Proactive recruitment predicts participant retention to end of treatment in a secondhand smoke reduction trial with low-income maternal smokers

Abstract

Improving smoking intervention trial retention in underserved populations remains a public health priority. Low retention rates undermine clinical advancements that could reduce health disparities. To examine the effects of recruitment strategies on participant retention among 279 low-income, maternal smokers who initiated treatment in a 16-week behavioral counseling trial to reduce child secondhand smoke exposure (SHSe). Participants were recruited using either reactive strategies or methods that included proactive strategies. Logistic regression analysis was used to test associations among retention and recruitment method in the context of other psychosocial and sociodemographic factors known to relate to retention. Backwards stepwise procedures determined the most parsimonious solution. Ninetyfour percent of participants recruited with proactive + reactive methods were retained through end of treatment compared to 74.7% of reactive-recruited participants. Retention likelihood was five times greater if participants were recruited with proactive + reactive strategies rather than reactive recruitment alone (odds ration [OR]=5.36; confidence interval [CI], 2.31-12.45). Greater knowledge of SHS consequences (OR=1.58; CI, 1.07-2.34) was another significant factor retained in the final LR model. Proactive recruitment may improve retention among underserved smokers in behavioral intervention trials. Identifying factors influencing retention may improve the success of recruitment strategies in future trials, in turn, enhancing the impact of smoking interventions.

Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers

“…A recent study found that retention was five times greater for low-income pregnant participants enrolled in a second-hand smoke reduction trial when recruited both reactively and proactively compared to reactively alone. [61] Future research should test the utility of proactive recruitment approaches in the Centrelink setting . This may increase retention rates and engagement with treatment in smokers recruited from Centrelink and similar social welfare agencies internationally.…”

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

“…Proactive recruitment strategies, that include assessing the risks of smoking with a focus on child health during routine clinic visits and provision of referral information about clinical trials to all identified smokers, may improve recruitment rates among underserved women (Collins et al, 2011). Potentially effective retention strategies for low-income minority women include provision of financial and other incentives, regular updates of contact information, and emphasis on cultural sensitivity of research staff (El-Khorazaty et al, 2007).…”

Reducing Underserved Children’s Exposure to Tobacco Smoke

“…60 Participants were recruited both actively from pediatric primary care and community clinics providing the Special Supplementary Nutrition Program for Women, Infants, and Children (WIC) as well as passively with advertisements in free community newspapers, on mass transit serving low-income neighborhoods, and on fliers in local stores. Participants were randomized with block randomization using small blocks of random length, stratified by child race, gender, and recruitment site (WIC, pediatrics, or advertisements).…”