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Klein JD, Gorzkowski J, Resnick EA, Harris D, Kaseeska K, Pbert L, Prokorov A, Wang T, Davis J, Gotlieb E, Wasserman R. Delivery and Impact of a Motivational Intervention for Smoking Cessation: A PROS Study. Pediatrics 2020; 146:e20200644. [PMID: 32989082 PMCID: PMC7546094 DOI: 10.1542/peds.2020-0644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We tested a Public Health Service 5As-based clinician-delivered smoking cessation counseling intervention with adolescent smokers in pediatric primary care practice. METHODS We enrolled clinicians from 120 practices and recruited youth (age ≥14) from the American Academy of Pediatrics Pediatric Research in Office Settings practice-based research network. Practices were randomly assigned to training in smoking cessation (intervention) or social media counseling (attentional control). Youth recruited during clinical visits completed confidential screening forms. All self-reported smokers and a random sample of nonsmokers were offered enrollment and interviewed by phone at 4 to 6 weeks, 6 months, and 12 months after visits. Measures included adolescents' report of clinicians' delivery of screening and counseling, current tobacco use, and cessation behaviors and intentions. Analysis assessed receipt of screening and counseling, predictors of receiving 5As counseling, and effects of interventions on smoking behaviors and cessation at 6 and 12 months. RESULTS Clinicians trained in the 5As intervention delivered more screening (β = 1.0605, P < .0001) and counseling (β = 0.4354, P < .0001). In both arms, clinicians more often screened smokers than nonsmokers. At 6 months, study arm was not significantly associated with successful cessation; however, smokers in the 5As group were more likely to have quit at 12 months. Addicted smokers more often were counseled, regardless of study arm, but were less likely to successfully quit smoking. CONCLUSIONS Adolescent smokers whose clinicians were trained in 5As were more likely to receive smoking screening and counseling than controls, but the ability of this intervention to help adolescents quit smoking was limited.
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Affiliation(s)
- Jonathan D Klein
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois;
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
| | - Julie Gorzkowski
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
| | - Elissa A Resnick
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Donna Harris
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois
| | - Kristen Kaseeska
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Tianxiu Wang
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - James Davis
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois
| | - Edward Gotlieb
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois
| | - Richard Wasserman
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois
- Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont; and
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Cuthel A, Rogers E, Daniel F, Carroll E, Pham-Singer H, Shelley D. Barriers and Facilitators in the Recruitment and Retention of More Than 250 Small Independent Primary Care Practices for EvidenceNOW. Am J Med Qual 2019; 35:388-396. [PMID: 31865749 DOI: 10.1177/1062860619893422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Few studies have examined factors that facilitate recruitment of small independent practices (SIPs) (<5 full-time clinicians) to participate in research and methods for optimizing retention. The authors analyzed qualitative data (eg, recruiter's field notes and diary entries, provider interviews) to identify barriers and facilitators encountered in recruiting and retaining 257 practices in HealthyHearts New York City (NYC). This study was a stepped-wedge randomized controlled trial that took place 2015 through 2018 across 5 boroughs in NYC. Three main factors facilitated rapid recruitment: (1) a prior well-established relationship with the local health department, (2) alignment of project goals with practice priorities, and (3) providing appropriate monetary incentives. Retention was facilitated through similar mechanisms and an ongoing multifaceted communication strategy. This article identifies specific strategies that enhance recruitment of SIPs and fills gaps in knowledge about factors that influence retention in the context of a design that requires waiting to receive the intervention.
