain Research Registry and across five study sites in the Netherlands. Participants were randomized to either a high-intensity or a low-intensity intervention group. The multidomain intervention comprises a combination of 7 lifestyle components (physical activity, cognitive training, cardiovascular risk factor management, nutritional counseling, sleep counseling, stress management, and social activities) and 1 nutritional product (Souvenaid®) that could help maintain cognitive functioning. The high-intensity intervention group receives a personalized, supervised and hybrid intervention consisting of group meetings (on-site and online) and individual sessions guided by a trained lifestyle coach, and access to a digital intervention platform that provides custom-made training materials and selected lifestyle apps. The low-intensity intervention group receives bi-monthly online lifestyle-related health advice via the digital intervention platform. Primary outcome is 2-year change on a cognitive composite score covering processing speed, executive function, and memory.ResultsWithin 17 months, participant recruitment has been successfully completed (N = 1210; mean age: 67.7 years (SD: 4.6); 64% female). Modifiable risk factors commonly present at baseline were physical inactivity (89%), low mental/cognitive activity (50%), low social engagement (39%), hypertension (39%) and high alcohol consumption (39%). The mean body mass index of participants was 28.3 (SD: 4.2) and the total serum cholesterol was 5.4 mmol/L (SD: 1.2).ConclusionsBaseline lifestyle and clinical measurements showed successful recruitment of participants with sufficient potential for prevention. Results of FINGER-NL will provide further insight into the efficacy of a multidomain lifestyle intervention to prevent cognitive decline in older adults.Trial registrationClinicalTrials.gov (ID: NCT05256199)/2022–01-11.

The Feasibility and Acceptability of a Data Capture Methodology in Pediatric Cancer Patients Treated with Targeted Agents and Immunotherapies.

As childhood cancer treatments have improved to include new and innovative agents, the need for more advanced monitoring of their long-term effects and related research has increased. This has resulted in a need for evidence-based research methodologies for the longitudinal care of childhood cancer patients treated with targeted agents and immunotherapies. The rationale for this pilot study was to determine the feasibility and acceptability of a data capture methodology for pediatric, adolescent, and young adult cancer patients treated with targeted agents and immunotherapy as there is little research to inform this delivery of care. Data were collected from thirty-two patients and two providers for descriptive statistics and thematic analyses. Feasibility was characterized by expected participant attrition. Key drivers of acceptability were (1) providers' language and clarity of communication and (2) convenient participation requirements. Long-term follow-up research practices developed with input from key stakeholders, including patients, caregivers, and providers, can lead to acceptable and feasible research protocols that optimize successful participant recruitment. These evidence-based research practices can result in high participant satisfaction and can be implemented as program development initiatives across centers caring for childhood cancer survivors.

Recruitment Barriers of an mHealth Pediatric Asthma Pilot Study.

Successful participant recruitment for pediatric studies can be challenging and even result in study discontinuation. In conducting a 2-year pilot study for a pediatric mobile health (mHealth) asthma intervention, a group of researchers experienced multiple barriers and failures in all 4 areas of recruitment: generating initial contacts, screening, consenting, and enrollment and retention. The main failures that resulted in minimal participant enrollment were poor participation, communication issues, and difficulties related to recruiting in an emergency department during a pandemic. The following is a report on this study's recruitment efforts, including preliminary and adapted strategies, the results of these strategies, and considerations for researchers who conduct studies with children. The research team concluded that frequent and clear communication, flexibility, and a willingness to alter initial recruitment plans are essential elements for recruitment success in pediatric studies.

Uncovering key clinical trial features influencing recruitment.

