title: Value of recruitment strategies used in a primary care practice-based trial.
abstract: OBJECTIVE
  "Physicians-recruiting-physicians" is the preferred recruitment approach for practice-based research. However, yields are variable; and the approach can be costly and lead to biased, unrepresentative samples. We sought to explore the potential efficiency of alternative methods.
  
  
  METHODS
  We conducted a retrospective analysis of the yield and cost of 10 recruitment strategies used to recruit primary care practices to a randomized trial to improve cardiovascular disease risk factor management. We measured response and recruitment yields and the resources used to estimate the value of each strategy. Providers at recruited practices were surveyed about motivation for participation.
  
  
  RESULTS
  Response to 6 opt-in marketing strategies was 0.40% (53/13290), ranging from 0% to 2.86% by strategy; 33.96% (18/53) of responders were recruited to the study. Of those recruited from opt-out strategies, 8.68% joined the study, ranging from 5.35% to 41.67% per strategy. A strategy that combined both opt-in and opt-out approaches resulted in a 51.14% (90/176) response and a 10.80% (19/90) recruitment rate. Cost of recruitment was $613 per recruited practice. Recruitment approaches based on in-person meetings (41.67%), previous relationships (33.33%), and borrowing an Area Health Education Center's established networks (10.80%), yielded the most recruited practices per effort and were most cost efficient. Individual providers who chose to participate were motivated by interest in improving their clinical practice (80.5%); contributing to CVD primary prevention (54.4%); and invigorating their practice with new ideas (42.1%).
  
  
  CONCLUSIONS
  This analysis provides suggestions for future recruitment efforts and research. Translational studies with limited funds could consider multi-modal recruitment approaches including in-person presentations to practice groups and exploitation of previous relationships, which require the providers to opt-out, and interactive opt-in approaches which rely on borrowed networks. These approaches can be supplemented with non-relationship-based opt-out strategies such as cold calls strategically targeted to underrepresented provider groups.
authors.affiliation: Department of Outcomes Research, Duke Clinical Research Institute, Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A. shellie.ellis@duke.edu
authors.forename: Shellie D
authors.initials: SD
authors.lastname: Ellis
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.forename: Denise E
authors.initials: DE
authors.lastname: Bonds
authors.forename: C Randall
authors.initials: CR
authors.lastname: Clinch
authors.forename: Aarthi
authors.initials: A
authors.lastname: Balasubramanyam
authors.forename: Caroline
authors.initials: C
authors.lastname: Blackwell
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.forename: Michael
authors.initials: M
authors.lastname: Lischke
authors.forename: David C
authors.initials: DC
authors.lastname: Goff
mesh_terms: D000329:Advertising / Q000191:economics / Q000379:methods; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000517:prevention & control; D019058:Community Networks; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D009657:North Carolina; D010821:Physicians, Family; D011320:Primary Health Care; D011322:Primary Prevention; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012189:Retrospective Studies