title: Recruitment of rural physicians in a diabetes internet intervention study: overcoming challenges and barriers.
abstract: OBJECTIVE
  This paper highlights a descriptive study of the challenges and lessons learned in the recruitment of rural primary care physicians into a randomized clinical trial using an Internet-based approach.
  
  
  METHODS
  A multidisciplinary/multi-institutional research team used a multilayered recruitment approach, including generalized mailings and personalized strategies such as personal office visits, letters, and faxes to specific contacts. Continuous assessment of recruitment strategies was used throughout study in order to readjust strategies that were not successful.
  
  
  RESULTS
  We recruited 205 primary care physicians from 11 states. The 205 lead physicians who enrolled in the study were randomized, and the overall recruitment yield was 1.8% (205/11231). In addition, 8 physicians from the same practices participated and 12 nonphysicians participated. The earlier participants logged on to the study Web site, the greater yield of participation. Most of the study participants had logged on within 10 weeks of the study.
  
  
  CONCLUSIONS
  Despite successful recruitment, the 2 major challenges in recruitment in this study included defining a standardized definition of rurality and the high cost of chart abstractions. Because many of the patients of study recruits were African American, the potential implications of this study on the field of health disparities in diabetes are important.
authors.affiliation: The University of Alabama School of Medicine, Tuscaloosa, USA. ppayne-foster@cchs.ua.edu
authors.forename: Pamela Payne
authors.initials: PP
authors.lastname: Foster
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Williams
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Estrada
authors.forename: John C
authors.initials: JC
authors.lastname: Higginbotham
authors.forename: Mukesha L
authors.initials: ML
authors.lastname: Voltz
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.forename: Jeroan
authors.initials: J
authors.lastname: Allison
mesh_terms: D003920:Diabetes Mellitus / Q000628:therapy*; D004502:Education, Medical, Continuing / Q000458:organization & administration; D017408:Guidelines as Topic; D006801:Humans; D020407:Internet; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000592:standards; D011320:Primary Health Care / Q000592:standards; D016730:Program Development; D012423:Rural Health; D012424:Rural Population; D014481:United States