Cost-effectiveness analysis of recruitment strategies in a community-based intervention study of HIV-infected persons

Abstract

This paper describes and evaluates recruitment methods used to reach adults with HIV infection and to enroll eligible candidates in a randomized trial of aerobic exercise. Potential participants residing in the metropolitan Washington DC area were recruited from January 1994 to December 1996. The yield and associated cost of clinic centre site-visit (CSV) recruitment are compared to similar outcomes for community-based (CB) recruitment strategies, which consisted of presentations to local groups, mail/phone canvasses of caregivers, neighbourhood network promotion, public site postings and print media notices. Of 833 HIV infected adults ascertained during the recruitment phase as prospective study candidates, 66.7% were initially contacted during CSV recruitment. The remainder, 33.3% were CB recruits. The percentage of screened candidates who were subsequently enrolled in the study was 13.5% for CSV recruitment and 21% for CB recruitment. Ascertainment and screening costs combined were $158 per CB recruit compared to $232 per CSV recruit. Using multiple recruitment approaches we successfully achieved our enrollment goal of at least 100 volunteers from diverse populations by the end of the planned recruitment period.

Exceeding the recruitment target in a primary care paediatric trial: an evaluation of the Choice of Moisturiser for Eczema Treatment (COMET) feasibility randomised controlled trial

“…Therefore, we advise using a number of recruitment strategies to spread the risk, should one strategy prove more challenging or less fruitful than another. This is in agreement with other trial researchers who recommend using a number of strategies [36, 37]. We also emphasise the importance of careful recruitment monitoring because the additional measures we implemented during the trial (such as increasing the upper age limit and recruiting more practices) had an important and positive impact on recruitment and may not necessarily have been identified without monitoring.…”

Participant recruitment in intervention research: scientific integrity and cost‐effective strategies

“…Although some published reports on the cost-effectiveness of specific participant recruitment methods exist in the intervention research literature (e.g. Baigis, Francis, & Hoffman, 2003;Gill, McGloin, Gahbauer, Shepard, & Bianco, 2001), the overall number of these reports is relatively small.…”

“…RYC translates the RYE concept into research dollars (cf. Baigis et al, 2003;Gill et al, 2001). These ratios are as follows: RYE = (enrolment opportunities generated) ÷ (number of participants enrolled/ randomized) and RYC = (costs associated with a specific recruitment strategy/method) ÷ (number of participants enrolled/randomized).…”

Effort Required in Eligibility Screening for Clinical Trials

“…Published studies have typically focused on the costs associated with recruitment methods (personal and direct mailing, media advertisements, referrals, public-site posters and flyers, presentations to local groups, and so on). [9][10][11][12][13][14][15][16][17][18][19][20] The literature describing recruitment costs most frequently reports on nontherapeutic trials, such as screening studies, or interventions that pose minimal risk to study participants. 3,8,11,13,14,16,[21][22][23] Data for nontherapeutic trials may not accurately represent the effort required to screen patients for therapeutic trials that have more clinically complex protocol requirements such as assessing multiple comorbidities and completing detailed reviews of treatment history.…”