title: Challenges and strategies pertaining to recruitment and retention of frail elderly in research studies: a systematic review.
abstract: BACKGROUND
  Recruitment and retention of frail elderly in research studies can be difficult.
  
  
  OBJECTIVE
  To identify challenges and strategies pertaining to recruitment and retention of frail elderly in research studies.
  
  
  METHODS
  A systematic review was conducted. Four databases (MEDLINE, CINAHL, AgeLine, Embase) were searched from January 1992 to December 2012. Empirical studies were included if they explored barriers to or strategies for recruitment or retention of adults aged 60-plus who were identified as frail, vulnerable or housebound. Two researchers independently determined the eligibility of each abstract reviewed and assessed the level of evidence presented. Data concerning challenges encountered (type and impact) and strategies used (type and impact) were abstracted.
  
  
  RESULTS
  Of 916 articles identified in the searches, 15 met the inclusion criteria. The level of evidence of the studies retained varied from poor to good. Lack of perceived benefit, distrust of research staff, poor health and mobility problems were identified as common challenges. The most frequently reported strategies used were to establish a partnership with staff that participants knew and trusted, and be flexible about the time and place of the study. However, few studies performed analyses to compare the impact of specific challenges and strategies on refusal or drop-out rates.
  
  
  CONCLUSIONS
  This review highlights the need to improve knowledge about the impact of barriers and strategies on recruitment and retention of frail older adults. This knowledge will help to develop innovative and cost-effective ways to increase and maintain participation, which may improve the generalizability of research findings to this population.
authors.affiliation: Université Laval, Department of Rehabilitation, Quebec City, QC, Canada; CHU de Québec/Centre d'excellence sur le vieillissement de Québec, Quebec City, QC, Canada. Electronic address: Veronique.Provencher@fmed.ulaval.ca.
authors.forename: Véronique
authors.initials: V
authors.lastname: Provencher
authors.affiliation: University of British Columbia, Department of Occupational Science and Occupational Therapy, Vancouver, BC, Canada.
authors.forename: W Ben
authors.initials: WB
authors.lastname: Mortenson
authors.affiliation: CHU de Québec/Centre d'excellence sur le vieillissement de Québec, Quebec City, QC, Canada.
authors.forename: Laurence
authors.initials: L
authors.lastname: Tanguay-Garneau
authors.affiliation: CHU de Québec/Centre d'excellence sur le vieillissement de Québec, Quebec City, QC, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Bélanger
authors.affiliation: Université de Montréal, School of Rehabilitation, Montreal, QC, Canada.
authors.forename: Marion
authors.initials: M
authors.lastname: Dagenais
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D035843:Biomedical Research; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D007258:Informed Consent; D010352:Patient Dropouts; D018579:Patient Selection; D045808:Refusal to Participate; D035842:Research Subjects
keywords: Frail older adults; Patient dropouts; Refusal to participate; Review