Randomized clinical trials (RCT) are the foundation for medical advances, but participant recruitment remains a persistent barrier to their success. This retrospective data analysis aims to (1) identify clinical trial features associated with successful participant recruitment measured by accrual percentage and (2) compare the characteristics of the RCTs by assessing the most and least successful recruitment, which are indicated by varying thresholds of accrual percentage such as ≥ 90% vs ≤ 10%, ≥ 80% vs ≤ 20%, and ≥ 70% vs ≤ 30%. Data from the internal research registry at Columbia University Irving Medical Center and Aggregated Analysis of ClinicalTrials.gov were collected for 393 randomized interventional treatment studies closed to further enrollment. We compared two regularized linear regression and six tree-based machine learning models for accrual percentage (i.e., reported accrual to date divided by the target accrual) prediction. The outperforming model and Tree SHapley Additive exPlanations were used for feature importance analysis for participant recruitment. The identified features were compared between the two subgroups. CatBoost regressor outperformed the others. Key features positively associated with recruitment success, as measured by accrual percentage, include government funding and compensation. Meanwhile, cancer research and non-conventional recruitment methods (e.g., websites) are negatively associated with recruitment success. Statistically significant subgroup differences (corrected p-value < .05) were found in 15 of the top 30 most important features. This multi-source retrospective study highlighted key features influencing RCT participant recruitment, offering actionable steps for improvement, including flexible recruitment infrastructure and appropriate participant compensation.

Perceptions and attitudes toward participation in clinical research in the Eastern Mediterranean Region: A systematic review.

Introduction:Successful recruitment of participants into clinical research has always been challenging and is affected by many factors. This systematic review aimed to explore the perceptions and attitudes as well as identify the factors affecting the participation in clinical research among the Eastern Mediterranean Regional Office countries’ population.Methods:A systematic search of the literature was conducted to explore attitudes or perceptions of the general public or patients towards participation in clinical research. PubMed, Pro-Quest Central, World Health Organizations Index Medicus for the Eastern Mediterranean Region, and Google Scholar were searched. Studies were considered eligible for inclusion if they presented primary data and were conducted in one of the Eastern Mediterranean Regional Office countries. A data extraction sheet was used to record the following: year, country, aim, population, sample size, study design, data collection, and setting. The identified factors from the included studies were categorized into motivators and barriers.Results:In total, 23 original research articles were identified that addressed perceptions or attitudes towards clinical research participation. Six main motivators and barriers of research participation among patients, the general public, and patient family members were identified. The most common cited motivators included personal benefits to the individual, altruism and the desire to help others, the research process, the influence of the physician, family encouragement, and religion. Concerns regarding safety, confidentiality, and other factors in addition to the research process, lack of trust in healthcare providers or healthcare system, lack of interest in research and no perceived personal benefit, religious concerns, and family/cultural concerns were the most cited barriers to participation.Conclusion:The identified motivators and barriers are essential to tackle during clinical research planning among the population of Eastern Mediterranean Regional Office countries. Further research is needed to assess the attitudes and perceptions of individuals approached to participate in trials.

Recruitment and retention for chronic pain clinical trials: a narrative review.

Opioid misuse is at a crisis level. In response to this epidemic, the National Institutes of Health has funded $945 million in research through the Helping to End Addiction Long-term (HEAL) Pain Management Initiative, including funding to the Vanderbilt Recruitment Innovation Center (RIC) to strategize methods to catalyze participant recruitment. The RIC, recognizing the challenges presented to clinical researchers in recruiting individuals experiencing pain, conducted a review of evidence in the literature on successful participant recruitment methods for chronic pain trials, in preparation for supporting the HEAL Pain trials. Study design as it affects recruitment was reviewed, with issues such as sufficient sample size, impact of placebo, pain symptom instability, and cohort characterization being identified as problems. Potential solutions found in the literature include targeted electronic health record phenotyping, use of alternative study designs, and greater clinician education and involvement. For retention, the literature reports successful strategies that include maintaining a supportive staff, allowing virtual study visits, and providing treatment flexibility within the trial. Community input on study design to identify potential obstacles to recruitment and retention was found to help investigators avoid pitfalls and enhance trust, especially when recruiting underrepresented minority populations. Our report concludes with a description of generalizable resources the RIC has developed or adapted to enhance recruitment and retention in the HEAL Pain studies. These resources include, among others, a Recruitment and Retention Plan Template, a Competing Trials Tool, and MyCap, a mobile research application that interfaces with Research Electronic Data Capture (REDCap).

