Recruiting Rural Participants for a Telehealth Intervention on Diabetes Self‐Management

Abstract

Purpose Recruiting rural and underserved participants in behavioral health interventions is challenging. Community-based recruitment approaches are effective, but they are not always feasible in multisite, diverse community interventions. This study evaluates the feasibility of a rapid, multisite approach that uses rural clinic site coordinators to recruit study participants. The approach allows for rural recruitment in areas where researchers may not have developed long-term collaborative relationships. Methods Adults with diabetes were recruited from rural Federally Qualified Health Center (FQHC) clinics. Recruitment feasibility was assessed by analyzing field notes by the project manager and health coaches, and 8 in-depth, semi-structured interviews with clinic site coordinators and champions, followed by thematic analysis of field notes and interviews. Findings Forty-seven rural sites were contacted to obtain the 6 sites that participated in the study. On average, sites took 14 days to commit to study participation. One hundred and twenty-one participants were acquired from letters mailed to eligible participants and, in some sites, by follow-up phone calls from site coordinators. Facilitators and deterrents affecting study recruitment fell into 4 broad categories—study design, site, site coordinator, and participant factors. Conclusion The rapid multi-site approach led to quick and efficient recruitment of clinic sites and participants. Recruitment success was achieved in some, but not all, rural sites. The study highlights the opportunities and challenges of recruiting rural clinics and rural, underserved participants in multisite research. Suggestions are provided for improving recruitment for future interventions.

Review Strategies to Recruit and Retain Rural Patient Participating Self-management Behavioral Trials

“…The selected studies were conducted in three countries: the United States (Befort, Bennett, Christifano, Klemp, & Krebill, 2014; Bergeron et al, 2013 ; Dibartolo & McCrone, 2003; Miyamoto, Henderson, Young, Ward, & Santillan, 2013; Parra-Medina et al, 2004 ; Pribulick, Willams, & Fahs, 2010 ; Tanner, Kim, Friedman, Foster, & Bergeron, 2014 ) Canada ( Taylor, Stone, & Huijbregts, 2012 ), and Australia ( P. Reddy et al, 2011 ).…”

“…Reddy et al, 2011 ; Tanner et al, 2014 ; Taylor et al, 2012 ), the mean age of participants was 59.5 years, ranging from 35 to 84 years. Among all studies ( Befort et al, 2014 ; Bergeron et al, 2013 ; Dibartolo & McCrone, 2003 ; Miyamoto et al, 2013 ; Parra-Medina et al, 2004 ; Pribulick et al, 2010 ; P. Reddy et al, 2011 ; Tanner et al, 2014 ; Taylor et al, 2012 ), 64% of the participants were female.…”

“…Locations for recruitment included both non-healthcare settings ( Bergeron et al, 2013 ; Pribulick et al, 2010 ; Tanner et al, 2014 ; Taylor et al, 2012 ) and healthcare settings ( Befort et al, 2014 ; Dibartolo & McCrone, 2003 ; Miyamoto et al, 2013 ; Parra-Medina et al, 2004 ; P. Reddy et al, 2011 ).…”

“…Two commonly used recruitment approaches were specific and nonspecific targeting. The first approach involved direct targeting of potential candidates by face-to-face interviews ( Miyamoto et al, 2013 ; Taylor et al, 2012 ), phone contact ( Befort et al, 2014 ; Miyamoto et al, 2013 ), and referrals by healthcare professionals ( Befort et al, 2014 ; Miyamoto et al, 2013 ; P. Reddy et al, 2011 ).…”

Tracking Health Data Is Not Enough: A Qualitative Exploration of the Role of Healthcare Partnerships and mHealth Technology to Promote Physical Activity and to Sustain Behavior Change

“…With 96% of the US population currently living in areas where mobile networks exist, mHealth supporters also consider the technology to have the potential to improve health care access and reduce health care disparities for hard-to-reach and underserved populations [8]. In a best-case scenario, mobile technology offers the possibility to deliver specialty care where it may not exist, reduce transportation burden, and move care away from traditional clinic and hospital-based care settings, allowing patients to be active participants in the management of their conditions wherever they may be, at times convenient to them [9]. …”