Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial

Abstract

Background Men, particularly those living in disadvantaged areas, are less likely to participate in weight management programmes than women despite similar levels of excess weight. Little is known about how best to recruit men to weight management interventions. This paper describes patient and public involvement in pre-trial decisions relevant to recruitment and aims to report on recruitment to the subsequent men-only weight management feasibility trial, including the: i) acceptability and feasibility of recruitment; and ii) baseline sample characteristics by recruitment strategy. Methods Men with BMI ≥30 kg/m2 and/or waist circumference ≥ 40 in. were recruited to the feasibility trial via two strategies; community outreach (venue information stands and word of mouth) and GP letters, targeting disadvantaged areas. Recruitment activities (e.g. letters sent, researcher venue hours) were recorded systematically, and baseline characteristics questionnaire data collated. Qualitative interviews (n = 50) were conducted three months post-recruitment. Analyses and reporting followed a complementary mixed methods approach. Results 105 men were recruited within four months (community n = 60, GP letter n = 45). Community outreach took 2.3 recruiter hours per participant and GP letters had an opt-in rate of 10.2% (n = 90/879). More men were interested than could be accommodated. Most participants (60%) lived in more disadvantaged areas. Compared to community outreach, men recruited via GP letters were older (mean = 57 vs 48 years); more likely to report an obesity-related co-morbidity (87% vs 44%); and less educated (no formal qualifications, 32% vs 10%, degree educated 11% vs 41%). Recruitment strategies were acceptable, a sensitive approach and trusting relationships with recruiters valued, and the ‘catchy’ study name drew attention. Conclusions Targeted community outreach and GP letters were acceptable strategies that successfully recruited participants to a men-only weight management feasibility trial. Both strategies engaged men from disadvantaged areas, a typically underserved population. Using two recruitment strategies produced samples with different health risk profiles, which could add value to research where either primary or secondary prevention is of interest. Further work is required to examine how these strategies could be implemented and sustained in practice. Trial registration ClinicalTrials.gov: NCT03040518, 2nd February 2017.

A systematic review examining socioeconomic factors in trials of interventions for men that report weight as an outcome

“…In the Healthy Dads Healthy Kids feasibility study in the UK, individual and focus group interviews with fathers and other family members from a range of ethnic, religious, and socioeconomic groups informed the cultural adaptation of the programs, with patient and public involvement also integrated throughout 99 . In the “Game of Stones” feasibility trial of a remotely delivered individual intervention in Scotland, a focus group with men from lower socioeconomic areas informed the recruitment strategies; with a large survey, and patient and public involvement activities undertaken to inform the intervention design and study processes 41,102 . Eleven (30.6%) trials did not report intervention tailoring for men or undertake stakeholder or target group consultations.…”

“… 99 In the “Game of Stones” feasibility trial of a remotely delivered individual intervention in Scotland, a focus group with men from lower socioeconomic areas informed the recruitment strategies; with a large survey, and patient and public involvement activities undertaken to inform the intervention design and study processes. 41 , 102 Eleven (30.6%) trials did not report intervention tailoring for men or undertake stakeholder or target group consultations.…”

“…Several interventions that have been gender tailored in content, context, mode, and/or style of delivery have proved successful in engaging men living with obesity and supporting positive health behavior change 33–39 . Qualitative evidence from men's weight management interventions highlights the value men place on programs being developed and targeted specifically for them 26,40,41 . Systematic reviews indicate that men's weight management interventions can be effective at supporting weight reduction 31,42 .…”

“… 33 , 34 , 35 , 36 , 37 , 38 , 39 Qualitative evidence from men's weight management interventions highlights the value men place on programs being developed and targeted specifically for them. 26 , 40 , 41 Systematic reviews indicate that men's weight management interventions can be effective at supporting weight reduction. 31 , 42 However, the characteristics of men who participate in these programs and the extent to which socioeconomic factors are considered in the design and evaluation of these interventions are unknown.…”

Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial

“…Game of Stones (GoS) is a parallel, 3-arm RCT that delivers automated Short Messaging System (SMS) texts over a 1-year period, with or without financial incentives, and compares weight change at 12 months (M) from baseline with a waiting list comparator group, for men living with obesity. The GoS feasibility study was over-subscribed and demonstrated broad acceptability, and 60% of the 105 men participating lived in the two most disadvantaged Scottish Index of Multiple Deprivation (SIMD) postcode quintiles, a higher proportion than in other UK obesity trials [ 13 – 15 ]. Fewer men living in disadvantaged areas dropped out compared to men living in more advantaged areas.…”