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Wali N, Huda MN, Gill T, Green J, Renzaho AMN. A systematic review of recruitment and retention of ethnic minorities and migrants in obesity prevention randomised controlled trials. Int J Obes (Lond) 2024; 48:1065-1079. [PMID: 38834795 PMCID: PMC11281904 DOI: 10.1038/s41366-024-01545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Participants' recruitment and retention into community-based interventions can be challenging, especially in research involving ethnic minorities and migrants. Despite known challenges, there are limited reviews that probe recruitment and retention strategies involving ethnic minorities and migrants in the Organisation for Economic Cooperation and Development (OECD) countries. This systematic review aimed to measure recruitment and retention rates and identify the barriers and facilitators to effective recruitment and retention of ethnic minorities and migrants in community-based obesity prevention Randomised Control Trials (RCTs) in OECD countries. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases (CINAHL, Cochrane, Embase, Medline and PsychInfo) were searched from January 2000 to March 2022, in addition to Google and Google Scholar. Methodological quality and risk of bias were assessed, and pooled analysis and meta-ethnographic analysis were conducted on the included studies. RESULTS Twenty-five studies were included in the review. The pooled analysis found a 64% rate of recruitment of ethnic minorities in RCTs, with a retention rate of 71%. Key facilitators identified were-use of multiple communication channels, incentives, recruiting community champions, participant convenience and employing culturally sensitive strategies. Key barriers to participation were limited access to study sites, time constraints, limited trust, perceived fear, and anxiety. CONCLUSION Findings suggest the importance of undertaking culturally appropriate recruitment and retention strategies to minimise barriers and facilitate effective recruitment and retention of low-income ethnic minorities and migrants in community-based research.
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Affiliation(s)
- Nidhi Wali
- School of Social Sciences, Humanitarian and Development Research Initiative (HADRI), Western Sydney University, Sydney, NSW, 2751, Australia.
| | - Md Nazmul Huda
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Timothy Gill
- Charles Perkins Centre, University of Sydney, Sydney, NSW, 2050, Australia
| | - Julie Green
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Department of Paediatric, University of Melbourne, Parkville, VIC, 3052, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Andre M N Renzaho
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown, NSW, 2560, Australia
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Hardin HK, Bender AE, Killion CM, Moore SM. Materials and Methods for Recruiting Systematically Marginalized Youth and Families for Weight-Management Intervention Trials: Community Stakeholders' Perspectives. FAMILY & COMMUNITY HEALTH 2023; 46:13-27. [PMID: 36383230 PMCID: PMC9680002 DOI: 10.1097/fch.0000000000000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.
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Affiliation(s)
- Heather K Hardin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio (Drs Hardin, Killion, and Moore); and Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington (Dr Bender)
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LeCroy MN, Potter LN, Bandeen-Roche K, Bianco ME, Cappola AR, Carter EB, Dayan PS, Eckstrom E, Edwards DF, Farabi SS, Fisher SD, Giordano J, Hanson HA, Jenkins E, Juhn Y, Kaskel F, Stake CE, Reeds DN, Schleiss MR, Wafford QE, McColley SA. Barriers to and solutions for representative inclusion across the lifespan and in life course research: The need for structural competency highlighted by the COVID-19 pandemic. J Clin Transl Sci 2022; 7:e38. [PMID: 36845306 PMCID: PMC9947617 DOI: 10.1017/cts.2022.510] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Exclusion of special populations (older adults; pregnant women, children, and adolescents; individuals of lower socioeconomic status and/or who live in rural communities; people from racial and ethnic minority groups; individuals from sexual or gender minority groups; and individuals with disabilities) in research is a pervasive problem, despite efforts and policy changes by the National Institutes of Health and other organizations. These populations are adversely impacted by social determinants of health (SDOH) that reduce access and ability to participate in biomedical research. In March 2020, the Northwestern University Clinical and Translational Sciences Institute hosted the "Lifespan and Life Course Research: integrating strategies" "Un-Meeting" to discuss barriers and solutions to underrepresentation of special populations in biomedical research. The COVID-19 pandemic highlighted how exclusion of representative populations in research can increase health inequities. We applied findings of this meeting to perform a literature review of barriers and solutions to recruitment and retention of representative populations in research and to discuss how findings are important to research conducted during the ongoing COVID-19 pandemic. We highlight the role of SDOH, review barriers and solutions to underrepresentation, and discuss the importance of a structural competency framework to improve research participation and retention among special populations.