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Affiliation(s)
| | - Erin Rogers
- New York University School of Medicine, New York, NY
| | - Flora Daniel
- New York City Department of Health and Mental Hygiene, Queens, NY
| | - Emily Carroll
- New York City Department of Health and Mental Hygiene, Queens, NY
| | - Hang Pham-Singer
- New York City Department of Health and Mental Hygiene, Queens, NY
| | - Donna Shelley
- New York University School of Medicine, New York, NY
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Wong ST, Hogg W, Burge F, Johnston S, French I, Blackman S. Using the CollaboraKTion framework to report on primary care practice recruitment and data collection: costs and successes in a cross-sectional practice-based survey in British Columbia, Ontario, and Nova Scotia, Canada. BMC FAMILY PRACTICE 2018; 19:87. [PMID: 29898667 PMCID: PMC6001004 DOI: 10.1186/s12875-018-0782-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/25/2018] [Indexed: 12/16/2022]
Abstract
Background Across Canada and internationally we have poor infrastructure to regularly collect survey data from primary care practices to supplement data from chart audits and physician billings. The purpose of this work is to: 1) examine the variable costs for carrying out primary care practice-based surveys and 2) share lessons learned about the level of engagement required for recruitment of practices in primary care. Methods This work was part of a larger study, TRANSFORMATION that collected data from three provincial study sites in Canada. We report here on practice-based engagement. Surveys were administered to providers, organizational practice leads, and up to 20 patients from each participating provider. We used the CollaboraKTion framework to report on our recruitment and engagement strategies for the survey work. Data were derived from qualitative sources, including study team meeting minutes, memos/notes from survey administrators regarding their interactions with practice staff, and patients and stakeholder meeting minutes. Quantitative data were derived from spreadsheets tracking numbers for participant eligibility, responses, and completions and from time and cost tracking for patient survey administration. Results A total of 87 practices participated in the study (n = 22 in BC; n = 26 in ON; n = 39 in NS). The first three of five CollaboraKTion activities, Contacting and Connecting, Deepening Understandings, and Adapting and Applying the Knowledge Base, and their associated processes were most pertinent to our recruitment and data collection. Practice participation rates were low but similar, averaging 36% across study sites, and completion rates were high (99%). Patient completion rates were similarly high (99%), though participation rates in BC were substantially lower than the other sites. Recruitment and data collection costs varied with the cost per practice ranging from $1503 to $1792. Conclusions A comprehensive data collection system in primary care is possible to achieve with partnerships that balance researcher, clinical, and policy maker contexts. Engaging practices as valued community members and independent business owners requires significant time, and financial and human resources. An integrated knowledge translation and exchange approach provides a foundation for continued dialogue, exchange of ideas, use of the information produced, and recognises recruitment as part of an ongoing cycle.
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Affiliation(s)
- Sabrina T Wong
- School of Nursing, University of British Columbia, T201 2211 Westbrook Mall, Vancouver, BC, V6T 2B5, Canada. .,Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - William Hogg
- Department of Family Medicine, University of Ottawa, 201-600 Peter Morand Cresc, Ottawa, ON, K1G 5Z3, Canada.,Montfort Hospital Research Institute, 713 Montreal Rd, Ottawa, ON, K1K 0T2, Canada
| | - Fred Burge
- Department of Family Medicine, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Building, Halifax, NS, B3H 2E2, Canada
| | - Sharon Johnston
- Department of Family Medicine, University of Ottawa, 201-600 Peter Morand Cresc, Ottawa, ON, K1G 5Z3, Canada.,Montfort Hospital Research Institute, 713 Montreal Rd, Ottawa, ON, K1K 0T2, Canada
| | - Ilisha French
- Montfort Hospital Research Institute, 713 Montreal Rd, Ottawa, ON, K1K 0T2, Canada
| | - Stephanie Blackman
- Department of Family Medicine, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Building, Halifax, NS, B3H 2E2, Canada
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4
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Understanding and Improving Recruitment to Randomised Controlled Trials: Qualitative Research Approaches. Eur Urol 2017; 72:789-798. [DOI: 10.1016/j.eururo.2017.04.036] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/28/2017] [Indexed: 11/22/2022]
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5
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Sweeney SM, Hall JD, Ono SS, Gordon L, Cameron D, Hemler J, Solberg LI, Crabtree BF, Cohen DJ. Recruiting Practices for Change Initiatives Is Hard: Findings From EvidenceNOW. Am J Med Qual 2017; 33:246-252. [PMID: 28868889 DOI: 10.1177/1062860617728791] [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: 11/16/2022]
Abstract
Engaging primary care practices in initiatives designed to enhance quality, reduce costs, and promote safety is challenging as practices are already participating in numerous projects and mandated programs designed to improve care delivery and quality. Recruiters must expand their recruitment tools to engage today's practices in quality improvement. Using grant proposals, online diaries, observational site visits, and interviews with key stakeholders, the authors identify successful practice recruitment strategies in the EvidenceNOW initiative, which aimed to recruit approximately 1500 small- to medium-sized primary care practices. Recruiters learned they needed to articulate how participation in EvidenceNOW aligned with other initiatives and could help practices succeed with federal and state initiatives, recognition programs, and existing or future payment requirements. Recruiters, initiative leaders, and funders must now consider how their efforts align with ongoing initiatives to successfully recruit and engage practices, ease practice burden, and encourage participation in efforts that support practice transformation.
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Affiliation(s)
| | | | - Sarah S Ono
- 2 Oregon Health & Science University, Portland, OR.,3 VA Portland Health Care System, Portland, OR
| | - Leah Gordon
- 2 Oregon Health & Science University, Portland, OR
| | | | | | - Leif I Solberg
- 4 HealthPartners Institute for Education and Research, Minneapolis, MN
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McIntosh S, Johnson T, Wall AF, Prokhorov AV, Calabro KS, Ververs D, Assibey-Mensah V, Ossip DJ. Recruitment of Community College Students Into a Web-Assisted Tobacco Intervention Study. JMIR Res Protoc 2017; 6:e79. [PMID: 28483741 PMCID: PMC5440736 DOI: 10.2196/resprot.6485] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/28/2016] [Accepted: 12/22/2016] [Indexed: 11/23/2022] Open
Abstract
Background United States college students, particularly those attending community colleges, have higher smoking rates than the national average. Recruitment of such smokers into research studies has not been studied in depth, despite a moderate amount information on study recruitment success with smokers from traditional four-year colleges. Recruitment channels and success are evolving as technology evolves, so it is important to understand how to best target, implement, and evaluate recruitment strategies. Objective The aim of this paper is to both qualitatively and quantitatively explore recruitment channels (eg, mass email, in-person referral, posted materials) and their success with enrollment into a Web-Assisted Tobacco Intervention study in this priority population of underserved and understudied smokers. Methods Qualitative research methods included key informant interviews (n=18) and four focus groups (n=37). Quantitative research methods included observed online responsiveness to any channel (n=10,914), responses from those completing online screening and study consent (n=2696), and responses to a baseline questionnaire from the fully enrolled study participants (n=1452). Results Qualitative results prior to recruitment provided insights regarding the selection of a variety of recruitment channels proposed to be successful, and provided context for the unique attributes of the study sample. Quantitative analysis of self-reported channels used to engage with students, and to enroll participants into the study, revealed the relative utilization of channels at several recruitment points. The use of mass emails to the student body was reported by the final sample as the most influential channel, accounting for 60.54% (879/1452) of the total enrolled sample. Conclusions Relative channel efficiency was analyzed across a wide variety of channels. One primary channel (mass emails) and a small number of secondary channels (including college websites and learning management systems) accounted for most of the recruitment success. Trial Registration ClinicalTrials.gov NCT01692730; https://clinicaltrials.gov/ct2/show/NCT01692730 (Archived by WebCite at http://www.webcitation.org/6qEcFQN9Q)
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Affiliation(s)
- Scott McIntosh
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Tye Johnson
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Andrew F Wall
- School of Education, University of Redlands, Redlands, CA, United States
| | - Alexander V Prokhorov
- MD Anderson Cancer Center, Department of Behavioral Science, The University of Texas, Houston, TX, United States
| | - Karen Sue Calabro
- MD Anderson Cancer Center, Department of Behavioral Science, The University of Texas, Houston, TX, United States
| | - Duncan Ververs
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Vanessa Assibey-Mensah
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
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7
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Messner DA, Moloney R, Warriner AH, Wright NC, Foster PJ, Saag KG. Understanding practice-based research participation: The differing motivations of engaged vs. non-engaged clinicians in pragmatic clinical trials. Contemp Clin Trials Commun 2016; 4:136-140. [PMID: 29736476 PMCID: PMC5935887 DOI: 10.1016/j.conctc.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 11/17/2022] Open
Abstract