The Recruitment to Dissemination Continuum in Community-based Participatory Research

The Recruitment to Dissemination Continuum in Community-based Participatory Research Ahmed A. Mohamed, MD, Jennifer L. Ridgeway, PhD, Jane W. Njeru, MB, ChB, Luz E. Molina, Yahye A. Ahmed, Miriam Goodson, MS, Ahmed Osman, Graciela D. Porraz Capetillo, Omar Nur, Irene G. Sia, MD, MSc, and Mark L. Wieland, MD, MPH What Is the Purpose of This Study? • This study analyzes the link between the recruitment and dissemination processes of a community-engaged research study. What Is the Problem? • Findings in community-engaged research studies are almost always shared in scientific articles but only sometimes shared with communities who participate in the studies. • Sharing the results of research studies with communities can have positive effects including encouraging people to participate in future studies, but little is known about the link between dissemination of research findings and future recruitment. What Are the Findings? • This study demonstrated the ways in which recruitment of marginalized populations to research studies and dissemination of study results can manifest as a continuum. • This study shows that trust, relationship building, and capacity building are key features for successful participant recruitment and research dissemination strategies. • Strategies, resources, and relationships used or developed during the recruitment phase of research are directly applied to planning dissemination of results with community partners. • Participants and members of their communities were more likely to participate in future research studies as a result of attending a dissemination event. Who Should Care Most? • Community organizations involved in research partnerships. • Researchers engaged in community-based participatory research. Recommendations for Action • Community academic partnerships should consider building an intentional recruitment to dissemination continuum for their longitudinal work together. [End Page e3] • For successful recruitment and dissemination strategies, community partners and researchers should foster trust and capacity through long-term partnerships. • Dissemination of research findings are encouraged in order to bring attention to health issues that are important for the participating community. Disseminating research findings directly to participants and their communities encourages participation in future research. [End Page e4] Ahmed A. Mohamed Department of Medicine, Mayo Clinic Jennifer L. Ridgeway Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Jane W. Njeru Department of Medicine, Mayo Clinic Luz E. Molina Language Services, Mayo Clinic Yahye A. Ahmed Somali American Social Service Association Miriam Goodson Alliance of Chicanos, Hispanics, and Latin Americans Ahmed Osman Somali American Social Service Association Intercultural Mutual Assistance Association, Rochester Graciela D. Porraz Capetillo Language Services, Mayo Clinic Alliance of Chicanos, Hispanics, and Latin Americans Omar Nur Somali American Social Service Association Irene G. Sia Department of Medicine, Mayo Clinic Mark L. Wieland Department of Medicine, Mayo Clinic Copyright © 2022 Johns Hopkins University Press

Prioritise research on vaccines for pregnant and breastfeeding women

Prioritise research on vaccines for pregnant and breastfeeding women

Lead With the Why: Research Recruitment of Older Adults With HF During COVID-19

Recruitment of older adults with advanced heart failure is notoriously challenging, particularly for doctoral students conducting dissertation research studies with limited financial and personnel resources. Successful recruitment of participants requires a multifaceted recruitment strategy that is mindful of context and sensitive to the clinical partners who provide care in the recruitment setting. This article reflects on these challenges and proposes a practical framework to guide recruitment strategies in future research.

Stroke survivors\u2019 preferences regarding study participation in rehabilitation research