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Affiliation(s)
- Madison N. LeCroy
- Department of Pediatrics, Division of Academic General Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lindsey N. Potter
- Center for Health Outcomes and Population Equity (HOPE), Department of Population Health Sciences, Huntsman Cancer Institute and the University of Utah, Salt Lake City, UT, USA
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Institute for Clinical and Translational Research, Baltimore, MD, USA
| | - Monica E. Bianco
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anne R. Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ebony B. Carter
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University, School of Medicine, St. Louis, MO, USA
| | - Peter S. Dayan
- Department of Emergency Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Elizabeth Eckstrom
- Department of Medicine, Division of General Internal Medicine & Geriatrics, Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Dorothy F. Edwards
- Collaborative Center for Health Equity, Institute for Clinical and Translational Research and Department of Medicine, School of Medicine and Public Health, University of Wisconsin Madison, Health Sciences Learning Center, Madison, WI, USA
| | - Sarah S. Farabi
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
- Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO, USA
| | - Sheehan D. Fisher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine/Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Judy Giordano
- University of Rochester Medical Center, Rochester, NY, USA
| | - Heidi A. Hanson
- Department of Surgery and Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Emerald Jenkins
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Young Juhn
- Precision Population Science Lab and Artificial Intelligence Program, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Frederick Kaskel
- Department of Pediatrics, Division of Pediatric Nephrology, Children’s Hospital at Montefiore, Bronx, NY, USA
| | - Christine E. Stake
- Division of Pediatric Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Dominic N. Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
- Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO, USA
| | - Mark R. Schleiss
- Department of Pediatrics, Division of Infectious Diseases, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Q. Eileen Wafford
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susanna A. McColley
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Jernigan MM. Exploring Black Girls' Recommendations for Healthy Lifestyle Interventions to Address Obesity. J Pediatr Psychol 2021; 45:887-899. [PMID: 32815540 DOI: 10.1093/jpepsy/jsaa062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 11/12/2022] Open
Abstract
Objective This mixed-methods study investigated Black girls' (N = 15) definitions of health and reports on socio-ecological factors that influenced health attitudes, beliefs, and behaviors. Participants were surveyed about their emotional health, body image, experiences of discrimination, and eating patterns. Methods Directed content analysis was used to identify themes, categories, and capture the depth of information conveyed. The study also used the Nominal Group Technique to elicit recommendations about intervention content, structure, and facilitation of a healthy lifestyle program targeting Black girls. Participants represented various ethnic backgrounds, ranged in age from 14 to 17 years (M = 16), and were in the ninth and 10th grades. Participants also represented a specific sample of Black adolescent girls who are medically categorized as obese. Results Findings indicated that Black girls use an intersectional (race-gender) lens to frame their definitions of health and inform health-related behaviors. Recommendations for obesity interventions targeting Black girls include leveraging time during school to deliver services, intentional selection of program facilitators to include race-gender similarities, and professionals trained to work with adolescents. Additionally, considerations for provider-patient interactions include the use of nonstigmatizing language and direct communication. Conclusion Findings serve to address the paucity of culturally responsive interventions targeting Black girls' health. Implications include enhancement of program retention and sustained engagement to facilitate effective treatment outcomes and address the disparity in the prevalence of obesity. In doing so, there is a potential to reduce health disparities associated with increased weight as Black girls' transition into adulthood.
