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Wang C, Hunger JM, Liao J, Figueroa D, Lopez A, Tomiyama AJ. Examining the effect of weight-related recruitment information on participant characteristics: A randomized field experiment. Obes Sci Pract 2024; 10:e739. [PMID: 38313600 PMCID: PMC10835742 DOI: 10.1002/osp4.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/14/2023] [Accepted: 01/14/2024] [Indexed: 02/06/2024] Open
Abstract
Objective Although 82% of American adults have a body mass index (BMI) of over 25, individuals with elevated BMI are considered difficult to recruit for studies. Effective participant identification and recruitment are crucial to minimize the likelihood of sampling bias. One understudied factor that could lead to sampling bias is the study information presented in recruitment materials. In the context of weight research, potential participants with higher weight may avoid studies that advertise weight-related procedures. Thus, this study experimentally manipulated the phrasing of weight-related information included in recruitment materials and examined its impact on participants' characteristics. Methods Two visually similar flyers, either weight-salient or neutral, were randomly posted throughout a university campus to recruit participants (N = 300) for a short survey, assessing their internalized weight bias, anticipated and experienced stigmatizing experiences, eating habits, and general demographic characteristics. Results Although the weight-salient (vs. neutral) flyer took 18.5 days longer to recruit the target sample size, there were no between flyer differences in respondents' internalized weight bias, anticipated/experienced weight stigma, disordered eating behaviors, BMI, or perceived weight. Absolute levels of these variables, however, were low overall. Conclusion Providing detailed information about study procedures allows participants to have more autonomy over their participation without differentially affecting participant characteristics.
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Affiliation(s)
- Christy Wang
- Department of Psychology University of California Los Angeles California USA
| | | | - Joseph Liao
- Department of Psychology University of California Los Angeles California USA
| | - David Figueroa
- Department of Psychology University of California Los Angeles California USA
| | - Alejandra Lopez
- Department of Psychology University of California Los Angeles California USA
| | - A Janet Tomiyama
- Department of Psychology University of California Los Angeles California USA
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2
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Bessell E, Markovic TP, Caterson ID, Hendy C, Burk J, Picone T, Fuller NR. Cost-effectiveness analysis of recruitment strategies in a large diabetes prevention trial conducted across two sites in Sydney, Australia. Contemp Clin Trials 2024; 137:107421. [PMID: 38145712 DOI: 10.1016/j.cct.2023.107421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Diabetes prevention trials require large samples and community-based recruitment, which can be protracted and expensive. We analysed the cost-effectiveness of recruitment strategies used in a randomised placebo-controlled supplement trial in adults with prediabetes and overweight or obesity conducted in Sydney, Australia. METHODS Recruitment strategies included advertising through local radio stations and newspapers, television news coverage, online advertising and editorials, advertising in and referral from primary care settings, university- and hospital-based advertising, and attending or hosting local events. For each strategy, the number of expressions of interest, screenings booked, and randomised participants were collated. The percentage contribution from each strategy, overall cost, and cost per participant were calculated. RESULTS Of 4498 expressions of interest, 551 (12%) were eligible for onsite screening and 401 (9%) were randomised. Recruitment costs totalled AU$218,501, averaging AU$545 per participant. The recruitment strategy was recorded for 49% who expressed interest in the trial, and for 75% randomised into the trial. From these data, advertising on local radio stations was the most cost-effective strategy, contributing 46% of participants at AU$286 per participant, then advertising in and referral from primary care settings (57 participants [19%], AU$1438 per participant). The least cost-effective strategy was television news coverage, which was not targeted to the Sydney-based audience, contributing only six participants (AU$10,000 per participant). CONCLUSION Radio advertising and recruitment through healthcare were the most effective recruitment strategies in this trial. Recruitment strategies should be location-specific and appropriate for the target population, prioritising low-effort high-yield strategies. Trial investigators should seek opportunities for free advertising.
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Affiliation(s)
- Erica Bessell
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia.
| | - Tania P Markovic
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia; Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Ian D Caterson
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia; Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Chelsea Hendy
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia
| | - Jessica Burk
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia
| | - Tegan Picone
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia
| | - Nicholas R Fuller
- The University of Sydney, The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, NSW, Australia
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3
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Gwon SH, Lee HJ, Cho YI, Noonan D. Recruitment of Young Adults: Lessons Learned From Research on Rural E-Cigarette Use and Cessation. West J Nurs Res 2023; 45:980-985. [PMID: 37646373 DOI: 10.1177/01939459231196434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Electronic nicotine delivery system (ENDS) use continues to grow in rural areas of the United States. In particular, young adults (18-24 years) in rural areas are a hard-to-reach population in regard to understanding the growing ENDS use trend. The purpose of this article was to describe recruitment strategies that were used for a series of ENDS-relevant projects for young adults in rural areas, report recruitment yields from these strategies, and provide methodological considerations to aid researchers in improving recruitment. We used descriptive statistical methods to characterize recruitment yields (responses to screening vs initial invites, and number of individuals who fully met eligibility criteria vs responses to screening) from 2 ENDS studies that focused on 3 main recruitment strategies, including student directories, leadership offices (eg, Student Affairs), and regional tobacco control support networks (eg, Area Health Education Centers) for reaching young adults in rural communities. The recruitment yield rates varied and ranged from 2% to 14% depending on strategy with leadership offices resulting in the highest recruitment yield. Methodological considerations by strategy are described in detail. Results of this study can be used to inform tailored recruitment strategies to increase the representation of rural young adults in ENDS or other tobacco research.
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Affiliation(s)
- Seok Hyun Gwon
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
- Clinical & Translational Science Institute, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Young Ik Cho
- Joseph J. Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Devon Noonan
- School of Nursing, Duke University, Durham, NC, USA
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4
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Pérez-Muñoz A, Horn TL, Graber J, Chowdhury SMR, Bursac Z, Krukowski RA. Recruitment strategies for a post cessation weight management trial: A comparison of strategy cost-effectiveness and sample diversity. Contemp Clin Trials Commun 2022; 30:101037. [DOI: 10.1016/j.conctc.2022.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/28/2022] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
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5
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Tang JS, Haslam RL, Ashton LM, Fenton S, Collins CE. Gender differences in social desirability and approval biases, and associations with diet quality in young adults. Appetite 2022; 175:106035. [PMID: 35405222 DOI: 10.1016/j.appet.2022.106035] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 01/05/2023]
Abstract
Social desirability and approval biases can influence self-report of diet, contributing to inaccurate assessment. Biases may be influenced by sex. This study examined gender differences in social desirability and approval, and diet quality in young adults, and relationships between social biases and diet quality. Data from 1003 young adults participating in the Advice, Ideas and Motivation for My Eating trial, median age 21.7 years, BMI 24.7 kg/m2 were included. Biases were measured using Marlowe-Crowne Social Desirability Scale Short-Form, Martin Larsen Approval Motivation Scale, and diet quality using the Australian Recommended Food Score. Pearson chi-square, t-test and Wilcoxon tests evaluated gender differences and Spearman's rank-order tested strengths of correlations between biases and diet quality. Social desirability did not differ by gender, however females reported higher social approval scores than males (p = 0.009). Among females, there was a positive correlation between social desirability and diet quality (p = 0.002), and between social approval and dairy sub-scale (p < 0.001); and a negative correlation between social approval and vegetable subscale (p = 0.045). Among males there were no correlations between social desirability or social approval and overall diet quality. Social approval may be more common in females and influence self-reported diet. To address bias and mis-reporting errors, future studies should account for participants' social desirability and/or social approval status, especially among young adult females. Further research is needed to explore gender differences in social desirability and approval in young adults, and associations between social biases and diet quality.
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Affiliation(s)
- Jei Sey Tang
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Rebecca L Haslam
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Lee M Ashton
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; College of Human and Social Futures, School of Education, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Sasha Fenton
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Clare E Collins
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
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Zhang Q, O'Connor DB, Hugh-Jones S. Feasibility of a multiple-component mindfulness intervention for Chinese adolescents living with overweight: A pilot randomized trial. Appl Psychol Health Well Being 2022; 15:516-535. [PMID: 35860947 DOI: 10.1111/aphw.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/10/2022] [Indexed: 11/27/2022]
Abstract
The prevalence of obesity among Chinese adolescents is rising rapidly, and theoretically informed, scalable weight management interventions are needed. We developed and evaluated the feasibility and preliminary effects of an mHealth nutrition education and mindful snacking intervention for weight loss and improved dietary practices among Chinese adolescents with overweight. We examined whether including implementation intention formation (using if-then plans) improved outcomes. With user consultation, we created a 3-week mindful eating intervention delivered as 10 videos to user smartphones. Participants (n = 55) were randomly assigned to mindful eating or mindful eating + planning. Forty-six (83.6%) participants (age = 16.35 ± 0.48 years; body mass index [BMI] = 25.79 ± 2.05 kg/m2 ) completed the intervention. Both groups exhibited significant pre- to post-intervention weight loss (M = 1.42 and 1.79 kg, respectively); decreases in snacking frequencies, emotional eating, external eating, and trait craving; and significant increases in mindful eating and eating self-efficacy. No significant intervention group differences were observed. User experience data (n = 16) indicated acceptability and meaningful behavior change. Findings suggest that a smartphone-delivered mindfulness-based intervention for Chinese adolescents living with overweight is feasible and efficacious.