BackgroundTo pursue high quality research, successful participant recruitment is essential, but recruitment rates are often low. This is specifically true in target populations with impairments, for instance, among stroke survivors. Previous studies focusing on recruitment have mainly relied on information from professionals, and there is therefore a need to contribute with new methodological insights to how potential rehabilitation research participants describe their interest and preferences to participate in research. The purpose of this study was to generate knowledge about stroke survivors’ interest in participating in rehabilitation research, reasons for being interested or not, and preferred forms and foci of rehabilitation interventions. An additional aim was to describe preferences regarding survey administration modes and processes for recruitment to studies.MethodThis cross-sectional study recruited Swedish residents who had sustained a stroke, initially by using advertisement on the National Stroke Association’s website, flyers posted at local occupational and physical therapy offices and at local stroke/senior organization meetings. Secondly, participants were recruited through a local stroke register. The survey, administered either in a paper form returned by postal mail; online or as a phone interview with 128 stroke survivors.ResultsMost of the participants were interested in participating in rehabilitation research, particularly younger persons (p = 0.001) and those closer to stroke onset (p = 0.047). Contribution to research, possibility to try new rehabilitation interventions and meeting others in the same situation were reasons that attracted an interest to participate. Other important aspects were related to motivation, individual needs, as well as how skilled the people who provided the intervention were. Participants preferred group-based programs, and programs focusing on regaining lost functions were highly requested. A majority wanted to be contacted through postal mail (70%) and most of them (90%) used the paper form to respond to the survey.ConclusionsA range of personal and external aspects, including challenges related to digitized administration modes, should be considered to achieve high participation rates in rehabilitation research targeting stroke survivors. The importance of addressing individual needs and prerequisites in an individualized manner should not be underestimated and might be a useful strategy to recruitment success.

Feasibility of student-designed, peer-led classroom physical activity breaks in graduate school

Objective: We evaluated the feasibility of Pitt Moves, a classroom-based, peer-led physical activity break (PAB) intervention developed by graduate students to improve mood, focus, and boredom among students. Participants: One hundred and thirty-two graduate-level students in 10 courses during an academic semester. Methods: Process evaluation with a formative focus involving document review, surveys, and interviews with students and facilitators. Results: Eighty-four percent of eligible students participated in ≥1 of 65 PABs. Participants said Pitt Moves provided a mental break, promoted community building, and increased their physical activity. They recommended increasing accessibility. Organizers’ time was a constraint in running this program. Conclusion: Pitt Moves was feasible based on successful recruitment of participants, delivery of PABs as planned, and participant acceptability. A formal study should evaluate whether Pitt Moves can improve mood, focus, and boredom among graduate students. Organizational encouragement and audiovisuals could enhance marketing and program implementation.

Development and Implementation of Businesses That Care in Zacatecas, Mexico.

As part of the Global Smart Drinking Goals campaign launched in 2018 in 6 “City Pilots” around the world, the Businesses That Care (BTC; Empresas Que se Cuidan in Spanish) prevention system was developed and implemented in Zacatecas, Mexico. BTC is a private business sector adaptation of the Communities That Care prevention system. BTC is designed to address underage alcohol use through a combination of a company-led prevention system, an adapted family-based prevention program with parents employed at participating companies, and environmental prevention strategies for company employees. BTC was designed to be congruent with other health and safety efforts in the region (e.g., media campaign, road safety, and school prevention efforts). This study presents the feasibility and adoption of the BTC system in Zacatecas. Process implementation measures indicated successful participant recruitment, retention, and adherence to intervention protocols. The first 4 stages of BTC implementation were completed within 14 months, with Stage 5 being interrupted by the COVID-19 pandemic. BTC Prevention Committee members, made up of employees from BTC participating companies, received 9 out of 10 BTC trainings/workshops during this time. Results provide evidence of the acceptability and feasibility for private companies to implement a prevention system approach for reducing youth alcohol use.

Obstetricians’ engagement for successful recruitment of participants in a randomized controlled trial promoting healthful fish consumption during pregnancy