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Jernigan MM. “Why Doesn’t Anyone Help Us?”: Therapeutic Implications of Black Girls’ Perceptions of Health. WOMEN & THERAPY 2019. [DOI: 10.1080/02703149.2019.1622913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brigden A, Parslow RM, Linney C, Higson-Sweeney N, Read R, Loades M, Davies A, Stoll S, Beasant L, Morris R, Ye S, Crawley E. How are behavioural interventions delivered to children (5-11 years old): a systematic mapping review. BMJ Paediatr Open 2019; 3:e000543. [PMID: 31909219 PMCID: PMC6937047 DOI: 10.1136/bmjpo-2019-000543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/11/2019] [Accepted: 10/18/2019] [Indexed: 01/19/2023] Open
Abstract
CONTEXT Behavioural interventions are used to prevent, manage and treat a wide variety of conditions including obesity, diabetes, chronic pain, asthma and emotional difficulties. There has been inadequate attention to the delivery of behavioural interventions to younger children (5-11 years old). OBJECTIVE Our objectives were to describe the characteristics of behavioural interventions for children aged 5-11 years. DATA SOURCES We searched five databases: CINAHL, EMBASE, PsycINFO, MEDLINE and Cochrane Library, from January 2005 to August 2019. STUDY SELECTION The inclusion criteria were (1) children aged 5-11, (2) cognitive and/or behavioural interventions, (3) randomised controlled trials and (4) 2005 onward. Two researchers independently identified studies for inclusion. DATA EXTRACTION Two researchers independently extracted data from eligible papers. RESULTS The search identified 10 541 papers. We extracted information on 117 interventions (from 152 papers). Many of the interventions were categorised as complex. This was particularly true for clinical populations; 78.7% were delivered to both the child and parent, and 33.9% took place across multiple settings, typically health and school settings. Most (70.9%) were 'First Wave' (behavioural) interventions, and few (4.3%) were 'Third Wave' (characterised by metacognition, acceptance and mindfulness). Thirty-nine per cent used interactive techniques (play, arts, story and/or games). Purely digital and paper-based interventions were rare, but around a third used these tools as supplements to face-face delivery. There were differences in interventions for younger (5-7 years) and older (8-11 years) children. CONCLUSIONS Interventions designed and delivered to children should be developmentally sensitive. This review highlights characteristics of interventions delivered to children 5-11 years old: the involvement of the child's parent, using behavioural (rather than cognitive) modalities, using interactive techniques and some interventions were delivered across multiple settings.
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Affiliation(s)
- Amberly Brigden
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Roxanne Morin Parslow
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Catherine Linney
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Rebecca Read
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Maria Loades
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Anna Davies
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Stoll
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lucy Beasant
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard Morris
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Siyan Ye
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther Crawley
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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Perez AJ, Kebbe M, Holt NL, Gokiert R, Chanoine JP, Legault L, Morrison KM, Sharma AM, Ball GDC. Parent Recommendations to Enhance Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management. J Pediatr 2018; 192:122-129. [PMID: 29246332 DOI: 10.1016/j.jpeds.2017.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/26/2017] [Accepted: 09/14/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore parents' recommendations to enhance enrollment in multidisciplinary clinical care for managing pediatric obesity. STUDY DESIGN Data for this interpretative description study were collected through individual, semistructured interviews that were audiorecorded, transcribed verbatim, and analyzed thematically. Parents (n = 79) were recruited from 4 multidisciplinary weight management clinics in Canada located in Edmonton, Hamilton, Montreal, and Vancouver. RESULTS Most interviewed parents had children with obesity (body mass index ≥95th percentile; 84.2%), were female (87.3%), had postsecondary education (69.6%), and were white (75.9%). Parents' recommendations referred to enrollment opportunities, information about obesity services, motivation for treatment, and accessibility to obesity services. Specifically, parents recommended to increase referral options and follow-up contacts with families during the enrollment process, inform referring physicians and families about the availability and characteristics of obesity services, enhance families' motivation for treatment, prevent families from getting discouraged, make services more appealing to families, and address accessibility issues (eg, offering multiple options for appointment times, providing support for transportation). CONCLUSIONS Parents' recommendations support the need for family-centered approaches to enhance enrollment; however, their feasibility, acceptability, and effectiveness remain to be tested empirically.
