Recruitment strategies for predominantly low-income, multi-racial/ethnic children and parents to 3-year community-based intervention trials: Childhood Obesity Prevention and Treatment Research (COPTR) Consortium

Zhaohui Cui, Kimberly P Truesdale, Thomas N Robinson, Victoria Pemberton, Simone A French, Juan Escarfuller, Terri L Casey, Anne M Hotop, Donna Matheson, Charlotte A Pratt, Lynn J Lotas, Eli Po'e, Sharon Andrisin, Dianne S Ward, Zhaohui Cui, Kimberly P Truesdale, Thomas N Robinson, Victoria Pemberton, Simone A French, Juan Escarfuller, Terri L Casey, Anne M Hotop, Donna Matheson, Charlotte A Pratt, Lynn J Lotas, Eli Po'e, Sharon Andrisin, Dianne S Ward

Abstract

Background: The recruitment of participants into community-based randomized controlled trials studying childhood obesity is often challenging, especially from low-income racial/ethnical minorities and when long-term participant commitments are required. This paper describes strategies used to recruit and enroll predominately low-income racial/ethnic minority parents and children into the Childhood Obesity Prevention and Treatment Research (COPTR) consortium.

Methods: The COPTR consortium has run four independent 3-year, multi-level (individual, family, school, clinic, and community) community-based randomized controlled trials. Two were prevention trials in preschool children and the other two were treatment trials in pre-adolescents and adolescent youth. All trials reported monthly participant recruitment numbers using a standardized method over the projected 18-24 months of recruitment. After randomization of participants was completed, recruitment staff and investigators from each trial retrospectively completed a survey of recruitment strategies and their perceived top three recruitment strategies and barriers.

Results: Recruitment was completed in 15-21 months across trials, enrolling a total of 1745 parent-child dyads- out of 6314 screened. The number of children screened per randomized child was 4.6 and 3.5 in the two prevention trials, and 3.1 and 2.5 in the two treatment trials. Recruitment strategies reported included: (1) careful planning, (2) working with trusting community partners, (3) hiring recruitment staff who were culturally sensitive, personality appropriate, and willing to work flexible hours, (4) contacting potential participants actively and repeatedly, (5) recruiting at times and locations convenient for participants, (6) providing incentives to participants to complete baseline measures, (7) using a tracking database, (8) evaluating whether participants understand the activities and expectations of the study, and (9) assessing participants' motivation for participating. Working with community partners, hiring culturally sensitive staff, and contacting potential participants repeatedly were cited by two trials among their top three strategies. The requirement of a 3-year commitment to the trial was cited by two trials to be among the top three recruitment barriers.

Conclusions: Comprehensive strategies that include community partnership support, culturally sensitive recruitment staff, and repeated contacts with potential participants can result in successful recruitment of low-income racial/ethnic minority families into obesity prevention and treatment trials.

Trial registration: NET-Works trial: ClinicalTrials.gov, NCT01606891 . Registered on 28 May 2012. GROW trial: ClinicalTrials.gov, NCT01316653 . Registered on 16 March 2011. GOALS trial: ClinicalTrials.gov, NCT01642836 . Registered on 17 July 2012. IMPACT trial: ClinicalTrials.gov, NCT01514279 . Registered on 23 January 2012.

Keywords: African American; Barrier; Children; Hispanic; Intervention; Low-income; Minority; Parent–child dyads; Recruitment; Strategy.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Seven stages and key components of recruitment
Fig. 2
Fig. 2
Consort diagram of recruitment of parent-child dyads by trial. CWRU Case Western Reserve University