BACKGROUND AND AIM: Human biomonitoring trials depend on the voluntary participation of citizens, who donate biological samples and personal information related to the investigated chemical exposures. Pregnant women are vulnerable to exposure to mercury, a potent developmental neurotoxicant. In Europe, the primary source of exposure to mercury relates to fish consumption. At the same time, fish consumption during pregnancy provides essential nutrients for optimal fetal brain and eye development. The benefits can outweigh the risks if suitable dietary advice is provided during pregnancy. METHODS: Cyprus, a small coastal Southeastern European country, used national data of fish consumption and mercury occurrence in fish to develop the first ever recommendations for Cypriot pregnant women. These are tested in the European “HBM4EU-mom” randomized control trial (10/2020 – 12/2021, Horizon2020 Programme Contract No.733032 ) with the involvement of 130 women of 18-45 years in a healthy singleton pregnancy, willing to eat fish. 15 trained obstetricians nation-wide recruit women under their care and take their hair sample during routine pregnancy appointments. RESULTS:Within one month, 78 pregnant women, corresponding to 60% of the recruitment target, were successfully recruited and provided hair samples. Virtually all women invited to join the study, consent to participation. Some women provide their informed consent at the time of invitation, while others review the information for participants at home and return the completed certificate of informed consent at the next scheduled meeting. Based on current data, it is predicted that the recruitment target will be reached within two months total. CONCLUSIONS:Recruitment of pregnant women and sampling by obstetricians is successful because it builds on the trust that the pregnant women feel towards their health care provider. It also overcomes obstacles due to the COVID-19 pandemic, creates educational opportunities for the doctors and facilitates the communication of personal results to the participants via their health care provider. KEYWORDS: Community-engaged research, Policy, Chemical exposures, Heavy metals, Exposure assessment, Pregnancy outcomes

Latino-to-Latino: Promotores' Beliefs on Engaging Latino Participants in Autism Research.

In Latino(a) communities, promotores de salud (i.e., community health workers; promotores) are becoming critical participants in prevention, health promotion, and the delivery of health care. Although involving culturally diverse participants in research is a national priority, recruitment and retention of research participants from these groups is challenging. Therefore, there is an increased need to identify strategies for successful recruitment of participants from underrepresented minority backgrounds. Our overall study purpose was to gain promotores' perspectives on recruiting Latino(a) immigrant community members for an intervention study on autism spectrum disorders (ASD). The goal of this paper is to explore insider promotores' views on the barriers and facilitators to research participation in the Latino(a) community and learn strategies for recruiting Latino(a) participants in a nontraditional destination city. We conducted qualitative focus groups with an established group of promotores known as Latinos Unidos por la Salud (LU-Salud), who were members of a community-academic research team. Fifteen LU-Salud promotores participated in the focus groups. Focus group interviews were analyzed by using Leininger's data analysis enabler. These results will inform our partnerships with promotores and Latino(a) neighborhood agencies to increase recruitment for community-based research on promoting awareness of ASD among Latino(a) families. Promotores were credible community members able to gain community trust and committed to improving the health and well-being of their Latino(a) community, including involving them in research. Latino(a) research involvement meant facilitating community members' engagement to overcome barriers of distrust around legal and health care systems. Challenges included legal uncertainties, language and literacy barriers, health knowledge, and economic hardship. Promotores also voiced the diversity of cultural practices (subcultures) within the Latino(a) culture that influenced: (1) research engagement, (2) guidance from promotores, (3) immersion in the Latino(a) community, and (4) health and well-being. Experienced promotores, who are living in a nontraditional migration area, believe the primary facilitator to increasing research involvement is Latino(a)-to-Latino(a) recruitment. These findings will aid in building partnerships to recruit participants for future studies that promote early recognition of ASD in the Latino(a) community.

Using Citizen Science to Scout Honey Bee Colonies That Naturally Survive Varroa destructor Infestations.