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Affiliation(s)
- Qian Zhang
- School of Psychology, University of Leeds, Leeds, UK
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7
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Valle CG, Camp LN, Diamond M, Nezami BT, LaRose JG, Pinto BM, Tate DF. Recruitment of young adult cancer survivors into a randomized controlled trial of an mHealth physical activity intervention. Trials 2022; 23:254. [PMID: 35379294 PMCID: PMC8981777 DOI: 10.1186/s13063-022-06148-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
Few studies have recruited young adult cancer survivors (YACS) from around the USA into remotely-delivered behavioral clinical trials. This study describes recruitment strategies used in the IMproving Physical Activity after Cancer Treatment (IMPACT) study, a 12-month randomized controlled trial of a mobile physical activity intervention for YACS.
Methods
We conducted formative work to guide development of recruitment messages and used a variety of methods and channels to recruit posttreatment YACS (diagnosed ages 18–39, participating in < 150 min/week of moderate-to-vigorous intensity activity). We used targeted social media advertisements, direct mailings, clinical referrals, and phone calls to potentially eligible individuals identified through local tumor registries. We also asked community organizations to share study information and advertized at a national conference for YACS.
Results
The final sample of 280 participants (23% identified as racial/ethnic minority individuals, 18% male, mean 33.4 ± 4.8 years) was recruited over a 14-month period. About 38% of those who completed initial screening online (n = 684) or via telephone (n = 63) were randomized. The top recruitment approach was unpaid social media, primarily via Facebook posts by organizations/friends (45%), while direct mail yielded 40.7% of participants. Other social media (paid advertisements, Twitter), email, clinic referrals, and conference advertisements each yielded 3% or fewer participants. The most cost-effective methods per participant recruited were unpaid social media posts and direct mailings.
Conclusions
The IMPACT trial successfully met enrollment goals using a national strategy to recruit physically inactive YACS. Our approaches can inform recruitment planning for other remotely-delivered intervention trials enrolling YACS.
Trial registration
ClinicalTrials.govNCT03569605. Registered on 26 June 2018.
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Baldassari I, Oliverio A, Krogh V, Bruno E, Gargano G, Cortellini M, Casagrande A, Di Mauro MG, Venturelli E, Del Sette Cerulli D, Manuela B, Berrino F, Pasanisi P. Recruitment in randomized clinical trials: The MeMeMe experience. PLoS One 2022; 17:e0265495. [PMID: 35333878 PMCID: PMC8956174 DOI: 10.1371/journal.pone.0265495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
Recruitment is essential for the success of clinical trials. We are conducting a randomized clinical trial to test the effect of a Mediterranean dietary intervention with or without 1700 mg/day of metformin for the prevention of age-related chronic diseases, the MeMeMe trial (Trial registration number: EudraCT number: 2012-005427-32 ClinicalTrials.gov ID: NCT02960711). MeMeMe recruiting experience, highlighting strengths, limitations encountered and results is reported.
Patients and methods
Statistical analysis focused on the reasons for withdrawal according to the recruitment method (“active” versus “passive” criterion) and the time of withdrawal. Logistic regression models were used to explore the associations between the risk of withdrawal and sex, recruitment method, randomization arm, and with markers of compliance to the intervention, such as one-year change in body weight.
Results
Out of 2035 volunteers, 660 (32.4%) were recruited “actively” and 1375 (67.6%) “passively”. Among people who dropped out of the trial after randomization, there were 19.5% for the “active” and 22.0% for the “passive” method (p = 0.28). The risk of withdrawal was significantly higher in women (OR:1.91; 95% CI:1.17–3.12; p = 0.01), in volunteers older at recruitment (OR:1.25; 95% CI:1.07–1.45; p = 0.004), and in those with a higher BMI at baseline (OR:1.23; 95% CI:1.07–1.43; p = 0.004). Volunteers who lost at least 2 kg (the median weight change) in the first year of intervention were significantly less (53%) likely to withdraw from the trial (OR:0.48; 95% CI:0.30–0.75; p = 0.001).
Conclusion
Our findings suggest that the “passive” recruitment method was more effective than the “active” one to advance recruitment. The benefits of “passive” recruitment hardly outweighed the drawbacks.
Trial registration
Trial registration number: EudraCT number: 2012-005427-32. ClinicalTrials.gov ID: NCT02960711.
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Affiliation(s)
- Ivan Baldassari
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Andreina Oliverio
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
- * E-mail:
| | - Vittorio Krogh
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Eleonora Bruno
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Giuliana Gargano
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Mauro Cortellini
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Alice Casagrande
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Maria G. Di Mauro
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Elisabetta Venturelli
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Daniela Del Sette Cerulli
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Bellegotti Manuela
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Franco Berrino
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
| | - Patrizia Pasanisi
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan (MI), Italy
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Willmott TJ, Mathew A, Luck E, Rundle-Thiele S, Carins J, Vincze L, Williams L, Ball L. Participatory design application in obesity prevention targeting young adults and adolescents: a mixed-methods systematic scoping review protocol. Syst Rev 2022; 11:51. [PMID: 35317866 PMCID: PMC8939071 DOI: 10.1186/s13643-022-01900-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 02/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Prevention of obesity is economically and sociologically preferable to treatment, with early intervention key to preventing excess weight gain and obesity. The transition from adolescence to young adulthood is a critical intervention period. An expert-led, top-down model has dominated obesity prevention research and practice with limited success. Participatory design (PD) offers potential in transforming obesity prevention research and practice by delivering bottom-up solutions that young people value and may therefore voluntarily engage with over time. An evidence synthesis of PD application in obesity prevention targeting adolescents and young adults is currently lacking. OBJECTIVES Report the protocol for a mixed-methods systematic scoping review which aims to integrate and synthesise available evidence on PD application in obesity prevention targeting adolescents and young adults. Specifically, the review will address three research questions: RQ1: How is PD defined in obesity prevention interventions targeting adolescents and young adults? RQ2: To what extent is PD applied in obesity preventions interventions targeting adolescents and young adults? RQ3a: How is the utility of PD evaluated in obesity preventions interventions targeting adolescents and young adults? RQ3b: What is the utility of PD application in obesity prevention interventions targeting adolescents and young adults? METHODS This mixed-methods systematic scoping review protocol adheres to the PRISMA-P guidelines and is informed by the PRISMA extension for scoping reviews (PRISMA-ScR). The search strategy and eligibility criteria are informed by the sample, phenomenon of interest, design, evaluation, and research type tool. Eligible studies will be peer-reviewed literature published in English, reporting on PD application in obesity prevention interventions (including intervention development, implementation, and/or evaluation) targeting adolescents and young adults (aged 10-35 years). Study designs will include qualitative, quantitative, and mixed methods. The review will comprise a systematic literature search, eligibility screening, data extraction, quality assessment using the Mixed-Methods Appraisal Tool (MMAT), and data analysis using an iterative narrative evidence synthesis approach. Evidence on PD application will be thematically integrated in terms of who was involved, when they were involved, and how and why they were involved. Further thematic analyses will be conducted according to the MATE taxonomy and the United Kingdom Medical Research Council (UK MRC's) key functions of process evaluations. The MATE taxonomy classifies PD application in terms of methodology, agent of change, training, and engagement. The MRC describes three functions of process evaluations: implementation, mechanisms of impact, and context. Applying both in the evidence synthesis is intended to provide a more complete picture of PD application. Exploratory analyses will be conducted to assess any potential associations between PD application and effectiveness across key outcomes (weight, physical activity, sedentary time, nutrition and dietary habit, mental health, and sleep) reported within intervention evaluations. CONCLUSIONS Elucidating PD application is a prerequisite to establishing its utility. Through the location and synthesis of available evidence on PD application in obesity prevention targeting adolescents and young adults, this review will categorise and describe different methods of PD application and explore the utility of PD application including whether any differences may be observed between PD method applied and the effectiveness of obesity prevention interventions. Implications will be delineated from the narrative evidence synthesis to inform future research and advance practice in this context. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021268240.
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Affiliation(s)
- Taylor Jade Willmott
- Adelaide Business School, The University of Adelaide, 10 Pulteney Street, Adelaide, South Australia, 5005, Australia.