References

    1. Mims B. The challenges of recruiting African American subjects and entry strategies used in northeast Ohio. ABNF J. 2001;12:101–104.
    1. Swanson GM, Ward AJ. Recruiting minorities into clinical trials: toward a participant-friendly system. J Natl Cancer Inst. 1995;87:1747–1759. doi: 10.1093/jnci/87.23.1747.
    1. Yancey AK, Ortega AN, Kumanyika SK. Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006;27:1–28. doi: 10.1146/annurev.publhealth.27.021405.102113.
    1. Nicholson LM, Schwirian PM, Klein EG, Skybo T, Murray-Johnson L, Eneli I, et al. Recruitment and retention strategies in longitudinal clinical studies with low-income populations. Contemp Clin Trials. 2011;32:353–362. doi: 10.1016/j.cct.2011.01.007.
    1. Schnirer L, Stack-Cutler H. Recruitment and engagement of low-income populations: service provider and researcher perspectives. . Accessed 22 May 2019.
    1. Story M, Sherwood NE, Obarzanek E, Beech BM, Baranowski JC, Thompson NS, et al. Recruitment of African-American pre-adolescent girls into an obesity prevention trial: the GEMS pilot studies. Ethn Dis. 2003;13(1):S78–S87.
    1. Cui Z, Seburg EM, Sherwood NE, Faith MS, Ward DS. Recruitment and retention in obesity prevention and treatment trials targeting minority or low-income children: a review of the clinical trials registration database. Trials. 2015;16:564. doi: 10.1186/s13063-015-1089-z.
    1. Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005;111:1999–2012. doi: 10.1161/01.CIR.0000161369.71722.10.
    1. Cote AT, Harris KC, Panagiotopoulos C, Sandor GG, Devlin AM. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol. 2013;62:1309–1319. doi: 10.1016/j.jacc.2013.07.042.
    1. Puhl RM, King KM. Weight discrimination and bullying. Best Pract Res Clin Endocrinol Metab. 2013;27:117–127. doi: 10.1016/j.beem.2012.12.002.
    1. Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen D. Is obesity a risk factor for psychopathology among adolescents? Pediatr Int. 2004;46:296–301. doi: 10.1111/j.1442-200x.2004.01882.x.
    1. Gordon-Larsen P, The NS, Adair LS. Longitudinal trends in obesity in the United States from adolescence to the third decade of life. Obesity. 2010;18:1801–1804. doi: 10.1038/oby.2009.451.
    1. Trasande L, Chatterjee S. The impact of obesity on health service utilization and costs in childhood. Obesity. 2009;17:1749–1754. doi: 10.1038/oby.2009.67.
    1. Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and socioeconomic status in children and adolescents: United States, 2005-2008. NCHS Data Brief. 2010;51:1–8.
    1. De La OA, Jordan KC, Ortiz K, Moyer-Mileur LJ, Stoddard G, Friedrichs M, et al. Do parents accurately perceive their child's weight status? J Pediatr Health Care. 2009;23:216–221. doi: 10.1016/j.pedhc.2007.12.014.
    1. Patel AI, Madsen KA, Maselli JH, Cabana MD, Stafford RS, Hersh AL. Underdiagnosis of pediatric obesity during outpatient preventive care visits. Acad Pediatr. 2010;10:405–409. doi: 10.1016/j.acap.2010.09.004.
    1. Benson L, Baer HJ, Kaelber DC. Trends in the diagnosis of overweight and obesity in children and adolescents: 1999-2007. Pediatrics. 2009;123:e153–e158. doi: 10.1542/peds.2008-1408.
    1. Lundahl A, Kidwell KM, Nelson TD. Parental underestimates of child weight: a meta-analysis. Pediatrics. 2014;133:e689–e703. doi: 10.1542/peds.2013-2690.
    1. Gauthier KI, Gance-Cleveland B. Hispanic Parental Perceptions of Child Weight in Preschool-Aged Children: An Integrated Review. Child Obes. 2015;11:549–559. doi: 10.1089/chi.2014.0152.
    1. Pratt CA, Boyington J, Esposito L, Pemberton VL, Bonds D, Kelley M, et al. Childhood Obesity Prevention and Treatment Research (COPTR): interventions addressing multiple influences in childhood and adolescent obesity. Contemp Clin Trials. 2013;36:406–413. doi: 10.1016/j.cct.2013.08.010.
    1. Sherwood NE, French SA, Veblen-Mortenson S, Crain AL, Berge J, Kunin-Batson A, et al. NET-Works: Linking families, communities and primary care to prevent obesity in preschool-age children. Contemp Clin Trials. 2013;36:544–554. doi: 10.1016/j.cct.2013.09.015.
    1. Po'e EK, Heerman WJ, Mistry RS, Barkin SL. Growing Right Onto Wellness (GROW): a family-centered, community-based obesity prevention randomized controlled trial for preschool child-parent pairs. Contemp Clin Trials. 2013;36:436–449. doi: 10.1016/j.cct.2013.08.013.
    1. Moore SM, Borawski EA, Cuttler L, Ievers-Landis CE, Love TE. IMPACT: a multi-level family and school intervention targeting obesity in urban youth. Contemp Clin Trials. 2013;36:574–586. doi: 10.1016/j.cct.2013.08.009.
    1. Robinson TN, Matheson D, Desai M, Wilson DM, Weintraub DL, Haskell WL, et al. Family, community and clinic collaboration to treat overweight and obese children: Stanford GOALS-A randomized controlled trial of a three-year, multi-component, multi-level, multi-setting intervention. Contemp Clin Trials. 2013;36:421–435. doi: 10.1016/j.cct.2013.09.001.
    1. Martinson BC, Lazovich D, Lando HA, Perry CL, McGovern PG, Boyle RG. Effectiveness of monetary incentives for recruiting adolescents to an intervention trial to reduce smoking. Prev Med. 2000;31:706–713. doi: 10.1006/pmed.2000.0762.
    1. Barkin SL, Gesell SB, Po'e EK, Escarfuller J, Tempesti T. Culturally tailored, family-centered, behavioral obesity intervention for Latino-American preschool-aged children. Pediatrics. 2012;130:445–456. doi: 10.1542/peds.2011-3762.
    1. El-Khorazaty MN, Johnson AA, Kiely M, El-Mohandes AA, Subramanian S, Laryea HA, et al. Recruitment and retention of low-income minority women in a behavioral intervention to reduce smoking, depression, and intimate partner violence during pregnancy. BMC Public Health. 2007;7:233. doi: 10.1186/1471-2458-7-233.
    1. Kennedy BM, Harsha DW, Bookman EB, Hill YR, Rankinen T, Rodarte RQ, et al. Challenges to recruitment and retention of African Americans in the gene-environment trial of response to dietary interventions (GET READI) for heart health. Health Educ Res. 2011;26:923–936. doi: 10.1093/her/cyr061.
    1. Robinson TN, Kraemer HC, Matheson DM, Obarzanek E, Wilson DM, Haskell WL, et al. Stanford GEMS phase 2 obesity prevention trial for low-income African-American girls: design and sample baseline characteristics. Contemp Clin Trials. 2008;29:56–69. doi: 10.1016/j.cct.2007.04.007.
    1. Hunt JR, White E. Retaining and tracking cohort study members. Epidemiol Rev. 1998;20:57–70. doi: 10.1093/oxfordjournals.epirev.a017972.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera