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

Matthew D McDonald, Stephan U Dombrowski, Rebecca Skinner, Eileen Calveley, Paula Carroll, Andrew Elders, Cindy M Gray, Mark Grindle, Fiona M Harris, Claire Jones, Pat Hoddinott, Game of Stones team, Alison Avenell, Frank Kee, Michelle McKinley, Martin Tod, Marjon van der Pol, Matthew D McDonald, Stephan U Dombrowski, Rebecca Skinner, Eileen Calveley, Paula Carroll, Andrew Elders, Cindy M Gray, Mark Grindle, Fiona M Harris, Claire Jones, Pat Hoddinott, Game of Stones team, Alison Avenell, Frank Kee, Michelle McKinley, Martin Tod, Marjon van der Pol

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.

Keywords: Community outreach; Financial incentives; Health inequalities; Obesity; Primary care; Randomised feasibility trial; Recruitment; SMS; Weight management.

Conflict of interest statement

The following competing interests were declared by Co-Authors: Dr. Grindle reports the copyright to the Digital Narrative Approach is owned solely by Eos Digital Health Ltd. Dr. M. A. Grindle is managing director of Eos Digital Health Ltd. No other competing interest were declared.

Figures

Fig. 1
Fig. 1
Game of Stones Study Recruitment Poster/Flyer. Should not be reproduced without the permission of the study Principal Investigators: p.m.hoddinott@stir.ac.uk and stephan.dombrowski@unb.ca

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