Background/Aims Pragmatic clinical trials (PCTs) represent an increasingly used strategy for “real-world” trials. Successful PCTs typically require participation of community-based practices. However, community clinicians often have limited interest or experience in clinical research. Many barriers to practice-based research have been described, but possible motivations to participate among community practices not active in research have not been well explored. The tendency is for researchers to assume similar motivations and priorities across all candidate practices. This is not necessarily the case. A better understanding of the range of reasons clinicians might see for participating in pragmatic trials could be key to promoting this type of practice-based research. Methods Semi-structured interviews were conducted with 30 clinicians and staff members. Half of the interviewees had experience doing practice-based clinical trials and half did not. Individuals in these two groups were also diversified in terms of their practice size and location. Participants were asked about motivations and barriers to doing practice-based research in the context of a planned osteoporosis pragmatic clinical trial. Interviews were transcribed, coded, and analyzed. Results Barriers identified for both experienced and not-experienced clinicians and staff members included: a lack of time, increased paperwork, disruption to work flows, and concern over practice finances. Similar findings have been reported in the US, UK, Europe, and Australia. However, regarding positive motivations of practices to participate, we found systematic differences in attitude between research-engaged and research-naïve practices that have not been previously reported. The research-experienced group offered a greater number and variety of reasons to take part than the not-experienced group. While both groups expressed motivations related to patient care, clinicians and staff members experienced in practice-based clinical trials were much more likely to cite intellectual, professional, and societal benefits not envisioned by the other group. Conclusions We conclude that clinicians not already participating in practice-based trials may have a narrower range of motivations than those already participating. The lack of a broader view of possible benefits to participation may also translate into more obdurate recruiting challenges. These results point to the need for recruitment, engagement, and messaging approaches differentially tailored to the needs and interests of non-participating practices.
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Affiliation(s)
| | | | - Amy H Warriner
- Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, USA
| | - Phillip J Foster
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
| | - Kenneth G Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
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8
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Recruitment of community pharmacies in a randomized trial to generate patient referrals to the tobacco quitline. Res Social Adm Pharm 2012; 9:396-404. [PMID: 22841641 DOI: 10.1016/j.sapharm.2012.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/09/2012] [Accepted: 06/09/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Community pharmacies have the potential to reduce the prevalence of tobacco use, yet most pharmacies do not integrate cessation activities into routine practice. OBJECTIVES The objective of this study was to describe the recruitment strategy and participant yield for a 2-state, randomized trial evaluating 2 intervention approaches for increasing pharmacy-based referrals to tobacco quitlines. METHODS Detailed study recruitment tracking forms were used to document all contact attempts between the study investigators and each potential study site. These data were analyzed to characterize the overall recruitment and consent process for community pharmacies and pharmacy personnel (pharmacists, technicians). RESULTS Achieving the target sample size of 64 study sites required contacting a total of 150 pharmacies (84 independent and 66 chain). Excluding 22 ineligible pharmacies, participation rates were 49% (32 of 65) for independent pharmacies and 51% (32 of 63) for chain pharmacies (50% overall). Across the 64 participating pharmacies, a total of 124 pharmacists (of 171; 73%) and 127 pharmacy technicians (of 215; 59%) were enrolled in the study. Pharmacies that chose not to participate most often cited time constraints as the primary reason. Overall, combining both the recruitment and consent process, a median of 5 contacts were made with each participating pharmacy (range, 2-19; interquartile range [IQR], 4-7), and the median overall duration of time elapsed from initial contact to consent was 25 days (range, 3-122 days; IQR, 12-47 days). CONCLUSIONS Results from this study suggest that community pharmacy personnel are receptive to participation in multisite, tobacco cessation clinical research trials. However, execution of a representative sampling and recruitment scheme for a multistate study in this practice setting is a time- and labor-intensive process.
