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MacLachlan A, Crawford K, Shinwell S, Nixon C, Henderson M. Recruiting hard-to-reach pregnant women at high psychosocial risk: strategies and costs from a randomised controlled trial. Trials 2021; 22:402. [PMID: 34134724 PMCID: PMC8207826 DOI: 10.1186/s13063-021-05348-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 06/01/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Recruiting participants to randomised controlled trials (RCTs) is often challenging, particularly when working with socially disadvantaged populations who are often termed 'hard-to-reach' in research. Here we report the recruitment strategies and costs for the Trial for Healthy Relationship Initiatives in the Very Early years (THRIVE), an RCT evaluating two group-based parenting interventions for pregnant women. METHODS THRIVE aimed to recruit 500 pregnant women with additional health and social care needs in Scotland between 2014 and 2018. Three recruitment strategies were employed: (1) referrals from a health or social care practitioner or voluntary/community organisation (practitioner-led referral), (2) direct engagement with potential participants by research staff (researcher-led recruitment) and (3) self-referral in response to study advertising (self-referral). The number of referrals and recruited participants from each strategy is reported along with the overall cost of recruitment. The impact of recruitment activities and the changes in maternity policy/context on recruitment throughout the study are examined. RESULTS THRIVE received 973 referrals: 684 (70%) from practitioners (mainly specialist and general midwives), 273 (28%) from research nurses and 16 (2%) self-referrals. The time spent in antenatal clinics by research nurses each month was positively correlated with the number of referrals received (r = 0.57; p < 0.001). Changes in maternity policies and contexts were reflected in the number of referrals received each month, with both positive and negative impacts throughout the trial. Overall, 50% of referred women were recruited to the trial. Women referred via self-referral, THRIVE research nurses and specialist midwives were most likely to go on to be recruited (81%, 58% and 57%, respectively). Key contributors to recruitment included engaging key groups of referrers, establishing a large flexible workforce to enable recruitment activities to adapt to changes in context throughout the study and identifying the most appropriate setting to engage with potential participants. The overall cost of recruitment was £377 per randomised participant. CONCLUSIONS Recruitment resulted from a combination of all three strategies. Our reflections on the successes and challenges of these strategies highlight the need for recruitment strategies to be flexible to adapt to complex interventions and real-world challenges. These findings will inform future research in similar hard-to-reach populations. TRIAL REGISTRATION International Standard Randomised Controlled Trials Number Registry ISRCTN21656568 . Retrospectively registered on 28 February 2014.
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Affiliation(s)
- Alice MacLachlan
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR Scotland
| | - Karen Crawford
- Institute of Health and Wellbeing, Level 4, Academic CAMHS, Yorkhill Hospital, University of Glasgow, Dalnair Street, Glasgow, G3 8SJ Scotland
| | - Shona Shinwell
- School of Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ Scotland
| | - Catherine Nixon
- Scottish Children’s Reporter Administration, 10-20 Bell Street, Glasgow, G1 1LG Scotland
| | - Marion Henderson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR Scotland
- Social Work and Social Policy, University of Strathclyde, Lord Hope Building, 141 St James Road, Glasgow, G4 OLT Scotland
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Henderson M, Wittkowski A, McIntosh E, McConnachie A, Buston K, Wilson P, Calam R, Minnis H, Thompson L, O'Dowd J, Law J, McGee E, Wight D. Correction to: Trial of healthy relationship initiatives for the very early years (THRIVE), evaluating Enhanced Triple P for Baby and Mellow Bumps for those with additional social and care needs during pregnancy and their infants who are at higher risk of maltreatment: study protocol for a randomised controlled trial. Trials 2019; 20:557. [PMID: 31506097 PMCID: PMC6737664 DOI: 10.1186/s13063-019-3674-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Marion Henderson
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Top Floor 200 Renfield Street, Glasgow, G2 3AX, Scotland.
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, England
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, G12 8QQ, Scotland
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Boyd Orr Building, University of Glasgow, Glasgow, G12 8QQ, Scotland
| | - Katie Buston
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Top Floor 200 Renfield Street, Glasgow, G2 3AX, Scotland
| | - Philip Wilson
- Centre for Rural Health, University of Aberdeen, The Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland
| | - Rachel Calam
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, England
| | - Helen Minnis
- Institute of Health and Wellbeing, University of Glasgow, Caledonia House, Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, Scotland
| | - Lucy Thompson
- Centre for Rural Health, University of Aberdeen, The Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland.,Institute of Health and Wellbeing, University of Glasgow, Caledonia House, Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, Scotland
| | - John O'Dowd
- NHS Ayrshire and Arran, Afton House, Ailsa Hospital Campus, Dalmellington Road, Ayr, KA6 6AB, Scotland
| | - James Law
- Institute of Health and Society, School of Education, Communication and Language Sciences, University of Newcastle, Newcastle-upon-Tyne, NE1 7RU, England
| | - Elizabeth McGee
- Parenting and Family Support Research Programme, Department of Psychology and Allied Health Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland
| | - Daniel Wight
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Top Floor 200 Renfield Street, Glasgow, G2 3AX, Scotland
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