title: Recruiting Endometrial Cancer Survivors to Studies Examining Lifestyle Behaviors and Quality of Life: Challenges Faced and Lessons Learned.
abstract: There are a growing number of cancer survivors in the USA. Despite lifestyle behaviors being strongly associated with morbidity and mortality following primary treatment, recruitment to clinical research studies that aim to improve such behaviors remains a significant challenge. Furthermore, pilot and feasibility studies are critical for the refinement of research methods and form an important training opportunity for early career scientists. This report details the challenges faced and lessons learned in the process of recruiting a population of overweight/obese endometrial cancer survivors (ECS) to two separate studies focused on lifestyle behaviors: a survey study and a randomized behavioral intervention study that aimed to improve diet, physical activity, and quality of life. We used in-clinic and mail-based approaches to reach eligible patients identified from clinic records. Surveys were offered via paper or online. To evaluate the recruitment process, we compared clinic records and enrollment data over time and location. Chi-squared tests were also used to compare recruitment strategies. We address specific challenges at the patient level, the clinic/provider level, and the organizational level. Overall response rate was 13.9% to the survey and 4% to the intervention. Responses to in-clinic offers were greater than to mail-based approaches for the survey with no difference for the intervention. Identifying the unique characteristics of each survivorship population, adequate planning, resource allocation, and involvement of key staff are essential to supporting recruitment efforts to research studies. Having the support of physicians and nurses is especially critical to the success of recruitment.
authors.affiliation: Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA. arlucas@wakehealth.edu.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Lucas
authors.affiliation: Kinesiology, Department of Human Sciences, The Ohio State University, Columbus, OH, 43201, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Focht
authors.affiliation: Division of Gynecologic Oncology, The Ohio State University College of Medicine, M-210 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH, 43201, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.affiliation: Clinical Family Medicine, The Ohio State University College of Medicine, Suite 250 Northwood-High Building # 261, 2231 North High Street, Columbus, OH, 43201, USA.
authors.forename: Maryanna D
authors.initials: MD
authors.lastname: Klatt
authors.affiliation: Department of Kinesiology, University of Georgia, 115K Ramsey Center 330 River Road, Athens, GA, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Buckworth
mesh_terms: D000073116:Cancer Survivors / Q000523:psychology*; D016889:Endometrial Neoplasms / Q000523:psychology* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Diet; Endometrial cancer; Lifestyle behaviors; Obesity; Physical activity; Recruitment; Survivorship