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Carson KV, Verbiest MEA, Crone MR, Brinn MP, Esterman AJ, Assendelft WJJ, Smith BJ. Training health professionals in smoking cessation. Cochrane Database Syst Rev 2012:CD000214. [PMID: 22592671 PMCID: PMC10088066 DOI: 10.1002/14651858.cd000214.pub2] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cigarette smoking is one of the leading causes of preventable death world wide. There is good evidence that brief interventions from health professionals can increase smoking cessation attempts. A number of trials have examined whether skills training for health professionals can lead them to have greater success in helping their patients who smoke. OBJECTIVES To determine the effectiveness of training health care professionals in the delivery of smoking cessation interventions to their patients, and to assess the additional effects of training characteristics such as intervention content, delivery method and intensity. SEARCH METHODS The Cochrane Tobacco Addiction Group's Specialised Register, electronic databases and the bibliographies of identified studies were searched and raw data was requested from study authors where needed. Searches were updated in March 2012. SELECTION CRITERIA Randomized trials in which the intervention was training of health care professionals in smoking cessation. Trials were considered if they reported outcomes for patient smoking at least six months after the intervention. Process outcomes needed to be reported, however trials that reported effects only on process outcomes and not smoking behaviour were excluded. DATA COLLECTION AND ANALYSIS Information relating to the characteristics of each included study for interventions, participants, outcomes and methods were extracted by two independent reviewers. Studies were combined in a meta-analysis where possible and reported in narrative synthesis in text and table. MAIN RESULTS Of seventeen included studies, thirteen found no evidence of an effect for continuous smoking abstinence following the intervention. Meta-analysis of 14 studies for point prevalence of smoking produced a statistically and clinically significant effect in favour of the intervention (OR 1.36, 95% CI 1.20 to 1.55, p= 0.004). Meta-analysis of eight studies that reported continuous abstinence was also statistically significant (OR 1.60, 95% CI 1.26 to 2.03, p= 0.03).Healthcare professionals who had received training were more likely to perform tasks of smoking cessation than untrained controls, including: asking patients to set a quit date (p< 0.0001), make follow-up appointments (p< 0.00001), counselling of smokers (p< 0.00001), provision of self-help material (p< 0.0001) and prescription of a quit date (p< 0.00001). No evidence of an effect was observed for the provision of nicotine gum/replacement therapy. AUTHORS' CONCLUSIONS Training health professionals to provide smoking cessation interventions had a measurable effect on the point prevalence of smoking, continuous abstinence and professional performance. The one exception was the provision of nicotine gum or replacement therapy, which did not differ between groups.
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Affiliation(s)
- Kristin V Carson
- Clinical Practice Unit, The Queen Elizabeth Hospital, Adelaide, Australia.
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10
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Fletcher B, Gheorghe A, Moore D, Wilson S, Damery S. Improving the recruitment activity of clinicians in randomised controlled trials: a systematic review. BMJ Open 2012; 2:e000496. [PMID: 22228729 PMCID: PMC3253423 DOI: 10.1136/bmjopen-2011-000496] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 12/01/2011] [Indexed: 11/06/2022] Open
Abstract
Background Poor recruitment to randomised controlled trials (RCTs) is a widespread problem. Provision of interventions aimed at supporting or incentivising clinicians may improve recruitment to RCTs. Objectives To quantify the effects of strategies aimed at improving the recruitment activity of clinicians in RCTs, complemented with a synthesis of qualitative evidence related to clinicians' attitudes towards recruiting to RCTs. Data sources A systematic review of English and non-English articles identified from: The Cochrane Library, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ebsco CINAHL, Index to Theses and Open SIGLE from 2001 to March 2011. Additional reports were identified through citation searches of included articles. Study eligibility criteria Quantitative studies were included if they evaluated interventions aimed at improving the recruitment activity of clinicians or compared recruitment by different groups of clinicians. Information about host trial, study design, participants, interventions, outcomes and host RCT was extracted by one researcher and checked by another. Studies that met the inclusion criteria were assessed for quality using a standardised tool, the Effective Public Health Practice Project tool. Qualitative studies were included if they investigated clinicians' attitudes to recruiting patients to RCTs. All results/findings were extracted, and content analysis was carried out. Overarching themes were abstracted, followed by a metasummary analysis. Studies that met the inclusion criteria were assessed for quality using the Critical Appraisal Skills Programme qualitative checklist. Data extraction Data extraction was carried out by one researcher using predefined data fields, including study quality indicators, and verified by another. Results Eight quantitative studies were included describing four interventions and a comparison of recruiting clinicians. One study was rated as strong, one as moderate and the remaining six as weak when assessed for quality using the Effective Public Health Practice Project tool. Effective interventions included the use of qualitative research to identify and overcome barriers to recruitment, reduction of the clinical workload associated with participation in RCTs and the provision of extra training and protected research time. Eleven qualitative studies were identified, and eight themes were abstracted from the data: understanding of research, communication, perceived patient barriers, patient-clinician relationship, effect on patients, effect on clinical practice, individual benefits for clinicians and methods associated with successful recruitment. Metasummary analysis identified the most frequently reported subthemes to be: difficulty communicating trial methods, poor understanding of research and priority given to patient well-being. Overall, the qualitative studies were found to be of good quality when assessed using the Critical Appraisal Skills Programme checklist. Conclusions There were few high-quality trials that tested interventions to improve clinicians' recruitment activity in RCTs. The most promising intervention was the use of qualitative methods to identify and overcome barriers to clinician recruitment activity. More good quality studies of interventions are needed to add to the evidence base. The metasummary of qualitative findings identified understanding and communicating RCT methods as a key target for future interventions to improve recruitment. Reinforcement of the potential benefits, both for clinicians and for their patients, could also be a successful factor in improving recruitment. A bias was found towards investigating barriers to recruitment, so future work should also encompass a focus on successfully recruiting trials.
