Barriers to recruitment of professionals into a general practice childhood obesity program

Abstract

Recruiting general practitioners to take part in research in primary care is important and challenging. This paper describes the process, barriers and achievements experienced by a research team whilst recruiting Divisions and general practitioners (GPs)/practices into a project related to management of obesity in children, which used Breakthrough Series methodology in the intervention arm. The research team chose to recruit GPs through Divisions of General Practice, because of the existing positive relationship between the research team and the Divisions, and the Divisions' positive relationships with the GPs/practices in their area. The project aimed to recruit four Divisions of General Practice, who in turn would recruit a total of 24 GPs/practices. Four Divisions (two rural, two metropolitan) were recruited initially, but the two rural Divisions withdrew before the project commenced and were replaced by two metropolitan Divisions. As Divisions were unable to recruit sufficient GPs/practices, two additional strategies were used, but despite all efforts, only 17 practices were recruited. Reflection on recruitment failure focussed on reasons from the perspective of Divisions, GPs, other projects using the Breakthrough Series methodology with a chronic disease focus and other projects conducted in Australia where the focus was childhood obesity. The results showed that even Divisions who were enthusiastic about joining a project may be unable to recruit sufficient GPs and practices, for reasons including staff changeover and GP reluctance. Caution is suggested when setting recruitment targets where the condition is sensitive, is not the presenting problem, is not routinely tackled in general practice, involves minors, where treatment is perceived to be of doubtful effectiveness, or where major government policies may need to be considered.

What Affects Family Physicians’ Participation in Research: Outcomes from a Depression Self-Care Study

“…Amongst those FPs who met the recruiter, the predominant explanation for refusal was lack of time, a reason commonly cited in the literature [8,[16][17][18][19][20][21][22]. In other studies remuneration has been shown to play a positive role in physician recruitment; however, it was not reported as a factor influencing our FP sample [15,[22][23][24][25][26][27][28].…”

“…Of the 400 randomly selected FPs ( (38), not in office family practice (54), on leave (31), not actively practicing (31), did not have patients fitting study profile (13), remote from the research centre(3), for whom contact information was unavailable (1); ** No time (19), not interested in the project (9), never participate in research (5), finds remuneration for participation, insufficient (1), satisfied with present approach to care (1), patients with language barriers (1), no reasons given (7).…”

Encouraging general practitioners to complete the four‐year‐old Healthy Kids Check and provide healthy eating and physical activity messages

“…While low intervention intensity offers one explanation for low HKC uptake, other explanations include implementation barriers and/or reporting difficulties 26 . Low uptake of the HKC has been reported previously 27 .…”

Recruiting and retaining general practitioners to a primary care asthma-intervention study in Australia

“…Time constraints due to other commitments like audits and mass vaccinations can often hinder doctors' participation in research (Asch et al 2000;Rosemann and Szecsenyi 2004;Minas et al 2005;GoodyearSmith et al 2009) Australian GPs do not rate financial rewards as a reason to join a research project; however, financial incentives can support a practice's loss of time. There are also project-related and topic-related reasons why GPs do not participate, such as an overly complex research design or a disease area that is considered too sensitive, such as childhood obesity (Jones et al 2011(Jones et al , 2012.…”

“…Investigators have been urged to incorporate evaluations of recruitment strategies into study appraisals in an effort to obtain more evidence about the effectiveness of recruitment methods (Watson and Torgerson 2006). Such evaluations can help researchers obtain information regarding recruitment for studies similar to theirs (Jones et al 2011).…”