Simple SummaryCitizen Science is a valuable resource that can substantially contribute to the conservation of biodiversity. However, its use in honey bee research has remained minimal. The Survivors Task Force of the COLOSS association created and promoted an online surveying tool with the aim of identifying potential cases of Western honey bee, Apis mellifera, populations that are surviving infestations with ectoparasitic mites Varroa destructor without control measures by beekeepers. The reports suggest that there could be twice as many naturally surviving colonies worldwide than are currently known. The survey also shows that citizens can be readily engaged through social media, personal networks, and promotional campaigns to gather valuable and previously inaccessible data. These reports of surviving honey bee colonies will now be validated through the new initiative Honey Bee Watch, a global and multi-year Citizen Science project founded to connect citizens, beekeepers, and scientists. This will enable to increase scientific knowledge, mitigate honey bee colony losses, and develop education and conservation campaigns.Citizen Science contributes significantly to the conservation of biodiversity, but its application to honey bee research has remained minimal. Even though certain European honey bee (Apis mellifera) populations are known to naturally survive Varroa destructor infestations, it is unclear how widespread or common such populations are. Such colonies are highly valuable for investigating the mechanisms enabling colony survival, as well as for tracking the conservation status of free-living honey bees. Here, we use targeted Citizen Science to identify potentially new cases of managed or free-living A. mellifera populations that survive V. destructor without mite control strategies. In 2018, a survey containing 20 questions was developed, translated into 13 languages, and promoted at beekeeping conferences and online. After three years, 305 reports were collected from 28 countries: 241 from managed colonies and 64 from free-living colonies. The collected data suggest that there could be twice as many naturally surviving colonies worldwide than are currently known. Further, online and personal promotion seem to be key for successful recruitment of participants. Although the survivor status of these colonies still needs to be confirmed, the volume of reports and responses already illustrate how effectively Citizen Science can contribute to bee research by massively increasing generated data, broadening opportunities for comparative research, and fostering collaboration between scientists, beekeepers, and citizens. The success of this survey spurred the development of a more advanced Citizen Science platform, Honey Bee Watch, that will enable a more accurate reporting, confirmation, and monitoring of surviving colonies, and strengthen the ties between science, stakeholders, and citizens to foster the protection of both free-living and managed honey bees.

Recruitment Issues in Emerging Adult Populations: Focus on Adult Congenital Heart Disease.

High-quality nursing research is important to healthcare and is precipitated by successful participant recruitment. Young adults aged 18 to 30 years are particularly difficult to recruit due to transitions during this time, which makes it more problematic to locate these individuals and may make it more difficult for them to prioritize the need for participation. This paper includes data from two cross-sectional survey design pilot studies that aimed to enroll young adults with congenital heart disease using a variety of recruitment methods. The number of participants enrolled in these two pilot studies (7 and 22) was much lower than expected but the recruitment challenges encountered were consistent with other research studies that have recruited young adult populations. After presenting these data and a discussion of the relevant literature, we conclude with proposed strategies for research recruitment of young adults for nurse scientists who directly impact evidence-based literature and practice with research contributions.

Recruitment, retention, and adherence in a randomized feasibility trial of mindfulness-based stress reduction for patients with migraine

ObjectivesIncreasing evidence demonstrates effectiveness of Mindfulness-Based Stress Reduction (MBSR) for pain-related and functional disorders. In order to conduct successful and efficient trials of MBSR, evidence regarding the relative performance of strategies to improve recruitment, retention, and adherence is required, but few studies have examined these issues specifically. DesignIn preparation for a fully powered trial, we conducted a 2-arm, parallel comparison randomized controlled feasibility trial of MBSR vs. usual-care for 60 patients with migraine headache. SettingTwo large U.S. health systems in Northern California. InterventionMBSR is an 8-week classroom-based intervention that combines mindfulness meditation and yoga, with didactic presentations about stress psychology and group process/experiential education. Participants received the intervention at their choice of one of several existing, vetted community-based classes. Main outcome measuresSuccessful recruitment was defined a priori as 18 participants within any 9-week period or 60 participants enrolled within a 36-week period. We considered participants adherent to the intervention if they attended at least 5 of the 8 weekly classes and the day-long retreat. ResultsWe successfully enrolled 18 participants within a 7-week period, however, we did not attain our second goal of recruiting 60 participants within a 36-week period. Sixty-eight percent of our participants were adherent to the intervention. ConclusionsWe found that close monitoring of recruitment activities, flexibility in protocol modifications, and integration within the delivery system were crucial factors for successful participant recruitment, retention, and adherence in mindfulness research.

Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study.

Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health-sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005). Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.