| | - Alieena Mathew
- Social Marketing @ Griffith, Griffith Business School, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Eve Luck
- Social Marketing @ Griffith, Griffith Business School, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Julia Carins
- Social Marketing @ Griffith, Griffith Business School, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Lisa Vincze
- Nutrition and Dietetics, School of Health Sciences and Social Work, Griffith University, 1 Parklands Dr, Southport, QLD, 4215, Australia
| | - Lauren Williams
- Nutrition and Dietetics, School of Health Sciences and Social Work, Griffith University, 1 Parklands Dr, Southport, QLD, 4215, Australia
| | - Lauren Ball
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Southport, Australia
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Porter G, Michaud TL, Schwab RJ, Hill JL, Estabrooks PA. Reach Outcomes and Costs of Different Physician Referral Strategies for a Weight Management Program Among Rural Primary Care Patients: Type 3 Hybrid Effectiveness-Implementation Trial. JMIR Form Res 2021; 5:e28622. [PMID: 34668873 PMCID: PMC8567148 DOI: 10.2196/28622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rural residents are at high risk for obesity; however, little resources exist to address this disproportional burden of disease. Primary care may provide an opportunity to connect primary care patients with overweight and obesity to effective weight management programming. OBJECTIVE The purpose of this study is to examine the utility of different physician referral and engagement processes for improving the reach of an evidence-based and technology-delivered weight management program with counseling support for rural primary care patients. METHODS A total of 5 rural primary care physicians were randomly assigned a sequence of four referral strategies: point-of-care (POC) referral with active telephone follow-up (ATF); POC referral, no ATF; a population health registry-derived letter referral with ATF; and letter referral, no ATF. For registry-derived referrals, physicians screened a list of patients with BMI ≥25 and approved patients for participation to receive a personalized referral letter via mail. RESULTS Out of a potential 991 referrals, 573 (57.8%) referrals were made over 16 weeks, and 98 (9.9%) patients were enrolled in the program (58/98, 59.2% female). Differences based on letter (485/991, 48.9%) versus POC (506/991, 51.1%) referrals were identified for completion (100% vs 7%; P<.001) and for proportion screened (36% vs 12%; P<.001) but not for proportion enrolled (12% vs 8%; P=.10). Patients receiving ATF were more likely to be screened (47% vs 7%; P<.001) and enrolled (15% vs 7%; P<.001) than those not receiving ATF. On the basis of the number of referrals made in each condition, we found variations in the proportion and number of enrollees (POC with ATF: 27/190, 50%; POC no ATF: 14/316, 41%; letter ATF: 30/199; 15.1%; letter no ATF: 27/286, 9.4%). Across all conditions, participants were representative of the racial and ethnic characteristics of the region (60% female, P=.15; 94% White individuals, P=.60; 94% non-Hispanic, P=.19). Recruitment costs totaled US $6192, and the overall recruitment cost per enrolled participant was US $63. Cost per enrolled participant ranged from POC with ATF (US $47), registry-derived letter without ATF (US $52), and POC without ATF (US $56) to registry-derived letter with ATF (US $91). CONCLUSIONS Letter referral with ATF appears to be the best option for enrolling a large number of patients in a digitally delivered weight management program; however, POC with ATF and letters without ATF yielded similar numbers at a lower cost. The best referral option is likely dependent on the best fit with clinical resources. TRIAL REGISTRATION ClinicalTrials.gov NCT03690557; http://clinicaltrials.gov/ct2/show/NCT03690557.
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Affiliation(s)
- Gwenndolyn Porter
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, United States
| | - Tzeyu L Michaud
- Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE, United States
| | - Robert J Schwab
- University of Nebraska Medical Center, Omaha, NE, United States
| | - Jennie L Hill
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Paul A Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, United States
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11
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The Relationship Between Habitual Physical Activity, Sitting Time, and Cognitive Function in Young Adult Women. J Phys Act Health 2021; 18:1082-1087. [PMID: 34186507 DOI: 10.1123/jpah.2020-0705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is evidence that physical activity (PA), sitting time, and obesity may impact cognition, but few studies have examined this in young women. METHODS Healthy women (18-35 y), without conditions that impair cognition, were recruited for this cross-sectional study. Participants completed anthropometric and validated computerized cognitive assessments (IntegNeuro™). Performance on 5 cognitive domains (impulsivity, attention, information processing, memory, and executive function) was reported as z scores. Sitting hours and weekly PA calculated from time in low-, moderate-, and high-intensity activity were obtained via the International Physical Activity Questionnaire. Analysis of variance/analysis of covariance, chi-square, and linear regression were used. RESULTS 299 (25.9 [5.1] y) women (low PA = 19%; moderate PA = 40%; high PA = 41%) participated. High PA women had lower body mass index (high PA = 26.1 [6.5]; moderate PA = 30.0 [8.7]; low PA = 31.0 [11.1] kg/m2; P < .001) and less sitting time (high PA = 6.6 [3.1]; moderate PA = 7.7 [2.8]; low PA = 9.3 [3.6] hr/weekday; P < .0001). Cognitive function was within normal ranges and did not differ between any PA groups (P = .42). Adjusting for body mass index, C-reactive protein, or sitting hours did not alter results. Weak correlations were found between time in high-intensity activity and impulsivity (b = 0.12, r2 = .015; P = .04), and between sitting hours and information processing efficiency (b = -0.18, r2 = .03; P = .002). Valuesare presented as mean (SD). CONCLUSIONS Cognitive function was within the normal range, regardless of PA or sitting time.
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Whiteley JA, Faro JM, Mavredes M, Hayman LL, Napolitano MA. Application of social marketing to recruitment for a digital weight management intervention for young adults. Transl Behav Med 2021; 11:484-494. [PMID: 32293670 DOI: 10.1093/tbm/ibaa032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Recruiting young adults into weight loss interventions poses challenges that may be mitigated by the use of novel social marketing strategies. The purpose of this study is to describe how social marketing principles were applied to recruitment for a digitally delivered randomized controlled trial for weight management among young adults and report recruitment data and demographics on those who enrolled and did not enroll in the study. The marketing mix of the 7Ps (i.e., product, price, place, promotion, packaging, positioning, and people) was applied to intervention recruitment. Prior to enrollment, respondents completed a screening survey, which was examined to determine optimal strategies for study awareness and enrollment. Of the initial 5,731 who initiated a screener, 3,059 provided data on the source of where they heard about the study. Subsequently, 460 (12.5%) were enrolled in the study, 409 (51.3% non-White; 78.7% female; body mass index: 30.6 ± 4.3) provided data on recruitment source, with emails (72.5%), cited most often followed by flyers/posters (8.8%), "other" (6.7%), and multiple sources (6.6%). Although email remained the most frequently cited promotion source, Pearson's chi-squared tests revealed that, compared to those not enrolled in the study, those who enrolled were more likely to hear about the study via flyers/posters (enrolled = 14.4%; not enrolled = 7.9%; p < .001) and multiple sources (enrolled = 11.7%; not enrolled 5.85%; p < .01) and less likely to hear via email (enrolled = 62.1%; not enrolled = 74.2%; p < .01). This study applied social marketing principles to successfully recruit a large and diverse group of young adults. While email emerged as the most effective source of study awareness, multiple channels and a mix of marketing principles are recommended for recruiting in university settings.
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Affiliation(s)
- Jessica A Whiteley
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Jamie M Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Meghan Mavredes
- Department of Prevention and Community Health, The George Washington University, Washington, DC, USA
| | - Laura L Hayman
- Departments of Prevention and Community Health and Exercise and Nutrition Sciences, Boston, MA, USA
| | - Melissa A Napolitano
- Department of Prevention and Community Health, The George Washington University, Washington, DC, USA
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Ashton LM, Rollo ME, Adam M, Burrows T, Shrewsbury VA, Collins CE. Process Evaluation of the 'No Money No Time' Healthy Eating Website Promoted Using Social Marketing Principles. A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073589. [PMID: 33808432 PMCID: PMC8038032 DOI: 10.3390/ijerph18073589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Reaching and engaging individuals, especially young adults, in web-based prevention programs is challenging. ‘No Money No Time’ (NMNT) is a purpose built, healthy eating website with content and a social marketing strategy designed to reach and engage a young adult (18–34 year olds) target group. The aim of the current study was to conduct a process evaluation of the 12-month social marketing strategy to acquire and engage NMNT users, particularly young adults. Methods: a process evaluation framework for complex interventions was applied to investigate the implementation of the social marketing strategy component, mechanisms of impact and contextual factors. Google Analytics data for the first 12 months of operation (17 July 2019 to 17 July 2020) was evaluated. Results: in year one, 42,413 users from 150+ countries accessed NMNT, with 47.6% aged 18–34 years. The most successful channel for acquiring total users, young adults and return users was via organic search, demonstrating success of our marketing strategies that included a Search Engine Optimisation audit, a content strategy, a backlink strategy and regular promotional activities. For engagement, there was a mean of 4.46 pages viewed per session and mean session duration of 3 min, 35 s. Users clicked a ‘call-to-action’ button to commence the embedded diet quality tool in 25.1% of sessions. The most common device used to access NMNT (63.9%) was smartphone/mobile. Engagement with ‘quick, cheap and healthy recipes’ had the highest page views. Conclusions: findings can inform online nutrition programs, particularly for young adults, and can apply to other digital health programs.
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Affiliation(s)
- Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia
- Correspondence: ; Tel.: +61-(2)-4913-8034
| | - Megan E. Rollo
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Marc Adam
- School of Electrical Engineering and Computing, College of Engineering, Science and Environment, University of Newcastle, Callaghan, 2308 Newcastle, Australia;
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Vanessa A. Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
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Recruiting and retaining young adults: what can we learn from behavioural interventions targeting nutrition, physical activity and/or obesity? A systematic review of the literature. Public Health Nutr 2021; 24:5686-5703. [PMID: 33722332 DOI: 10.1017/s1368980021001129] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe strategies used to recruit and retain young adults in nutrition, physical activity and/or obesity intervention studies, and quantify the success and efficiency of these strategies. DESIGN A systematic review was conducted. The search included six electronic databases to identify randomised controlled trials (RCT) published up to 6 December 2019 that evaluated nutrition, physical activity and/or obesity interventions in young adults (17-35 years). Recruitment was considered successful if the pre-determined sample size goal was met. Retention was considered acceptable if ≥80 % retained for ≤6-month follow-up or ≥70 % for >6-month follow-up. RESULTS From 21 582 manuscripts identified, 107 RCT were included. Universities were the most common recruitment setting used in eighty-four studies (79 %). Less than half (46 %) of the studies provided sufficient information to evaluate whether individual recruitment strategies met sample size goals, with 77 % successfully achieving recruitment targets. Reporting for retention was slightly better with 69 % of studies providing sufficient information to determine whether individual retention strategies achieved adequate retention rates. Of these, 65 % had adequate retention. CONCLUSIONS This review highlights poor reporting of recruitment and retention information across trials. Findings may not be applicable outside a university setting. Guidance on how to improve reporting practices to optimise recruitment and retention strategies within young adults could assist researchers in improving outcomes.
