Recruitment and Retention Strategies for Parents Experiencing Vulnerability: Lessons from an Online Parenting Program

Abstract

Background Supportive parenting programs can promote parent-child interactions and children's development. However, families experiencing vulnerability (e.g., low socioeconomic status) report barriers (e.g., transportation, distrust of researchers) to research participation, and attrition rates of 40% and higher have been reported in parenting research. In response, we conducted a longitudinal evaluation of a digital parenting program in a major metropolitan centre in western Canada and retained 99% of our sample. Aim Review recruitment and retention strategies employed in the First Pathways study and evaluate associations between sociodemographic (e.g., income) and psychosocial (e.g., parental depression) factors with recruitment and retention strategies. Methods and Findings In collaboration with community agencies, we commenced recruitment of 100 families experiencing vulnerability (e.g., low-income) in June 2021. We utilized strategies to engage staff (e.g., presentations, gift cards, updates) and employed snowball sampling. Families recruited through community agencies were significantly more likely to experience vulnerability (e.g., low income and education, high adverse experiences) compared to families in the snowball sample. We incorporated strategies to minimize participant burden (e.g., choice of online or in-person meetings), promoted rapport (e.g., holiday texts, nonjudgmental environment), incorporated trauma-informed practices (e.g., sensitive inquiry), and demonstrated appreciation for participants’ contributions (i.e., honorarium). Family experiences of vulnerability (i.e., low income, depressive symptoms, adversity) were correlated with higher participant rescheduling. Conclusion Nurses need knowledge of strategies to promote equitable access to research for families experiencing vulnerability. Digital programs with protocols designed to establish rapport, include trauma-informed practices, and minimize participant burden will likely optimize participation and retention.

Study Protocol for Assessing the Effectiveness, Implementation Fidelity and Uptake of Attachment & Child Health (ATTACHTM) Online: Helping Children Vulnerable to Early Adversity

“…Thus, the researchers/knowledge users sought to deliver ATTACH™ Online, rather than in-person and engaged ATTACH™ Facilitators and parents in user-engaged design of an online intervention and data collection approach for ATTACH™. Users preferred Zoom™ (Graucher et al, 2022) for intervention delivery and REDCap (www.projectredcap.org) (Komanchuk et al, 2023) for data collection and both were successfully pilot tested for feasibility with 10 families. Thus, ATTACH TM Online is poised to address social and health inequities, ampli ed by the pandemic, by promoting accessibility of parenting support for vulnerable families, including those in rural and remote regions.…”

“…Partner agencies will collect the data via iPads with REDCap software installed, as per best practice recommendations (Garcia & Abrahão, 2021;Komanchuk et al, 2023;Rivera et al, 2021).Agency health and social service providers/ATTACH™ Online Facilitators will be trained and supervised to employ the iPads and REDCap as part of the ATTACH™ Online Training Program. Partner agency health and social service providers/ATTACH TM Online facilitators will be provided with a login information to access the baseline, immediate post-intervention, and delayed post-intervention questionnaires.…”