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Affiliation(s)
- Arnaldo J Perez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Kebbe
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas L Holt
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Rebecca Gokiert
- Community-University Partnership, Faculty of Extension, University of Alberta, Edmonton, Alberta, Canada
| | - Jean-Pierre Chanoine
- Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Katherine M Morrison
- Department of Pediatrics and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Arya M Sharma
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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Graves D, Sheldon JP. Recruiting African American Children for Research: An Ecological Systems Theory Approach. West J Nurs Res 2017; 40:1489-1521. [PMID: 28436265 DOI: 10.1177/0193945917704856] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
With health disparities still pervasive and persistent in the United States, medical researchers and social scientists continue to develop recruitment strategies to increase the inclusion of racial/ethnic minority groups in research and interventions. Effective methods for recruiting samples of African American participants for pediatric research may be best understood when situated within an overarching conceptual model-one that serves to organize and explain effective recruitment strategies. A theoretical framework well suited for this purpose is Bronfenbrenner's ecological systems theory, which views individuals as influencing and being influenced by (both directly and indirectly) a series of interconnected social systems. Based on the ecological systems theory and on previous research from multiple domains (e.g., medicine, psychology, public health, social work), in the current article, we review strategies for effective recruitment of African American children and adolescents for research.
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Kelleher E, Davoren MP, Harrington JM, Shiely F, Perry IJ, McHugh SM. Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review. Obes Rev 2017; 18:183-194. [PMID: 27862851 PMCID: PMC5245104 DOI: 10.1111/obr.12478] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/04/2016] [Accepted: 09/20/2016] [Indexed: 12/13/2022]
Abstract
The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.
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Affiliation(s)
- E Kelleher
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - M P Davoren
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - J M Harrington
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - F Shiely
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.,HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
| | - I J Perry
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - S M McHugh
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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Northrup TF, Greer TL, Walker R, Rethorst CD, Warden D, Stotts AL, Trivedi MH. An ounce of prevention: A pre-randomization protocol to improve retention in substance use disorder clinical trials. Addict Behav 2017; 64:137-142. [PMID: 27610591 DOI: 10.1016/j.addbeh.2016.08.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/26/2016] [Accepted: 08/30/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Missing data in substance use disorder (SUD) research pose a significant threat to internal validity. Participants terminate involvement or become less likely to attend intervention and research visits for many reasons, which should be addressed prior to becoming problematic. During a 9-month study targeting stimulant abuse, early dropouts and participant reported attendance barriers led to implementing a structured, pre-randomization protocol with participants about retention and solution-focused strategies (the "Fireside Chat"). Our aim is to outline this approach and present data on intervention participation and research visit attendance after implementation. METHODS/DESIGN STimulant Reduction using Dosed Exercise (STRIDE) was a two-arm, multisite randomized clinical trial testing treatment-as-usual for stimulant abuse/dependence augmented by Exercise or Health Education. For both groups, study intervention visits at the site were scheduled 3/week for 12weeks followed by 1/week for 24weeks. During The Chat, research staff thoroughly reviewed participants' expectations, and barriers and solutions to retention. Fifteen participants were randomized (to Exercise or Health Education) prior to and fourteen were randomized after Chat implementation. Intervention and monthly follow-up attendance (before and after implementation) were compared at the site (N=29) that developed and rigorously implemented The Chat. RESULTS Individuals who participated in The Chat (n=14) attended significantly more intervention visits during weeks 1-12 (p<0.001) and weeks 13-36 (p<0.05) and attended more research visits (p<0.001). DISCUSSION Proactive discussion of expectations and barriers prior to randomization was associated with greater study attendance. SUD researchers should consider tailoring this approach to suit their needs. Further investigation is warranted.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX 77030, USA.