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15
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Hoenink JC, Mackenbach JD, van der Laan LN, Lakerveld J, Waterlander W, Beulens JWJ. Recruitment of Participants for a 3D Virtual Supermarket: Cross-sectional Observational Study. JMIR Form Res 2021; 5:e19234. [PMID: 33560230 PMCID: PMC7902190 DOI: 10.2196/19234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/14/2020] [Accepted: 01/17/2021] [Indexed: 12/19/2022] Open
Abstract
Background Virtual supermarkets offer a practical and affordable setting to test the efficacy of different pricing and nudging strategies before they are implemented in the real world. Despite the advantages of using virtual supermarkets for this purpose, conducting studies in online settings is challenging with regard to recruitment and retention of sufficient and suitable participants. Objective To describe cost, time, and retention with regard to participants recruited using various strategies and potential sociodemographic differences between participants recruited via different strategies. Methods This cross-sectional study used data from a randomized controlled trial in which 455 Dutch adults with low and high educational levels were invited to shop 5 times in a 3D virtual supermarket. Participants were recruited via social media and flyers. A log that tracked the costs of and time spent on the different recruitment strategies was kept by the study team. Outcome measures included the cost of recruitment strategies, the time investment by researchers, and recruitment and attrition rates of participants in the study. Results The median age of study completers was 31.0 (IQR 25.0) and 157 out of 346 study completers (45.4%) were highly educated. Out of the 455 included participants, 235 (51.6%) were recruited via social media campaigns, 131 (28.8%) via home-delivered flyers, 38 (8.4%) via flyers directly distributed by the study team, and 46 (10.1%) via word-of-mouth. Of all paid recruitment strategies, social media campaigns were the cheapest and least time-consuming, whereas the distribution of flyers by the study team was the most expensive and time-consuming recruitment strategy. Age, sex, overweight status, employment situation, and number of adults within the household varied by recruitment strategy. Conclusions Using different recruitment strategies resulted in the efficient recruitment of a representative study sample and retention of participants was relatively high. While “word-of-mouth” was the most cost- and time-effective recruitment strategy, using only one type of recruitment strategy could result in a demographically skewed study population.
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Affiliation(s)
- Jody C Hoenink
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Laura Nynke van der Laan
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Wilma Waterlander
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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16
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Recruitment Issues in Emerging Adult Populations: Focus on Adult Congenital Heart Disease. NURSING REPORTS 2020; 10:135-145. [PMID: 34968358 PMCID: PMC8608111 DOI: 10.3390/nursrep10020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/26/2020] [Accepted: 11/26/2020] [Indexed: 11/21/2022] Open
Abstract
High-quality nursing research is important to healthcare and is precipitated by successful participant recruitment. Young adults aged 18 to 30 years are particularly difficult to recruit due to transitions during this time, which makes it more problematic to locate these individuals and may make it more difficult for them to prioritize the need for participation. This paper includes data from two cross-sectional survey design pilot studies that aimed to enroll young adults with congenital heart disease using a variety of recruitment methods. The number of participants enrolled in these two pilot studies (7 and 22) was much lower than expected but the recruitment challenges encountered were consistent with other research studies that have recruited young adult populations. After presenting these data and a discussion of the relevant literature, we conclude with proposed strategies for research recruitment of young adults for nurse scientists who directly impact evidence-based literature and practice with research contributions.
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Crino ND, Parker HM, Gifford JA, Lau KYK, Greenfield EM, Donges CE, O'Dwyer NJ, Steinbeck KS, O'Connor HT. What do young women with obesity want from a weight management program? Eat Weight Disord 2020; 25:1303-1309. [PMID: 31473985 DOI: 10.1007/s40519-019-00763-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/27/2019] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Early adulthood is a high-risk time for weight gain; however, young women with obesity are difficult to recruit to weight management programs. To encourage participation and retention, it is important to understand what young women want from these programs. The purpose of the study was to explore participants' perspectives on the features of an ideal weight management program. METHODS Semi-structured interview schedules were used to elicit information from eight focus groups [27 women; mean age of 29.1 (± 5.1) years, mean body mass index (BMI; kg/m2) of 35.8 (± 2.9)]. The focus groups were transcribed, coded and analyzed qualitatively. RESULTS The themes that emerged were program content, format, program characteristics, program name, location and duration. A major finding from the study is that participants value a program that includes nutritional, psychological and lifestyle interventions, and includes components that are not traditionally part of weight management programs such as body acceptance, sexual health and dressing and grooming. A program name that conveys wellness and body positivity was valued. Participants highlighted the importance of individualized programs that are also tailored to the needs of young adults, and delivered by credible and approachable staff who provide accountability. Cost-effectiveness, flexibility, accessibility, time-commitment were important considerations and the use of a combination of virtual and in-person methods (including group interventions) appealed to this cohort. CONCLUSION Knowledge of program features which resonate with young women facilitates development of innovative ways to engage and support evidence-based weight management in this vulnerable group. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Natalie D Crino
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.
| | - Helen M Parker
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia
| | - Janelle A Gifford
- Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia
| | - K Y Karen Lau
- Faculty of Science, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Eliya M Greenfield
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia
| | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, 2795, Australia
| | - Nicholas J O'Dwyer
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia.,School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, 2795, Australia
| | - Katharine S Steinbeck
- The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia
| | - Helen T O'Connor
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.,Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia
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18
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Crane MM, Seburg EM, Levy RL, Jeffery RW, Sherwood NE. Using targeting to recruit men and women of color into a behavioral weight loss trial. Trials 2020; 21:537. [PMID: 32546253 PMCID: PMC7298816 DOI: 10.1186/s13063-020-04500-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/10/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The majority of participants in weight loss trials are non-Hispanic White women, while men and women of color are underrepresented. This study presents data obtained from non-targeted and targeted recruitment approaches in a trial of behavioral weight loss programs to (1) describe the yields from each approach and (2) compare the demographics, weight control histories, and study involvement of samples recruited by each approach. METHODS Data for this observational study include source of recruitment, demographic information, weight loss experiences (e.g., lifetime weight loss, current weight loss behaviors), and completion of the 6-month assessment visit. RESULTS Men comprised 14.2% of participants who responded to non-targeted recruitment efforts, while targeted efforts yielded 50.4% men. Similarly, people of color comprised 12.8% of those who responded to non-targeted approaches, whereas targeted recruitment methods yielded 47.2% people of color. Men recruited through targeted methods were younger (p = 0.01) than men recruited through non-targeted means but were otherwise similar. Women of color recruited through targeted methods reported use of fewer weight loss strategies relative to women of color recruited through non-targeted means (p = 0.006) but were otherwise similar. There were no differences by recruitment method on retention to the study. CONCLUSIONS Using targeted recruitment methods increased the ethnic and gender diversity of the recruited sample without reducing study retention. This targeting also increased the enrollment of women with less weight loss experience who may not have otherwise sought out a weight loss program. Developing and implementing a targeted recruitment plan should be considered early in the clinical trial development process. TRIAL REGISTRATION Clinicaltrials.gov, NCT02368002. Registered on 20 February 2015.
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Affiliation(s)
- Melissa M Crane
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA.
| | - Elisabeth M Seburg
- HealthPartners Institute, 8170 33rd Ave South, Minneapolis, MN, 55440-1524, USA
| | - Rona L Levy
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA, 98105-6250, USA
| | - Robert W Jeffery
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
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Frampton GK, Shepherd J, Pickett K, Griffiths G, Wyatt JC. Digital tools for the recruitment and retention of participants in randomised controlled trials: a systematic map. Trials 2020; 21:478. [PMID: 32498690 PMCID: PMC7273688 DOI: 10.1186/s13063-020-04358-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 04/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Recruiting and retaining participants in randomised controlled trials (RCTs) is challenging. Digital tools, such as social media, data mining, email or text-messaging, could improve recruitment or retention, but an overview of this research area is lacking. We aimed to systematically map the characteristics of digital recruitment and retention tools for RCTs, and the features of the comparative studies that have evaluated the effectiveness of these tools during the past 10 years. METHODS We searched Medline, Embase, other databases, the Internet, and relevant web sites in July 2018 to identify comparative studies of digital tools for recruiting and/or retaining participants in health RCTs. Two reviewers independently screened references against protocol-specified eligibility criteria. Included studies were coded by one reviewer with 20% checked by a second reviewer, using pre-defined keywords to describe characteristics of the studies, populations and digital tools evaluated. RESULTS We identified 9163 potentially relevant references, of which 104 articles reporting 105 comparative studies were included in the systematic map. The number of published studies on digital tools has doubled in the past decade, but most studies evaluated digital tools for recruitment rather than retention. The key health areas investigated were health promotion, cancers, circulatory system diseases and mental health. Few studies focussed on minority or under-served populations, and most studies were observational. The most frequently-studied digital tools were social media, Internet sites, email and tv/radio for recruitment; and email and text-messaging for retention. One quarter of the studies measured efficiency (cost per recruited or retained participant) but few studies have evaluated people's attitudes towards the use of digital tools. CONCLUSIONS This systematic map highlights a number of evidence gaps and may help stakeholders to identify and prioritise further research needs. In particular, there is a need for rigorous research on the efficiency of the digital tools and their impact on RCT participants and investigators, perhaps as studies-within-a-trial (SWAT) research. There is also a need for research into how digital tools may improve participant retention in RCTs which is currently underrepresented relative to recruitment research. REGISTRATION Not registered; based on a pre-specified protocol, peer-reviewed by the project's Advisory Board.
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Affiliation(s)
- Geoff K. Frampton
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Karen Pickett
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton and Southampton University Hospital NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD UK
| | - Jeremy C. Wyatt
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
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Pegington M, French DP, Harvie MN. Why young women gain weight: A narrative review of influencing factors and possible solutions. Obes Rev 2020; 21:e13002. [PMID: 32011105 DOI: 10.1111/obr.13002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 01/02/2023]
Abstract
Significant weight gain occurs in women during young adulthood, which increases risk of diseases such as diabetes, cardiovascular disease, and many cancers. This review aims to inform future individually targeted weight gain prevention programmes and summarizes possible targets: key life events, mediators that influence energy intake and physical activity levels, and moderators that could identify groups of women at greatest risk. Life events affecting weight include pregnancy and motherhood, smoking cessation, marriage and cohabiting, attending university, and possibly bereavement. Research has identified successful methods for preventing weight gain associated with pregnancy and motherhood, which could now be used in practice, but evidence is inconclusive for preventing weight gain around other life events. Weight gain is mediated by lack of knowledge and skills around food and nutrition, depression, anxiety, stress, satiety, neural responses, and possibly sleep patterns and premenstrual cravings. A paucity of research exists into altering these to limit weight gain. Moderators include socioeconomic status, genetics, personality traits, and eating styles. More research is required to identify at-risk females and engage them in weight gain prevention. There is a need to address evidence gaps highlighted and implement what is currently known to develop effective strategies to limit weight gain in young women.
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Affiliation(s)
- Mary Pegington
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Prevent Breast Cancer Research Unit, The Nightingale Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Michelle N Harvie
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Prevent Breast Cancer Research Unit, The Nightingale Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Manchester Breast Centre, University of Manchester, Manchester, UK
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mHealth smoking cessation intervention among high school students: 3-month primary outcome findings from a randomized controlled trial. PLoS One 2020; 15:e0229411. [PMID: 32142514 PMCID: PMC7059915 DOI: 10.1371/journal.pone.0229411] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/05/2020] [Indexed: 11/20/2022] Open
Abstract
Background Smoking among adolescents remains a global public health issue as youth continue to maintain high prevalence rates. The evidence for the efficacy of text messaging interventions to reduce smoking behavior is well established, yet there is still a need for studies targeting high school students. The aim of the study was to determine the effectiveness of a text-based smoking cessation intervention among high school students in Sweden. Methods The study was a two-arm randomized trial conducted from January 10 2018 to January 11 2019, data were analysed from April 12 2019 to May 21 2019. Inclusion criteria were high school students who were daily or weekly smokers willing to attempt to quit smoking and owned a mobile phone. The study invited all students at 630 high schools units throughout Sweden. The intervention group received text messages based on components of effective smoking cessation interventions for 12 weeks. The control group were offered treatment as usual. The primary outcomes were self-reported prolonged abstinence (not having smoked more than 5 cigarettes over the last 8 weeks) and 4-week point prevalence of smoking abstinence. Findings A total of 535 participants, with a median age of 17 (IQR 16–18), were randomized into the study; 276 (164 [59.4%] women) were allocated to the intervention and 259 (162 [62.5%] women) to the control group. The outcomes of the trial were analyzed on a total of 212 (76.8%) participants in the intervention group and 201 (77.6%) participants in the control group. Prolonged abstinence at the 3-month follow-up was reported by 49 (23.1%) individuals in the intervention group and 39 (19.4%) individuals in the control group (adjusted OR, 1.21; 95% CI, 0.73–2.01; P value, .46). Four-week point prevalence of complete smoking cessation was reported by 53 (25.0%) individuals in the intervention group and 31 (15.4%) individuals in the control group (adjusted OR, 1.87; 95% CI, 1.12–3.17; P value, .018). Conclusions Estimates of 4-week point prevalence of complete cessation was 10 percentage points higher in the group that were given access to the intervention compared to the control. Findings provide confirmation that text messaging-based smoking cessation programs can affect quit rates among adolescents. Trial registration ISRCTN15396225; registration date October 13, 2017, https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-3028-2.
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McVay MA, Donahue ML, Cheong J, Bacon J, Perri MG, Ross KM. Effects of Intervention Characteristics on Willingness to Initiate a Weight Gain Prevention Program. Am J Health Promot 2020; 34:837-847. [PMID: 32077301 DOI: 10.1177/0890117120905709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To determine characteristics of weight gain prevention programs that facilitate engagement. DESIGN Randomized factorial experiment (5 × 2). SETTING Recruited nationally online. PARTICIPANTS Adults aged 18 to 75 with body mass index ≥25 who decline a behavioral weight loss intervention (n = 498). MEASURES Participants were randomly presented with one of 10 possible descriptions of hypothetical, free weight gain prevention programs that were all low dose and technology-based but differed in regard to 5 behavior change targets (self-weighing only; diet only; physical activity only; combined diet, physical activity, and self-weighing; or choice between diet, physical activity, and self-weighing targets) crossed with 2 financial incentive conditions (presence or absence of incentives for self-monitoring). Participants reported willingness to join the programs, perceived program effectiveness, and reasons for declining enrollment. ANALYSIS Logistic regression and linear regression to test effects of program characteristics offered on willingness to initiate programs and programs' perceived effectiveness, respectively. Content analyses for open-ended text responses. RESULTS Participants offered the self-weighing-only programs were more willing to initiate than those offered the programs targeting all 3 behaviors combined (50% vs 36%; odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.01-3.13). Participants offered the programs with financial incentives were more willing to initiate (50% vs 33%; OR = 2.08; 95% CI, 1.44-2.99) and anticipated greater intervention effectiveness (β = .34, P = .02) than those offered no financial incentives. Reasons for declining to initiate included specific program features, behavior targets, social aspects, and benefits. CONCLUSION Targeting self-weighing and providing financial incentives for self-monitoring may result in greater uptake of weight gain prevention programs. STUDY PREREGISTRATION https://osf.io/b9zfh, June 19, 2018.
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Affiliation(s)
- Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Marissa L Donahue
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - JeeWon Cheong
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Joseph Bacon
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Michael G Perri
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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Feasibility and Preliminary Efficacy of the Eating Advice to Students (EATS) Brief Web-Based Nutrition Intervention for Young Adult University Students: A Pilot Randomized Controlled Trial. Nutrients 2019; 11:nu11040905. [PMID: 31018565 PMCID: PMC6520699 DOI: 10.3390/nu11040905] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 02/08/2023] Open
Abstract
Young adult university students are a priority population for nutrition intervention. This study assessed the feasibility and preliminary efficacy of the EATS (Eating Advice to Students) brief (i.e., single use) web-based nutrition intervention for young adult university students. A 3-month pilot randomized controlled trial (RCT) was conducted with 124 students aged 17–35 from the University of Newcastle, Australia. Participants were randomized to EATS (n = 62) or attention control (n = 62). EATS aimed to improve four target eating behaviors (vegetables, fruit, discretionary foods, breakfast). Primary outcomes were feasibility (recruitment, retention, usage, program acceptability). Recruitment and retention numbers were recorded, the program acceptability was assessed by a process evaluation survey and the website usage was objectively tracked. Preliminary efficacy was assessed via changes in diet quality (primary), fruit, vegetables, discretionary foods and breakfast intake, measured using Food Frequency Questionnaire. Recruitment was completed in five weeks. Retention was 73% (90/124) at 3-months. Intervention participants used EATS 1.5 ± 1.0 times. Satisfaction with EATS was rated at 4.04 ± 0.74 (maximum five). Intervention participants significantly decreased the percentage energy/day from discretionary foods compared with control (−4.8%, 95%CI −8.6, −1.1, p = 0.012, d = −0.34). No significant between-group differences were observed for diet quality, fruit, vegetable or breakfast intakes. EATS demonstrated high feasibility, particularly for reach and acceptability. The university setting and a brief web-based intervention show promise in engaging young adults to improve their eating behaviors.
