Recruiting and retaining low-income, multi-ethnic women into randomized controlled trials: successful strategies and staffing.
Developing effective recruitment and retention strategies in populations with traditionally high attrition rates is critical to the success of Randomized Controlled Trials (RCTs). Data on successful participation of women from low-income, minority populations in RCTs of behavioral interventions are limited. This is problematic given the multiplicity of Healthy People 2020 goals that target health disparities in these populations. This paper reports successful recruitment and retention methods from two separately funded NIH clinical trials of primary care-based prenatal interventions to increase breastfeeding among ethnically diverse, low-income women in urban medical centers in the Bronx, NY. It also presents the required staff effort necessary to conduct such a successful RCT, in terms of full-time equivalents (FTEs). Results include timely recruitment of 941 participants over 29 months, with 98.1% completing >¯¯1 follow-up interview. A recruitment and retention plan that maximized study staff access and availability to the participant, as well as strong study staff rapport with participants, addressed previously reported barriers in this population, optimizing follow-up rates. A qualitative assessment of the participants' study experience suggesting that high retention was due to strong rapport with participants, short interviews requiring little time commitment, and participants' perception of the study as informative, provides further evidence of our approach's effectiveness. Logistical protocol procedures and staff management strategies relating to successful recruitment/retention are provided to propose a practical, cost-effective and translational recruitment-retention plan for other researchers to adopt.
Albert Einstein College of Medicine, Department of Family and Social Medicine, Bronx, NY, USA. joabarnett@gmail.com
Josephine
J
Barnett
Stephanie
S
Aguilar
Mindy
M
Brittner
Karen
K
Bonuck
D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel / Q000458:organization & administration*; D006801:Humans; D007802:Language; D009519:New York City; D010352:Patient Dropouts; D018579:Patient Selection; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D013997:Time Factors; D014186:Transportation; D035502:Trust