| | - Tracy L Greer
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
| | - Robrina Walker
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
| | - Chad D Rethorst
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
| | - Diane Warden
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
| | - Angela L Stotts
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX 77030, USA; Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX 77030, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
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Perez AJ, Avis JLS, Holt NL, Gokiert R, Chanoine JP, Legault L, Morrison KM, Sharma AM, Ball GDC. Why do families enrol in paediatric weight management? A parental perspective of reasons and facilitators. Child Care Health Dev 2016; 42:278-87. [PMID: 26728419 DOI: 10.1111/cch.12311] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/10/2015] [Accepted: 11/22/2015] [Indexed: 01/26/2023]
Abstract
BACKGROUND Few children with obesity who are referred for weight management end up enroled in treatment. Factors enabling enrolment are poorly understood. Our purpose was to explore reasons for and facilitators of enrolment in paediatric weight management from the parental perspective. METHODS Semi-structured interviews were conducted with parents of 10- to 17-year-olds who were referred to one of four Canadian weight management clinics and enroled in treatment. Interviews were audio-recorded and transcribed verbatim. Manifest/inductive content analysis was used to analyse the data, which included the frequency with which parents referred to reasons for and facilitators of enrolment. RESULTS In total, 65 parents were interviewed. Most had a child with a BMI ≥95th percentile (n = 59; 91%), were mothers (n = 55; 85%) and had completed some post-secondary education (n = 43; 66%). Reasons for enrolment were related to concerns about the child, recommended care and expected benefits. Most common reasons included weight concern, weight loss expectation, lifestyle improvement, health concern and need for external support. Facilitators concerned the referral initiator, treatment motivation and barrier control. Most common facilitators included the absence of major barriers, parental control over the decision to enrol, referring physicians stressing the need for specialized care and parents' ability to overcome enrolment challenges. CONCLUSIONS Healthcare providers might optimize enrolment in paediatric weight management by being proactive in referring families, discussing the advantages of the recommended care to meet treatment expectations and providing support to overcome enrolment barriers.
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Affiliation(s)
- A J Perez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - J L S Avis
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - N L Holt
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - R Gokiert
- Community-University Partnership, Faculty of Extension, University of Alberta, Edmonton, AB, Canada
| | - J-P Chanoine
- Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - L Legault
- Department of Pediatrics, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - K M Morrison
- Department of Pediatrics and Population Health Research Institute, Faculty of Medicine, McMaster University, Hamilton, ON, Canada
| | - A M Sharma
- Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, AB, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Cui Z, Seburg EM, Sherwood NE, Faith MS, Ward DS. Recruitment and retention in obesity prevention and treatment trials targeting minority or low-income children: a review of the clinical trials registration database. Trials 2015; 16:564. [PMID: 26651822 PMCID: PMC4674912 DOI: 10.1186/s13063-015-1089-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 11/27/2015] [Indexed: 12/27/2022] Open
Abstract
Background Efforts to recruit and retain participants in clinical trials are challenging, especially in studies that include minority or low-income children. To date, no studies have systematically examined recruitment and retention strategies and their effectiveness in working successfully with this population. We examined strategies employed to recruit or retain minority or low-income children in trials that included an obesity-related behavior modification component. Methods First, completed home-, community-, and school-based trials involving minority or low-income children aged 2–17 years were identified in a search of the ClinicalTrials.gov registry. Second, a PubMed search of identified trials was conducted to locate publications pertinent to identified trials. Recruitment and retention rates were calculated for studies that included relevant information. Results Our final analytic sample included 43 studies. Of these, 25 studies reported recruitment or retention strategies, with the amount of information varying from a single comment to several pages; 4 published no specific information on recruitment or retention; and 14 had no publications listed in PubMed. The vast majority (92 %) of the 25 studies reported retention rates of, on average, 86 %. Retention rates were lower in studies that: targeted solely Hispanics or African Americans (vs. mixed races of African Americans, whites, and others); involved children and parents (vs. children only); focused on overweight or obese children (vs. general children), lasted ≥1 year (vs. <1 year), were home or community-based (vs. school-based), included nutrition and physical activity intervention (vs. either intervention alone), had body mass index or other anthropometrics as primary outcome measures (vs. obesity-related behavior, insulin sensitivity, etc.). Retention rates did not vary based on child age, number of intervention sessions, or sample size. Conclusions Variable amounts of information were provided on recruitment and retention strategies in obesity-related trials involving minority or low-income children. Although reported retention rates were fairly high, a lack of reporting limited the available information. More and consistent reporting and systematic cataloging of recruitment and retention methods are needed. In addition, qualitative and quantitative studies to inform evidence-based decisions in the selection of effective recruitment and retention strategies for trials including minority or low-income children are warranted.