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Bracken K, Askie L, Keech AC, Hague W, Wittert G. Recruitment strategies in randomised controlled trials of men aged 50 years and older: a systematic review. BMJ Open 2019; 9:e025580. [PMID: 30948584 PMCID: PMC6500287 DOI: 10.1136/bmjopen-2018-025580] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/17/2018] [Accepted: 02/13/2019] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To identify and review evaluations of strategies to recruit men aged 50 years and over to randomised controlled trials (RCTs). DESIGN Systematic review and narrative synthesis. DATA SOURCES MEDLINE, EMBASE, CINAHL and ORRCA databases were searched to 1 December 2017. ELIGIBILITY CRITERIA Studies using quantitative methods to evaluate recruitment strategies to RCTs of men aged 50 years and older. DATA EXTRACTION AND SYNTHESIS A single reviewer extracted data (for each strategy, number of participants approached, screened and randomised, and cost). Study quality was assessed using National Heart, Lung and Blood Institute Quality Assessment Tools and considered study design, description of interventions, description and measurement of outcomes, completeness of outcome reporting, performance of statistical testing and consideration of confounders. Recruitment strategies were categorised by the recruitment stage they addressed. RESULTS Sixteen studies (n >14 000) were included: one good quality, ten fair quality and five poor quality. Studies evaluated strategies to identify prospective participants, and to improve the processes for assessing participant eligibility, providing participant information and seeking consent. In good and fair quality studies, the most effective strategies for identifying participants were referral from an affiliated health service provider (two studies), mass mailing (five studies) and media coverage (two studies). Community outreach activities such as displaying posters and attending local community events were not effective (two studies). Trial-specific training of site recruitment staff, developed using qualitative analysis of recruitment visits (two studies), and provision of study information to prospective participants at a multidisciplinary, group information session (one study) both improved recruitment. CONCLUSION Improved engagement of men aged 50 years and older in RCTs is needed. A gender-sensitised approach to RCT recruitment may help to address this need. We have identified several promising recruitment strategies that merit further evaluation. PROSPERO REGISTRATION NUMBER CRD42017060301.
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Affiliation(s)
- Karen Bracken
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Lisa Askie
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Anthony C Keech
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Wendy Hague
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Gary Wittert
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Whatnall M, Patterson A, Hutchesson M. A Brief Web-Based Nutrition Intervention for Young Adult University Students: Development and Evaluation Protocol Using the PRECEDE-PROCEED Model. JMIR Res Protoc 2019; 8:e11992. [PMID: 30920382 PMCID: PMC6458536 DOI: 10.2196/11992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022] Open
Abstract
Background Young adults are a priority population for nutrition interventions because of the high prevalence of unhealthy eating behaviors, high risk of weight gain, and the importance of this life stage for developing lifelong eating behaviors. Innovative intervention strategies are needed to reach and engage young adults, whereas more detailed reporting of intervention development and testing would facilitate progress in this challenging research area. Objective This paper describes the development of the EATS (Eating Advice To Students) intervention, a targeted, brief Web-based nutrition intervention for young adult (17 to 35 years) university students, and describes the pilot randomized controlled trial (RCT) to assess intervention feasibility. Methods EATS was developed using the PRECEDE-PROCEED model. The development involved a cross-sectional survey of university students’ eating behaviors and determinants, a systematic review of brief nutrition interventions, and consultation with a project steering committee. EATS was developed as a website with 4 components: (1) brief screening quiz with personalized feedback, (2) provision of information, tips, and strategies for each target eating behavior (consumption of vegetables, fruit, discretionary foods, and breakfast) and 2 guided exercises to facilitate behavior change, (3) goal setting, and (4) creating strategies. A pilot RCT with students from the University of Newcastle, Australia, was conducted from February to July 2018. The students were randomized to EATS or a brief Web-based alcohol intervention (attention control). The process evaluation included intervention acceptability (Web-based survey postintervention completion) and objective usage data (collected in real time). Efficacy data (Web-based survey at baseline and 3 months) included diet quality, consumption of target food groups (eg, fruits and vegetables), alcohol intake, self-efficacy to perform target eating behaviors, and well-being. Results Collection of the 3-month follow-up data was completed in July 2018. Conclusions EATS presents an innovative solution to many of the difficulties faced in targeting young adults to improve their eating behaviors. Given the strong methodological approach undertaken, this study provides a significant contribution to advance this research area. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000118202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374365&isReview=true (Archived by WebCite at http://www.webcitation.org/765o5fVwa) International Registered Report Identifier (IRRID) DERR1-10.2196/11992
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Affiliation(s)
- Megan Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Amanda Patterson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Melinda Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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Crino ND, Parker HM, Gifford JA, Lau KYK, Greenfield EM, Donges CE, O'Dwyer NJ, Steinbeck KS, O'Connor HT. Recruiting young women to weight management programs: Barriers and enablers. Nutr Diet 2018; 76:392-398. [PMID: 30575276 DOI: 10.1111/1747-0080.12505] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 12/17/2022]
Abstract
AIM Recruiting young women to weight management research programs is difficult. The purpose of this study was to gain insights into the barriers and motivators that influence participation and to explore effective methods of recruitment from the perspective of young women with obesity living in both urban and regional areas. METHODS Semi-structured interviews were used to elicit information from focus groups. The interviews were transcribed, coded and analysed qualitatively. Eight focus groups, which included a total of 27 women, were conducted. Participants had a mean age of 29.1 (±5.1) years and a mean body mass index of 35.8 (±2.9) kg/m2 . RESULTS The barriers to participation were multifaceted and largely similar across urban and regional participants. Fear of judgement and uncertainty about the process were major psychosocial barriers. A lack of tailoring of program content was an important program-related barrier. Physical barriers such as time commitment, cost and access were discussed extensively, particularly in urban groups. The provision of incentives and the use of positive language that focusses on the benefits of the intervention were viewed positively. Physical and virtual methods of recruitment were identified as potentially effective provided they were presented in media that this group is likely to use and can access in a private location. CONCLUSIONS The results of this study provide a greater understanding of the challenges faced by young women in relation to participation in weight management programs and some of the potential methods that could be utilised to facilitate participation.
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Affiliation(s)
- Natalie D Crino
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Helen M Parker
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - Janelle A Gifford
- Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - K Y Karen Lau
- Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicholas J O'Dwyer
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.,School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Katharine S Steinbeck
- The Children's Hospital at Westmead Clinical School, University of Sydney, New South Wales, Australia
| | - Helen T O'Connor
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
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27
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Ryan C, Dadabhoy H, Baranowski T. Participant Outcomes from Methods of Recruitment for Videogame Research. Games Health J 2018; 7:16-23. [PMID: 29394108 DOI: 10.1089/g4h.2017.0049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The most productive methods of recruitment for a videogame for health (G4H) trial are not known. Success or failure of recruitment methods has been reported for a variety of clinical trials, but few specifically for G4H trials. This study's goal was to recruit 444 overweight or obese (body mass index percentile between the 84.5th-99.4th percentiles) children between the ages of 10-12 years. The article reports the results of different methods of participant recruitment. MATERIALS AND METHODS Participants had to agree to three fasting blood samples (baseline, immediately after, and 2 months later); be willing to wear an accelerometer for 7 days at each assessment; read and speak English fluently (because the games were in English); have no history of any condition that would affect what he/she could eat or how much physical activity he/she could get; and have an eligible home computer purchased in the last 5 years with high-speed internet. Hardware criteria reflected the types of computers upon which Diab-Nano could be effectively played. Recruitment was conducted over a 35-month period and included electronic media, print advertising, community recruitment, and an internal volunteer list. Respondents were guided to a web-based screening questionnaire that asked for source of hearing about the study. RESULTS Although diverse recruitment methods were used, slow recruitment resulted in obtaining only 45% of the recruitment goal (n = 199). Electronic media (e.g., radio, television, and internet), which reached millions of targeted parents, resulted in only 76 respondents, of whom 13 became participants; print media (e.g., magazine, newsletter/newspaper, and mail), which also reached large numbers of parents, resulted in 192 respondents, of whom 19 became participants; community recruitment (e.g., school, friend or family, doctors office, flyer, work, community program) resulted in 162 respondents, of whom 38 became participants; and the internal volunteer list resulted in 413 respondents, of whom 128 became participants. CONCLUSION Inclusionary and exclusionary criteria and restricted access by gatekeepers could be deterrents to successful recruitment. The documented payoff of alternative comprehensive methods of recruitment should benefit other investigations in optimally allocating their recruitment resources.
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Affiliation(s)
- Courtney Ryan
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center , Baylor College of Medicine, Houston, Texas
| | - Hafza Dadabhoy
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center , Baylor College of Medicine, Houston, Texas
| | - Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center , Baylor College of Medicine, Houston, Texas
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28
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Hsu MSH, Harper C, Gibson AA, Sweeting AN, McBride J, Markovic TP, Caterson ID, Byrne NM, Sainsbury A, Seimon RV. Recruitment Strategies for a Randomised Controlled Trial Comparing Fast Versus Slow Weight Loss in Postmenopausal Women with Obesity-The TEMPO Diet Trial. Healthcare (Basel) 2018; 6:healthcare6030076. [PMID: 29986398 PMCID: PMC6163885 DOI: 10.3390/healthcare6030076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/12/2022] Open
Abstract
Current research around effective recruitment strategies for clinical trials of dietary obesity treatments have largely focused on younger adults, and thus may not be applicable to older populations. The TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity) is a randomised controlled trial comparing the long-term effects of fast versus slow weight loss on body composition and cardio-metabolic health in postmenopausal women with obesity. This paper addresses the recruitment strategies used to enrol participants into this trial and evaluates their relative effectiveness. 101 post-menopausal women aged 45–65 years, with a body mass index of 30–40 kg/m2 were recruited and randomised to either fast or slow weight loss. Multiple strategies were used to recruit participants. The total time cost (labour) and monetary cost per randomised participant from each recruitment strategy was estimated, with lower values indicating greater cost-effectiveness and higher values indicating poorer cost-effectiveness. The most cost-effective recruitment strategy was word of mouth, followed (at equal second place) by free publicity on TV and radio, and printed advertorials, albeit these avenues only yielded 26/101 participants. Intermediate cost-effective recruitment strategies were flyer distribution at community events, hospitals and a local tertiary education campus, internet-based strategies, and clinical trial databases and intranets, which recruited a further 40/101 participants. The least cost-effective recruitment strategy was flyer distribution to local health service centres and residential mailboxes, and referrals from healthcare professionals were not effective. Recruiting for clinical trials involving postmenopausal women could benefit from a combination of recruitment strategies, with an emphasis on word of mouth and free publicity via radio, TV, and print media, as well as strategic placement of flyers, supplemented with internet-based strategies, databases and intranets if a greater yield of participants is needed.