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Affiliation(s)
- Ben Fletcher
- School of Health and Population Sciences, The University of Birmingham, Edgbaston, Birmingham, UK
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11
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Hum AM, Robinson LA, Jackson AA, Ali KS. Physician communication regarding smoking and adolescent tobacco use. Pediatrics 2011; 127:e1368-74. [PMID: 21576307 PMCID: PMC3103271 DOI: 10.1542/peds.2010-1195] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Physician advice increases quit rates 1% to 3% above unassisted quit rates among adults, an increase sufficient to be ranked as a high-priority, evidence-based preventive service. However, there is little research on the potential impact of physician advice on adolescent smoking. OBJECTIVE The purpose of this study was to examine the association between recalled physician communication and adolescents' attitudes toward smoking, knowledge about smoking, intentions to smoke, tobacco use, and quitting behaviors. METHODS This study was a retrospective observational study of 5154 students (82.9% black, 17.1% white) from an urban, mid-South school system. Outcome variables included adolescents' self-rated attitudes toward smoking, knowledge about smoking, intentions to smoke, tobacco use, and quitting behaviors. RESULTS Physician advice and the combination of screening and advice were associated with healthier attitudes about smoking. Physician screening and advice were also associated with a more accurate knowledge regarding tobacco-related damage. Among current smokers, recalled physician advice was also associated with reduced intentions to smoke in 5 years. Importantly, advised teens were more likely to plan to quit smoking in 6 months. Furthermore, teens who were screened by their physician reported significantly more quit attempts than those who were neither screened nor advised (P = .007). CONCLUSIONS Physician's tobacco-related interactions with adolescents seemed to positively impact their attitudes, knowledge, intentions to smoke, and quitting behaviors. Brief physician interventions have the potential to be a key intervention on a public health level through the prevention, cessation, and reduction of smoking and smoking-related disease.
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Affiliation(s)
- Ashley M. Hum
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | | | - Ashley A. Jackson
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Khatidja S. Ali
- Department of Psychology, The University of Memphis, Memphis, Tennessee
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12
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Pinto-Foltz MD, Logsdon MC, Derrick A. Engaging adolescent mothers in a longitudinal mental health intervention study: challenges and lessons learned. Issues Ment Health Nurs 2011; 32:214-9. [PMID: 21355755 PMCID: PMC3079417 DOI: 10.3109/01612840.2010.544841] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Little is known about recruiting and retaining adolescent mothers in research studies. Investigators who study adolescent mothers have been guided by trial and error, clinical experience, qualitative inquiry, literature of special populations, or the advice of stakeholders. This paper describes the challenges and lessons learned in engaging adolescent mothers in a longitudinal community-based mental health intervention study. Audio-recorded data that describes the circumstances of five adolescent mothers lost to attrition were extracted from a longitudinal mental health intervention study. Adolescent mothers described a chaotic home environment with multiple demands, family conflict, health issues, limited access to a telephone, transportation, financial, and social support. Utilizing a multidisciplinary community advisory group, dedicated telephone, and free electronic media may assist in overcoming modifiable barriers to recruitment and retention of adolescent mothers. Exploring a waiver of informed consent and the engagement of mothers of adolescents in research are indicated.
