title: Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medically underserved counties of South Carolina: the POWER study.
abstract: We evaluated the feasibility of recruiting overweight adults with diabetes, living in rural, medically underserved communities, to a weight management intervention consisting of a 12-month clinical trial of two weight management programs and usual care. The sampling frame consisted of adults ages 45 years and older with clinically diagnosed diabetes from two community health centers. The recruitment process included medical record review, prescreening telephone call, two screening visits, and a randomization visit. Over 1,400 medical records were reviewed; 78.6% met eligibility criteria; 60.1% were contacted for telephone prescreening, and 35.5% remained eligible and were interested in participating. Of these, 187 completed visit 1, 164 completed visit 2, and 143 were randomized. Forty-six people were randomized who entered the study as walk-ins at screening visit 1, resulting in 189 subjects. The final yield was 21.5%. Subject mean age was 60.4 years, mean body mass index was 36.4 kg/m(2), 80% were African-American, and 46.6% had less than a high school education. Retention at 12 months was 81.5%. Successful strategies included partnering with community health centers, positive reinforcement and social supportiveness, monitoring progress, and free transportation. This work provides a useful example of an academic-community partnership designed to reach groups previously considered hard to reach.
authors.affiliation: Department of Health Promotion, Education, and Behavior, Norman J. Arnold School of Public Health, University of South Carolina, Columbia 29208, USA. dpmedina@sc.edu
authors.forename: Deborah
authors.initials: D
authors.lastname: Parra-Medina
authors.forename: Angela
authors.initials: A
authors.lastname: D'antonio
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Smith
authors.forename: Sarah
authors.initials: S
authors.lastname: Levin
authors.forename: Gregory
authors.initials: G
authors.lastname: Kirkner
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mayer-Davis
mesh_terms: D001741:Black or African American; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000178:diet therapy* / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009765:Obesity; D018579:Patient Selection; D011203:Poverty; D019035:Rural Health Services; D013022:South Carolina; D014186:Transportation; D016896:Treatment Outcome; D015431:Weight Loss