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Affiliation(s)
- Michelle S H Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Alice A Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Arianne N Sweeting
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - John McBride
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Tania P Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Ian D Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Radhika V Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
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29
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Hutchesson MJ, Callister R, Morgan PJ, Pranata I, Clarke ED, Skinner G, Ashton LM, Whatnall MC, Jones M, Oldmeadow C, Collins CE. A Targeted and Tailored eHealth Weight Loss Program for Young Women: The Be Positive Be Health e Randomized Controlled Trial. Healthcare (Basel) 2018; 6:healthcare6020039. [PMID: 29724054 PMCID: PMC6023329 DOI: 10.3390/healthcare6020039] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/18/2018] [Accepted: 04/26/2018] [Indexed: 12/14/2022] Open
Abstract
Young women are gaining weight rapidly. Evidence for effective weight loss interventions targeting young women is lacking. This randomized controlled trial assessed the efficacy and acceptability of a six-month targeted and tailored eHealth weight loss program for young women (Be Positive Be Healthe (BPBH)). Women aged 18–35 years were randomized to BPBH (n = 29) or control (n = 28). BPBH supported participants to modify diet and physical activity behaviours using evidenced-based strategies (e.g., self-monitoring) tailored for young women and delivered using e-health (website, social media, smartphone application, email, text messages). The primary outcome was a change in weight (kg) at six months. Acceptability was assessed via a process evaluation survey and usage of intervention components. No significant between-group differences were observed for weight, with significant mean differences favouring the intervention group observed for body fat (kg) (−3.10 (−5.69, 0.52), p = 0.019) and intakes of alcohol (g) (−0.69 (−1.33, 0.04), p = 0.037), vegetables (% energy/day) (4.71 (−2.20, 7.22), p < 0.001) and energy-dense, nutrient-poor foods (% energy/day) (−9.23 (−16.94, 1.52), p = 0.018). Retention, intervention usage and satisfaction were moderate. BPBH facilitated positive improvements in body fat and dietary intake, but not weight. Intervention acceptability findings support the use of some intervention components (e.g., Facebook, Smartphone app) with young women.
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Affiliation(s)
- Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Philip J Morgan
- School of Education, Faculty of Education and Arts, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Ilung Pranata
- School of Electrical Engineering and Computing, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan 2308, Australia.
| | - Erin D Clarke
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Geoff Skinner
- School of Electrical Engineering and Computing, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan 2308, Australia.
| | - Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Mark Jones
- Clinical Research Design and Statistics Support Unit, Hunter Medical Research Institute, New Lambton Heights 2305, Australia.
| | - Christopher Oldmeadow
- Clinical Research Design and Statistics Support Unit, Hunter Medical Research Institute, New Lambton Heights 2305, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
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Hayba N, Partridge SR, Nour MM, Grech A, Allman Farinelli M. Effectiveness of lifestyle interventions for preventing harmful weight gain among young adults from lower socioeconomic status and ethnically diverse backgrounds: a systematic review. Obes Rev 2018; 19:333-346. [PMID: 29178423 DOI: 10.1111/obr.12641] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/26/2017] [Accepted: 09/30/2017] [Indexed: 12/18/2022]
Abstract
The incidence of overweight and obesity are increasing with each successive generation of young adults. Associated co-morbidities will emerge at an earlier age unless weight gain is prevented. Evidence has demonstrated young adults (aged 18-35 years) from low socioeconomic and ethnically diverse backgrounds are at greater risk of overweight or obesity, yet it is unclear how to effectively intervene in this population. This systematic review aimed to assess the effectiveness of lifestyle interventions conducted in this population. Thirty studies reporting on lifestyle interventions for prevention of weight gain were identified from eight electronic databases searched. Six interventions included subgroup analyses to determine if ethnicity moderated weight change, and two included subgroup analyses to determine if socioeconomic status had an effect on change in weight. Five of these six studies were effective in preventing weight gain, and subgroup analyses showed no differences in effect by ethnicity. Of these five studies, two included a subgroup analysis that showed socioeconomic status to have no effect on weight outcome. Despite the promising results from these five lifestyle interventions utilizing online and mobile components to effectively reach and prevent weight gain in this priority population, the evidence base of high quality trials is limited.
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Affiliation(s)
- N Hayba
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - S R Partridge
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - M M Nour
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - A Grech
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - M Allman Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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31
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Iron Deficiency Anemia, Not Iron Deficiency, Is Associated with Reduced Attention in Healthy Young Women. Nutrients 2017; 9:nu9111216. [PMID: 29113086 PMCID: PMC5707688 DOI: 10.3390/nu9111216] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 12/14/2022] Open
Abstract
Women of reproductive age are at increased risk for iron deficiency (ID) and iron deficiency anemia (IDA), with both implicated in decreased cognitive function (CF). Obesity may complicate this association via inflammatory-mediated ferritin elevation. This cross-sectional study examined the association between hematological iron status (iron replete (IR), ID or IDA) and CF in healthy, young (18-35 years) women of normal-weight (NW: BMI 18.5-24.9 kg/m²) or obese-weight (OB: BMI >30 kg/m²). Participants completed a validated, computer-based cognition assessment evaluating impulsivity, attention, information processing, memory and executive function; CF reported as z-scores (mean ± SD). Iron status and CF were compared between groups via ANOVA, with adjustment for potential confounders (BMI, physical activity, C-reactive protein) via ANCOVA. A total of 157 NW and 142 OB women (25.8 ± 5.1 years) participated. Prevalence of ID and IDA were 14% and 6% respectively, with no significant difference between NW and OB groups. Women with IDA scored significantly lower on attention (although within normal range; ±1 z-score), compared to ID (IDA: -0.75 ± 1.89; ID: 0.53 ± 1.37; p = 0.004) but not IR (0.03 ± 1.33, p = 0.21) groups; there were no significant differences between ID and IR groups (p = 0.34). Adjustment for confounders did not significantly alter these results. In conclusion, women with IDA showed significantly reduced attention compared to women with ID.
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Cook RL, O'Dwyer NJ, Donges CE, Parker HM, Cheng HL, Steinbeck KS, Cox EP, Franklin JL, Garg ML, Rooney KB, O'Connor HT. Relationship between Obesity and Cognitive Function in Young Women: The Food, Mood and Mind Study. J Obes 2017; 2017:5923862. [PMID: 29291133 PMCID: PMC5651104 DOI: 10.1155/2017/5923862] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/11/2017] [Accepted: 08/09/2017] [Indexed: 11/17/2022] Open
Abstract
Limited research addresses links between obesity and cognitive function in young adults. Objective. To investigate the relationship between obesity and cognitive function in young women. Methods. This cross-sectional study recruited healthy, young (18-35 y) women of normal (NW: BMI = 18.5-24.9 kg·m-2) or obese (OB: BMI ≥ 30.0 kg·m-2) weight. Participants completed a validated, computer-based cognitive testing battery evaluating impulsivity, attention, information processing, memory, and executive function. Questionnaires on depression and physical activity and a fasting blood sample for C-reactive protein and the Omega-3 Index were also collected. Cognition data are presented as z-scores (mean ± SD), and group comparisons were assessed via ANOVA. Potential confounding from questionnaire and blood variables were evaluated using ANCOVA. Results. 299 women (NW: n = 157; OB: n = 142) aged 25.8 ± 5.1 y were enrolled. Cognition scores were within normal range (±1 z-score), but OB had lower attention (NW: 0.31 ± 1.38; OB: -0.25 ± 1.39; ES: 0.41, CI: 0.17-0.64; p < 0.001) and higher impulsivity (NW: 0.36 ± 1.14; OB: -0.07 ± 1.07; ES: 0.39, CI: 0.15-0.62; p=0.033). Confounder adjustment had minimal impact on results. Conclusion. The OB group had normal but significantly lower performance on attention and were more impulsive compared to NW participants. This may indicate early cognitive decline, but longitudinal research confirming these findings is warranted.
