Evaluation of active and passive recruitment methods used in randomized controlled trials targeting pediatric obesity

Abstract

Objective-Evaluate enrollment numbers, randomization rates, costs, and cost-effectiveness of active versus passive recruitment methods for parent-child dyads into two pediatric obesity intervention trials.Methods-Recruitment methods were categorized into active (pediatrician referral and targeted mailings, with participants identified by researcher/health care provider) versus passive methods (newspaper, bus, internet, television, and earning statements; fairs/community centers/schools; and word of mouth; with participants self-identified). Numbers of enrolled and randomized families and costs/recruitment method were monitored throughout the 22-month recruitment period. Costs (in USD) per recruitment method included staff time, mileage, and targeted costs of each method.Results-A total of 940 families were referred or made contact, with 164 families randomized (child: 7.2±1.6 years, 2.27±0.61 standardized body mass index [zBMI], 86.6% obese, 61.7% female, 83.5% white; parent: 38.0±5.8 years, 32.9±8.4 BMI, 55.2% obese, 92.7% female, 89.6% white). Pediatrician referral, followed by targeted mailings, produced the largest number of enrolled and randomized families (both methods combined producing 87.2% of randomized families). Passive recruitment methods yielded better retention from enrollment to randomization (p <0.05), but produced few families (21 in total). Approximately $91 000 was spent on recruitment, with cost per randomized family at $554.77. Pediatrician referral was the most costeffective method, $145.95/randomized family, but yielded only 91 randomized families over 22-months of continuous recruitment.Conclusion-Pediatrician referral and targeted mailings, which are active recruitment methods, were the most successful strategies. However, recruitment demanded significant resources. Successful recruitment for pediatric trials should use several strategies.

Clinical Research Involving Children: Registration, Completeness, and Publication

“…Possible reasons for poor recruitment, and strategies to enhance children' s participation in clinical research, have been discussed in the literature. [56][57][58][59][60][61][62][63][64] Public confidence in clinical research is integral to improving recruitment and participation in research involving children. 65 Better regulation and oversight of research transparency, including consistent posting of results from all clinical research, may help improve public trust.…”

Evaluation of recruitment methods for a trial targeting childhood obesity: Families for Health randomised controlled trial

“…Recruitment methods can be categorised as active, in which researchers target potentially eligible participants, such as with a targeted letter or referral from a health professional, or as passive, in which researchers inform the whole community using flyers, posters, public events and media. A study from the USA evaluating active versus passive recruitment for parent–child pairs in two child obesity intervention trials [ 8 ] showed that active recruitment methods, such as paediatric referral and targeted mailings, led to a higher number of recruited participants but required significant resources. The Loozit randomised controlled trial also reported the effectiveness of strategies to recruit overweight and obese adolescents aged 13–16 years from the community to a weight management treatment trial [ 9 ].…”

Recruitment and reach in a pragmatic behavioral weight loss randomized controlled trial: implications for real-world primary care practice

“…For example, one study found that participants recruited through proactive phone calls, compared to participants who made the first contact, were more likely to be racial/ethnic minorities and to have lower education [25]. A cost analysis of recruitment methods for clinic-based pediatric obesity trials found that provider referrals was the most cost-effective, and the combination of provider referrals with targeted mailings the most successful [44]. Our findings support the combined strategy of targeted mailings and provider referrals.…”