Participant recruitment and retention in a pilot program to prevent weight gain in low-income overweight and obese mothers

Abstract

BackgroundRecruitment and retention are key functions for programs promoting nutrition and other lifestyle behavioral changes in low-income populations. This paper describes strategies for recruitment and retention and presents predictors of early (two-month post intervention) and late (eight-month post intervention) dropout (non retention) and overall retention among young, low-income overweight and obese mothers participating in a community-based randomized pilot trial called Mothers In Motion.MethodsLow-income overweight and obese African American and white mothers ages 18 to 34 were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in southern Michigan. Participants (n = 129) were randomly assigned to an intervention (n = 64) or control (n = 65) group according to a stratification procedure to equalize representation in two racial groups (African American and white) and three body mass index categories (25.0-29.9 kg/m2, 30.0-34.9 kg/m2, and 35.0-39.9 kg/m2). The 10-week theory-based culturally sensitive intervention focused on healthy eating, physical activity, and stress management messages that were delivered via an interactive DVD and reinforced by five peer-support group teleconferences. Forward stepwise multiple logistic regression was performed to examine whether dietary fat, fruit and vegetable intake behaviors, physical activity, perceived stress, positive and negative affect, depression, and race predicted dropout as data were collected two-month and eight-month after the active intervention phase.ResultsTrained personnel were successful in recruiting subjects. Increased level of depression was a predictor of early dropout (odds ratio = 1.04; 95% CI = 1.00, 1.08; p = 0.03). Greater stress predicted late dropout (odds ratio = 0.20; 95% CI = 0.00, 0.37; p = 0.01). Dietary fat, fruit, and vegetable intake behaviors, physical activity, positive and negative affect, and race were not associated with either early or late dropout. Less negative affect was a marginal predictor of participant retention (odds ratio = 0.57; 95% CI = 0.31, 1.03; p = 0.06).ConclusionDropout rates in this study were higher for participants who reported higher levels of depression and stress.Trial registrationCurrent Controlled Trials NCT00944060

Culturally adapting a physical activity intervention for Somali women: the need for theory and innovation to promote equity

“…Some attrition could have been mitigated by selecting the day/time for the program ahead of recruitment, which was not done for the pilot. However, the challenges to retention are consistent with other trials conducted in community settings and with low-income and minority populations [e.g., [51]]. Race/ethnicity and income are important factors predicting attendance and retention in interventions, and further research is needed to develop and test strategies for promoting retention among groups at risk for attrition [52].…”

Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone

“…This was achieved with disadvantaged men, who commonly have lower engagement in research 10 and are more likely to be lost to follow up 66, 67. Mobile phone‐delivered interventions that tackle adverse health behaviours typically have retention rates of 70–90% 26, 27, 29, so the present study ranks among the highest.…”

What are successful recruitment and retention strategies for underserved populations? Examining physical activity interventions in primary care and community settings

“…Intervention characteristics-Interventions most commonly were group-based classes; also included were promotion of walking [28][29][30][31][32][33][34], individual, homebased lifestyle physical activity (physical activity type not specified) [35,36], and mixed/multiple types of activity [33,[37][38][39]. The majority of interventions were either neighborhood-or community-based (n=11) or at community/cultural or recreation centers (n=9).…”

“…Two studies purposively recruited a combination of Hispanic and African American participants [54,56]. Three studies [39,59,60] focused on Asian populations, and two studies [37,61,62] had mixed/multiple ethnicities represented. The majority of interventions were for adults (n=26), with fewer numbers of studies describing recruitment or retention strategies for children (n=6) or family/parent-child dyads (n= 3).…”

“…The majority of interventions were for adults (n=26), with fewer numbers of studies describing recruitment or retention strategies for children (n=6) or family/parent-child dyads (n= 3). Most studies (n=27) focused on urban populations, with smaller numbers of rural [29,37,44] or mixed [28,55,63] study environments. While all of the studies reported data on participants' ethnicity and/or racial background fairly consistently, income and educational level of participants were reported in differing ways.…”