Effective recruitment strategies in an exercise trial for patients with fibromyalgia

Michelle Park, Raveendhara R Bannuru, Lori Lyn Price, William F Harvey, Jeffrey B Driban, Chenchen Wang, Michelle Park, Raveendhara R Bannuru, Lori Lyn Price, William F Harvey, Jeffrey B Driban, Chenchen Wang

Abstract

Background: Recruitment of fibromyalgia populations into long-term clinical trials involving exercise interventions is a challenge. We evaluated the cost and randomization yields of various recruitment methods used for a fibromyalgia trial in an urban setting. We also investigated differences in participant characteristics and exercise intervention adherence based on recruitment source.

Methods: We recruited individuals with fibromyalgia in the greater Boston area to a randomized controlled trial (RCT) using six recruitment strategies: newspaper advertisements, web advertisements, flyers, clinic referrals, direct mailing to patients in a clinic database, and word of mouth. We used the American College of Rheumatology 1990 and 2010 diagnostic criteria to screen and enroll participants. During an initial phone call to an interested participant, the study staff asked how they heard about the study. In this study, we compared the cost and yield of the six recruitment strategies as well as baseline characteristics, adherence, and attendance rates of participants across strategies.

Results: Our recruitment resulted in 651 prescreens, 272 screening visits, and 226 randomized participants. Advertisements in a local commuter newspaper were most effective, providing 113 of 226 randomizations, albeit high cost ($212 per randomized participant). Low-cost recruitment strategies included clinical referrals and web advertisements, but they only provided 32 and 16 randomizations. Community-based strategies including advertisement and flyers recruited a more racially diverse participant sample than clinic referrals and mailing or calling patients. There was no evidence of difference in adherence among participants recruited from various strategies.

Conclusions: Newspaper advertisement was the most effective and most expensive method per randomized participant for recruiting large numbers of individuals with fibromyalgia in an urban setting. Community-based strategies recruited a more racially diverse cohort than clinic-based strategies.

Trial registration: ClinicalTrials.gov NCT01420640 . Registered on 19 August 2011.

Keywords: Chronic pain; Complementary and integrative health; Exercise trial; Fibromyalgia; Pain management; Recruitment.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Yields per recruitment strategy. Numbers in bars indicate absolute numbers of participants prescreened, screened, and randomized through each strategy. Lengths of bars represent the percentage of participants who were screened or randomized out of the total prescreened (100%) by each strategy
Fig. 2
Fig. 2
Randomized participants by recruitment strategy. Number of randomized participants yielded from each recruitment strategy (total n = 226)
Fig. 3
Fig. 3
Relationship between cost and number of randomizations for recruitment strategies. Note: Strategies not shown here, clinical referrals and word of mouth referrals, incurred $0 in recruitment costs

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Source: PubMed

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