You are how you recruit: a cohort and randomized controlled trial of recruitment strategies

Abstract

BackgroundRecruitment is a challenge in developing population-representative pregnancy and birth cohorts.MethodsWe developed a collaborative recruitment infrastructure (CRI) to recruit pregnant women for 4 pregnancy cohorts using: faxes from obstetrical offices, in-clinic recruiters, university and funder-driven free-media events, paid-media, and attendance at relevant tradeshows. Recruitment rates and demographic differences were compared between recruitment methods.ResultsWe received 5008 referrals over 40 months. Compared to fax, free-media referrals were 13 times more likely to be recruited (OR 13.0, 95% CI 4.2, 40.4: p < 0.001) and paid-media referrals were 4 times more likely to be recruited (OR 4.6, 95% CI 2.1, 10.3: p < 0.001). Among paid-media advertisements, free-to-read print (e.g. Metro) was the most effective (OR 3.3, 95% CI 2.3, 4.5: p < 0.05). Several demographic differences were identified between recruitment methods and against a reference population. Between recruitment methods, media recruits had a similar proportion families with incomes ≥ $40,000 (paid-media: 94.4%; free-media: 93.3%) compared to fax recruits (95.7%), while in-clinic recruits were less likely to have family incomes ≥ $40,000 (88.8%, p < 0.05). Maternal recruits from fax and in-clinic were more likely to attend university (Fax: 92.6%, in-clinic 89.8%) versus the reference population (52.0%; p < 0.05 for both) and both were less likely to smoke (Fax: 6.8%, in-clinic 4.2%) versus reference (18.6%; p < 0.05 for both). However, while fax referrals were more likely to be Caucasian (85.9% versus reference 77.5%; p < 0.05), in-clinic referrals were not significantly different (78.2%; P > 0.05).ConclusionRecruitment methods result in different recruitment rates and participant demographics. A variety of methods are required to recruit a generalizable sample.

Effectiveness of community outreach and engagement in recruitment success for a prebirth cohort

“…Media outreach predicted consent in 2 of the 3 ARS groups, DO and EHBR. This finding is consistent with Maghera et al [9] who found that passive recruitment using free and paid media had strong effects in predicting consent when compared with active contact from a healthcare provider. In an analysis of DO recruitment, Kaar et al [20] observed that in locations with high NCS awareness (≥75% of women who had heard), higher percentages of women said that they had heard through the media.…”

“…Reviews of community-based research suggest community engagement may increase enrollment [7]. The literature contains reports of outreach and engagement as a passive recruitment strategy whereby study information is made widely available throughout the community to encourage potential participants to contact study recruiters [8][9][10][11]. Little is known about the effectiveness of outreach and engagement in a preparatory role for active recruitment in which potential participants are contacted by staff and invited to join a study.…”

Impact of preconception enrollment on birth enrollment and timing of exposure assessment in the initial vanguard cohort of the U.S. National Children’s Study

“…Before discontinuation of the NCS, there was extensive discussion of the best way to realize its potential, including recommendations to abandon preconception recruitment [ 10 , 33 ], maintain preconception recruitment to the extent possible [ 34 ], maintain probability-based household sampling [ 35 ], move to provider-based sampling [ 22 , 36 ], focus on explicit hypotheses for important diseases of low incidence [ 37 ], and so on. All such suggestions involve choices and trade-offs between competing priorities and the impact of different types of recruitment for any birth cohort study [ 38 , 39 ]. Our analysis provides data informing some of these competing priorities in reference to assessment of peri-conception and early pregnancy exposures.…”

Facilitators and challenges in recruiting pregnant women to an infant obesity prevention programme delivered via telephone calls or text messages

“…Recruitment of participants to trials is acknowledged as a challenging facet of research [ 1 – 4 ]. The success of most participatory research and trials primarily depends on effective recruitment and retention of trial participants [ 5 ].…”