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Affiliation(s)
- Zhaohui Cui
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2202 McGavran-Greenberg Hall, Campus Box 7461, Chapel Hill, NC, 27599, USA.
| | - Elisabeth M Seburg
- HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
| | - Nancy E Sherwood
- HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
| | - Myles S Faith
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2202 McGavran-Greenberg Hall, Campus Box 7461, Chapel Hill, NC, 27599, USA.
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2202 McGavran-Greenberg Hall, Campus Box 7461, Chapel Hill, NC, 27599, USA.
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Nicholson LM, Schwirian PM, Groner JA. Recruitment and retention strategies in clinical studies with low-income and minority populations: Progress from 2004-2014. Contemp Clin Trials 2015; 45:34-40. [PMID: 26188163 DOI: 10.1016/j.cct.2015.07.008] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/25/2015] [Accepted: 07/06/2015] [Indexed: 10/23/2022]
Abstract
More than 20years have passed since the NIH 1993 Act was initiated, and while progress has been made toward better representation of minorities and women in clinical research studies, as this review will show, there is still tremendous room for improvement. The purpose of this review was to identify the current state of literature on recruitment and retention strategies in clinical studies of low-income and minority populations. We identified 165 studies published in English between 2004 and 2014. Data extracted included information on the study type (descriptive or analytical), study design, study focus (recruitment, retention, both recruitment and retention), health outcome, specific minority group, special population or age group, if specific recruitment/retention techniques were tested, and key research findings. Particular attention was given to articles that statistically analyzed the effectiveness of recruitment and retention strategies on enrollment/retention rates. Effective recruitment and retention strategies for low-income and minority groups, differential effectiveness across groups, and implications for future research are discussed.
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Affiliation(s)
- Lisa M Nicholson
- The Institute for Health Research and Policy, The University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States.
| | - Patricia M Schwirian
- The Ohio State University, College of Nursing and Department of Family Medicine, Columbus, OH United States
| | - Judith A Groner
- Section of Ambulatory Pediatrics, Nationwide Children's Hospital, Columbus, OH United States
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14
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Hall IJ, Johnson-Turbes A, Berkowitz Z, Zavahir Y. The African American Women and Mass Media (AAMM) campaign in Georgia: quantifying community response to a CDC pilot campaign. Cancer Causes Control 2015; 26:787-94. [PMID: 25732344 DOI: 10.1007/s10552-015-0540-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 02/19/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate whether a culturally appropriate campaign using "Black radio" and print media increased awareness and utilization of local mammography screening services provided by the Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program among African American women. METHODS The evaluation used a quasi-experimental design involving data collection during and after campaign implementation in two intervention sites in GA (Savannah with radio and print media and Macon with radio only) and one comparison site (Columbus, GA). We used descriptive statistics to compare mammography uptake for African American women during the initial months of the campaign (8/08-1/09) with the latter months (2/09-8/09) and a post-campaign (9/09-12/09) period in each of the study sites. Comparisons of monthly mammogram uptake between cities were performed with multinomial logistic regression. We assumed a p value <0.05 to be significant. RESULTS We observed an increase of 46 and 20 % in Savannah and Macon, respectively, from the initial period of the campaign to the later period. However, the increase did not persist in the post-campaign period. Analysis comparing monthly mammogram uptake in Savannah and Macon with Columbus showed a significant increase in uptake from the first to the second period in Savannah only (OR 1.269, 95 % CI (1.005-1.602), p = 0.0449). CONCLUSIONS Dissemination of health promotion messages via a culturally appropriate, multicomponent campaign using Black radio and print media was effective in increasing mammogram uptake in Savannah among low-income, African American women. Additional research is needed to quantify the relative contribution of campaign radio, print media, and community components to sustain increased mammography uptake.
