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Park M, Bannuru RR, Price LL, Harvey WF, Driban JB, Wang C. Effective recruitment strategies in an exercise trial for patients with fibromyalgia. Trials 2021; 22:557. [PMID: 34419131 PMCID: PMC8380385 DOI: 10.1186/s13063-021-05502-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/02/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Recruitment of fibromyalgia populations into long-term clinical trials involving exercise interventions is a challenge. We evaluated the cost and randomization yields of various recruitment methods used for a fibromyalgia trial in an urban setting. We also investigated differences in participant characteristics and exercise intervention adherence based on recruitment source. METHODS We recruited individuals with fibromyalgia in the greater Boston area to a randomized controlled trial (RCT) using six recruitment strategies: newspaper advertisements, web advertisements, flyers, clinic referrals, direct mailing to patients in a clinic database, and word of mouth. We used the American College of Rheumatology 1990 and 2010 diagnostic criteria to screen and enroll participants. During an initial phone call to an interested participant, the study staff asked how they heard about the study. In this study, we compared the cost and yield of the six recruitment strategies as well as baseline characteristics, adherence, and attendance rates of participants across strategies. RESULTS Our recruitment resulted in 651 prescreens, 272 screening visits, and 226 randomized participants. Advertisements in a local commuter newspaper were most effective, providing 113 of 226 randomizations, albeit high cost ($212 per randomized participant). Low-cost recruitment strategies included clinical referrals and web advertisements, but they only provided 32 and 16 randomizations. Community-based strategies including advertisement and flyers recruited a more racially diverse participant sample than clinic referrals and mailing or calling patients. There was no evidence of difference in adherence among participants recruited from various strategies. CONCLUSIONS Newspaper advertisement was the most effective and most expensive method per randomized participant for recruiting large numbers of individuals with fibromyalgia in an urban setting. Community-based strategies recruited a more racially diverse cohort than clinic-based strategies. TRIAL REGISTRATION ClinicalTrials.gov NCT01420640 . Registered on 19 August 2011.
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Affiliation(s)
- Michelle Park
- Tufts University School of Medicine, Boston, MA, USA
| | - Raveendhara R Bannuru
- Tufts University School of Medicine, Boston, MA, USA
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 406, Boston, MA, 02111, USA
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Lori Lyn Price
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 406, Boston, MA, 02111, USA
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - William F Harvey
- Tufts University School of Medicine, Boston, MA, USA
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 406, Boston, MA, 02111, USA
| | - Jeffrey B Driban
- Tufts University School of Medicine, Boston, MA, USA
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 406, Boston, MA, 02111, USA
| | - Chenchen Wang
- Tufts University School of Medicine, Boston, MA, USA.
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 406, Boston, MA, 02111, USA.
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Stegner AJ, Almassi NE, Dougherty RJ, Ellingson LD, Gretzon NP, Lindheimer JB, Ninneman JV, Van Riper SM, O'Connor PJ, Cook DB. Safety and efficacy of short-term structured resistance exercise in Gulf War Veterans with chronic unexplained muscle pain: A randomized controlled trial. Life Sci 2021; 282:119810. [PMID: 34256041 DOI: 10.1016/j.lfs.2021.119810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
AIMS Chronic widespread musculoskeletal pain (CMP) is a primary condition of Veterans suffering from Gulf War illness. This study evaluated the influence of resistance exercise training (RET) on symptoms, mood, perception of improvement, fitness, and total physical activity in Gulf War Veterans (GWV) with CMP. MAIN METHODS Fifty-four GWV with CMP were randomly assigned to 16 weeks of RET (n = 28) or wait-list control (n = 26). Supervised exercise was performed twice weekly starting at a low intensity. Outcomes, assessed at baseline, 6, 11 and 17 weeks and 6- and 12-months post-intervention, were: pain, fatigue, mood, sleep quality, perception of improvement, and physical activity via self-report and accelerometry. Muscular strength was assessed at baseline, 8 and 16 weeks. Accelerometer data yielded estimates of time spent in sedentary, light, and moderate-to-vigorous physical activities. Analyses used separate linear mixed models with group and time point as fixed effects. All models, except for perceived improvement, included baseline values as a covariate. KEY FINDINGS Participants assigned to RET completed 87% of training sessions and exhibited strength increases between 16 and 34% for eight lifts tested (Hedges' g range: 0.47-0.78). The treatment by time interaction for perceived improvement (F1,163 = 16.94, p < 0.001) was characterized by greater perceived improvement since baseline for RET at each time point, until the 12-month follow-up. Effects were not significant for other outcomes (p > 0.05). RET caused no adverse events. SIGNIFICANCE After 16 weeks of RET, GWV with CMP reported improvements in their condition and exhibited increases in muscular strength, without symptom exacerbation or reductions in total physical activity.
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Affiliation(s)
- Aaron J Stegner
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America.
| | - Neda E Almassi
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America
| | - Ryan J Dougherty
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Laura D Ellingson
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; Western Oregon University, Monmouth, OR, United States of America
| | - Nicholas P Gretzon
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America
| | - Jacob B Lindheimer
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America
| | - Jacob V Ninneman
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America
| | - Stephanie M Van Riper
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America
| | | | - Dane B Cook
- William S. Middleton Memorial Veterans Hospital, Madison, WI, United States of America; University of Wisconsin-Madison, Madison, WI, United States of America
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