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Affiliation(s)
- Rebecca L. Cook
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Nicholas J. O'Dwyer
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- School of Human Movement Sciences, Charles Sturt University, Bathurst, NSW, Australia
| | - Cheyne E. Donges
- School of Human Movement Sciences, Charles Sturt University, Bathurst, NSW, Australia
| | - Helen M. Parker
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - Hoi Lun Cheng
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, University of Sydney, NSW, Australia
| | - Katharine S. Steinbeck
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, University of Sydney, NSW, Australia
| | - Eka P. Cox
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Janet L. Franklin
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Manohar L. Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Kieron B. Rooney
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - Helen T. O'Connor
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
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Cooke R, Jones A. Recruiting adult participants to physical activity intervention studies using sport: a systematic review. BMJ Open Sport Exerc Med 2017; 3:e000231. [PMID: 28761714 PMCID: PMC5530105 DOI: 10.1136/bmjsem-2017-000231] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To undertake a systematic review of the effectiveness of recruitment mechanisms for engaging and retaining target participants in sports interventions to promote physical activity behaviour change in adults. DESIGN A narrative systematic review of published studies providing details of the effectiveness of recruitment techniques used in interventions aimed at increasing physical activity via sport in adults. DATA SOURCES Searches were conducted using five electronic databases, clinical trial registers, grey literature and snowballing from reference lists. All papers published in the English language were considered. The search was completed in November 2015. ELIGIBILITY CRITERIA All articles providing information on the recruitment of adults into interventions involving sport and reporting physical activity or participation outcomes were included. RESULTS Twenty-three studies met the inclusion criteria. The quality of recruitment reporting across included studies was generally classified as poor, lacking detailed descriptions of recruitment processes and providing insufficient reporting of recruitment outcomes. There was a distinct recruitment bias for more affluent, white, middle-aged women. Active-only recruitment techniques appeared to achieve a participant sample with more representative demographic characteristics than passive approaches. CONCLUSIONS Due to inadequate reporting and evaluation, the mechanisms for achieving effective recruitment and engagement in sport, particularly in hard-to-reach groups, are still unclear. Independent of recruitment mode, creating an intervention and context that reflect the interests and motivations of the target audience presents a promising area. There is an urgent need for more robust evaluation design and reporting of sports interventions.
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Affiliation(s)
- Rachel Cooke
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Andy Jones
- Norwich Medical School, University of East Anglia, Norwich, UK
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Volkova E, Michie J, Corrigan C, Sundborn G, Eyles H, Jiang Y, Mhurchu CN. Effectiveness of recruitment to a smartphone-delivered nutrition intervention in New Zealand: analysis of a randomised controlled trial. BMJ Open 2017; 7:e016198. [PMID: 28674144 PMCID: PMC5734449 DOI: 10.1136/bmjopen-2017-016198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Delivery of interventions via smartphone is a relatively new initiative in public health, and limited evidence exists regarding optimal strategies for recruitment. We describe the effectiveness of approaches used to recruit participants to a smartphone-enabled nutrition intervention trial. METHODS Internet and social media advertising, mainstream media advertising and research team networks were used to recruit New Zealand adults to a fully automated smartphone-delivered nutrition labelling trial (no face-to-face visits were required). Recruitment of Māori and Pacific participants was a key focus and ethically relevant recruitment materials and approaches were used where possible. The effectiveness of recruitment strategies was evaluated using Google Analytics, monitoring of study website registrations and randomisations, and self-reported participant data. The cost of the various strategies and associations with participant demographics were assessed. RESULTS Over a period of 13 months, there were 2448 registrations on the study website, and 1357 eligible individuals were randomised into the study (55%). Facebook campaigns were the most successful recruitment strategy overall (43% of all randomised participants) and for all ethnic groups (Māori 44%, Pacific 44% and other 43%). Significant associations were observed between recruitment strategy and age (p<0.001), household size (p<0.001), ethnicity (p<0.001), gender (p=0.005) and interest in healthy eating (p=0.022). Facebook campaigns resulted in the highest absolute numbers of study registrations and randomisations (966 and 584, respectively). Network strategies and Facebook campaigns cost least per randomised participant (NZ$4 and NZ$5, respectively), whereas radio advertising costs most (NZ$179 per participant). CONCLUSION Internet and social media advertising were the most effective and least costly approaches to recruiting participants to a smartphone-delivered trial. These approaches also reached diverse ethnic groups. However, more culturally appropriate recruitment strategies are likely to be necessary in studies where large numbers of participants from specific ethnic groups are sought. TRIAL REGISTRATION ACTRN12614000644662; Post-results.
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Affiliation(s)
- Ekaterina Volkova
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Jo Michie
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | | | - Gerhard Sundborn
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Helen Eyles
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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Nikolaou CK, Hankey CR, Lean MEJ. Accuracy of on-line self-reported weights and heights by young adults. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Estabrooks P, You W, Hedrick V, Reinholt M, Dohm E, Zoellner J. A pragmatic examination of active and passive recruitment methods to improve the reach of community lifestyle programs: The Talking Health Trial. Int J Behav Nutr Phys Act 2017; 14:7. [PMID: 28103935 PMCID: PMC5248490 DOI: 10.1186/s12966-017-0462-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/05/2017] [Indexed: 01/30/2023] Open
Abstract
Background A primary challenge for behavior change strategies is ensuring that interventions can be effective while also attracting a broad and representative sample of the target population. The purpose of this case-study was to report on (1) the reach of a randomized controlled trial targeting reduced sugary beverages, (2) potential participant characteristic differences based on active versus passive recruitment strategies, and (3) recruitment strategy cost. Methods Demographic and recruitment information was obtained for 8 counties and for individuals screened for participation. Personnel activities and time were tracked. Costs were calculated and compared by active versus passive recruitment. Results Six-hundred and twenty, of 1,056 screened, individuals were eligible and 301enrolled (77% women; 90% white; mean income $21,981 ± 16,443). Eighty-two and 44% of those responding to passive and active methods, respectively, enrolled in the trial. However, active recruitment strategies yielded considerably more enrolled (active = 199; passive = 102) individuals. Passive recruitment strategies yielded a less representative sample in terms of gender (more women), education (higher), and income (higher; p’s <0.05). The average cost of an actively recruited and enrolled participant was $278 compared to $117 for a passively recruited and enrolled participant. Conclusions Though passive recruitment is more cost efficient it may reduce the reach of sugary drink reduction strategies in lower educated and economic residents in rural communities. Trial registration Clinicaltrials.gov; ID: NCT02193009, July 2014, retrospectively registered.
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Affiliation(s)
- Paul Estabrooks
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA.
| | - Wen You
- Department of Applied and Agricultural Economics, Virginia Tech, 304 Hutcheson Hall, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Valisa Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 335A Wallace Hall, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Margaret Reinholt
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 1981 Kraft Drive, 1031 ILSB, Blacksburg, VA, 24060, USA
| | - Erin Dohm
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 1981 Kraft Drive, 1031 ILSB, Blacksburg, VA, 24060, USA
| | - Jamie Zoellner
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 1981 Kraft Drive, 1031 ILSB, Blacksburg, VA, 24060, USA
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Allman-Farinelli M, Partridge SR, McGeechan K, Balestracci K, Hebden L, Wong A, Phongsavan P, Denney-Wilson E, Harris MF, Bauman A. A Mobile Health Lifestyle Program for Prevention of Weight Gain in Young Adults (TXT2BFiT): Nine-Month Outcomes of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2016; 4:e78. [PMID: 27335237 PMCID: PMC4935797 DOI: 10.2196/mhealth.5768] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/19/2016] [Accepted: 05/19/2016] [Indexed: 02/06/2023] Open
Abstract
Background The unprecedented rise in obesity among young adults, who have limited interaction with health services, has not been successfully abated. Objective The objective of this study was to assess the maintenance outcomes of a 12-week mHealth intervention on prevention of weight gain in young adults and lifestyle behaviors at 9 months from baseline. Methods A two-arm, parallel, randomized controlled trial (RCT) with subjects allocated to intervention or control 1:1 was conducted in a community setting in Greater Sydney, Australia. From November 2012 to July 2014, 18- to 35-year-old overweight individuals with a body mass index (BMI) of 25-31.99 kg/m2 and those with a BMI ≥ 23 kg/m2 and a self-reported weight gain of ≥ 2 kg in the past 12 months were recruited. A 12-week mHealth program “TXT2BFiT” was administered to the intervention arm. This included 5 coaching calls, 96 text messages, 12 emails, apps, and downloadable resources from the study website. Lifestyle behaviors addressed were intake of fruits, vegetables, sugar-sweetened beverages (SSBs), take-out meals, and physical activity. The control group received 1 phone call to introduce them to study procedures and 4 text messages over 12 weeks. After 12 weeks, the intervention arm received 2 further coaching calls, 6 text messages, and 6 emails with continued access to the study website during 6-month follow-up. Control arm received no further contact. The primary outcome was weight change (kg) with weight measured at baseline and at 12 weeks and self-report at baseline, 12 weeks, and 9 months. Secondary outcomes were change in physical activity (metabolic equivalent of task, MET-mins) and categories of intake for fruits, vegetables, SSBs, and take-out meals. These were assessed via Web-based surveys.
Results Two hundred and fifty young adults enrolled in the RCT. Intervention participants weighed less at 12 weeks compared with controls (model β=−3.7, 95% CI −6.1 to −1.3) and after 9 months (model β=− 4.3, 95% CI − 6.9 to − 1.8). No differences in physical activity were found but all diet behaviors showed that the intervention group, compared with controls at 9 months, had greater odds of meeting recommendations for fruits (OR 3.83, 95% CI 2.10-6.99); for vegetables (OR 2.42, 95% CI 1.32-4.44); for SSB (OR 3.11, 95% CI 1.47-6.59); and for take-out meals (OR 1.88, 95% CI 1.07-3.30). Conclusions Delivery of an mHealth intervention for prevention of weight gain resulted in modest weight loss at 12 weeks with further loss at 9 months in 18- to 35-year-olds. Although there was no evidence of change in physical activity, improvements in dietary behaviors occurred, and were maintained at 9 months. Owing to its scalable potential for widespread adoption, replication trials should be conducted in diverse populations of overweight young adults. Trial Registration Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12612000924853; (Archived by WebCite at http://www.webcitation.org/6i6iRag55)
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Affiliation(s)
- Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, University of Sydney, Australia.
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