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Affiliation(s)
- Ingrid J Hall
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA,
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Fairbanks E, Shah S, Wilde MH, McDonald MV, Brasch J, McMahon JM. Successful recruitment methods in the community for a two-site clinical trial. Appl Nurs Res 2014; 27:254-7. [PMID: 24852451 DOI: 10.1016/j.apnr.2014.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 10/23/2013] [Accepted: 04/05/2014] [Indexed: 11/28/2022]
Abstract
Effective screening and recruitment are essential to the success of randomized clinical trials. This report is to describe key screening and recruitment strategies in a two site randomized clinical trial (RCT) conducted in community settings with a vulnerable chronically ill population and to suggest valuable approaches when planning trials. Differences between sites in a complex study with two considerably different environments (academic versus home care) and their participant pools presented challenges which required different screening and recruitment methods. A high level of communication between sites, creative problem solving and the ability to be flexible when problems were encountered were needed for successful screening and recruitment.
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Affiliation(s)
- Eileen Fairbanks
- University of Rochester, School of Nursing, Rochester, NY 14642.
| | - Shivani Shah
- Visiting Nurse Service of New York, Center for Home Care Policy and Research, New York, NY 10001
| | - Mary H Wilde
- University of Rochester, School of Nursing, Rochester, NY 14642
| | - Margaret V McDonald
- Visiting Nurse Service of New York, Center for Home Care Policy and Research, New York, NY 10001
| | - Judith Brasch
- University of Rochester, School of Nursing, Rochester, NY 14642
| | - James M McMahon
- University of Rochester, School of Nursing, Rochester, NY 14642
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What factors influence uptake into family-based obesity treatment after weight screening? J Pediatr 2013; 163:1657-1662.e1. [PMID: 24075623 DOI: 10.1016/j.jpeds.2013.08.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 07/10/2013] [Accepted: 08/16/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine what factors drive participation in a family-based weight management program for 4- to 8-year-old children following screening for overweight or obesity. STUDY DESIGN Children (n = 1093) attended a comprehensive screening appointment where parents completed questionnaires on demographics, motivation for healthy lifestyles, feeding practices, and beliefs about child size, prior to feedback about the child's weight. Parents of overweight or obese children (body mass index ≥85th percentile) attended a follow-up interview to assess reactions to feedback and willingness to participate in a 2-year intervention. RESULTS A total of 271 (24.8%) children were overweight or obese with 197 (72.7%) agreeing to the intervention. Socioeconomic status differed in intervention participants (n = 197) compared with non-participants (n = 74), whereas no differences were observed in parental feeding practices, ineffective parenting practices, or self-determined forms of motivation. However, fewer non-participating parents believed their child to be overweight (23% vs 49%, P < .001) or were concerned about it (16% vs 43%, P < .001), despite children having an average body mass index approximating the 95th percentile. Non-participating parents did not expect their child to be overweight (P = .002) and rated receiving this information as less useful (P = .008) than participating parents. CONCLUSION Preconceptions about child weight and reactions to feedback determined intervention uptake more than parenting or motivation for health. Many parents agreed to participate in the intervention despite not viewing their child as overweight.
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Wallace DC, Bartlett R. Recruitment and retention of African American and Hispanic girls and women in research. Public Health Nurs 2012; 30:159-66. [PMID: 23452110 DOI: 10.1111/phn.12014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 09/12/2012] [Accepted: 10/09/2012] [Indexed: 11/28/2022]
Abstract
Recruiting women and girls into research studies, especially minority women, continues to be a major challenge that impacts health policy and delivery systems. This article discusses various strategies to recruit and retain African American and Hispanic girls and women in studies. Strategies for successful recruitment focus on trust, familiarity and visibility, racial and ethnic similarities, environmental context, and convenience. Retention strategies include issues of transportation, language, literacy, cultural appropriateness, safety, flexibility, incentives, communication, and veracity. All strategies assist in meeting the challenge of engaging minority women in research to decrease health disparities.
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Affiliation(s)
- Debra C Wallace
- School of Nursing, University of North Carolina at Greensboro, Greensboro, North Carolina, NC 27412, USA.
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