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Affiliation(s)
- Melissa D. Pinto-Foltz
- KL2 Clinical Research Scholar, Case Western Reserve University/Cleveland Clinic Instructor, Frances Payne Bolton School of Nursing Case Western Reserve University 10900 Euclid Avenue, Cleveland, OH 44106-4904
| | - M. Cynthia Logsdon
- Associate Chief of Nursing Research, University of Louisville HospitalProfessor, School of Nursing; Professor of Obstetrics, Gynecology, and Women’s Health, School of Medicine; Associate Faculty, Department of Psychological and Brain Sciences, University of Louisville, 555 South Floyd Street, Louisville, KY 40202
| | - Ann Derrick
- Child and Adolescent Psychiatric Nurse Practitioner, Bingham Child Guidance Center, Louisville, KY
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Johnston S, Liddy C, Hogg W, Donskov M, Russell G, Gyorfi-Dyke E. Barriers and facilitators to recruitment of physicians and practices for primary care health services research at one centre. BMC Med Res Methodol 2010; 10:109. [PMID: 21144048 PMCID: PMC3017524 DOI: 10.1186/1471-2288-10-109] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 12/13/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While some research has been conducted examining recruitment methods to engage physicians and practices in primary care research, further research is needed on recruitment methodology as it remains a recurrent challenge and plays a crucial role in primary care research. This paper reviews recruitment strategies, common challenges, and innovative practices from five recent primary care health services research studies in Ontario, Canada. METHODS We used mixed qualitative and quantitative methods to gather data from investigators and/or project staff from five research teams. Team members were interviewed and asked to fill out a brief survey on recruitment methods, results, and challenges encountered during a recent or ongoing project involving primary care practices or physicians. Data analysis included qualitative analysis of interview notes and descriptive statistics generated for each study. RESULTS Recruitment rates varied markedly across the projects despite similar initial strategies. Common challenges and creative solutions were reported by many of the research teams, including building a sampling frame, developing front-office rapport, adapting recruitment strategies, promoting buy-in and interest in the research question, and training a staff recruiter. CONCLUSIONS Investigators must continue to find effective ways of reaching and involving diverse and representative samples of primary care providers and practices by building personal connections with, and buy-in from, potential participants. Flexible recruitment strategies and an understanding of the needs and interests of potential participants may also facilitate recruitment.
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Affiliation(s)
- Sharon Johnston
- Department of Family Medicine, University of Ottawa, 43 Bruyère Street, Ottawa, Ontario, Canada.
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Hoving C, Mudde AN, de Vries H. Effect of recruitment method and setting on the composition of samples consisting of adult smokers. PATIENT EDUCATION AND COUNSELING 2007; 65:79-86. [PMID: 16872796 DOI: 10.1016/j.pec.2006.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Revised: 05/22/2006] [Accepted: 05/26/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE This study aims to determine differences in samples of adult smokers recruited by passive or active recruitment in community pharmacy (PP and AP) or passive recruitment in general practice setting (PG), then comparing these samples to an unrecruited cohort of Dutch smokers. METHODS The three recruited samples were compared on demographics, smoking behaviour, motivational determinants, stage of change and intention to use specific action plans when quitting using multinomial logistic regression analyses; this method was also used to assess whether recruitment affected the acquired samples concerning demographic variables compared with the cohort. PP, AP and PG response rates were compared with Tukey post hoc tests. RESULTS Significant differences were found for both AP and PG smokers, compared with PP smokers. Most important results include a higher rate of pre-contemplators in the AP sample and a lower educational level in the PG sample. All recruited samples appeared to be significantly different from the cohort sample. CONCLUSION Recruitment method and primary care setting does influence the sample recruited, this should be taken into consideration when recruiting a specific sub-sample. PRACTICE IMPLICATIONS These results are valuable for researchers contemplating recruitment in a primary care setting.
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Affiliation(s)
- Ciska Hoving
- University of Maastricht, Department of Health Promotion and Health Education, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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