Strategies for In-Person Recruitment: Lessons Learned from a New Jersey Primary Care Research Network (NJPCRN) Study (original) (raw)
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Process Evaluation of Recruitment for a Cancer Screening Trial in Primary Care
Health Promotion Practice, 2011
Many cancer screening studies are conducted in primary care settings yet few systematically analyze recruitment challenges found at these sites. During a randomized trial promoting colorectal cancer screening, we implemented a process evaluation of recruitment. Recruiters maintained logs that registered the numbers of patients entering the clinic, approached by recruiters, declining to participate; and reasons for non-approach and non-participation. One-half of age-eligible patients were approached (n=1489), and half of those who met basic eligibility requirements agreed to engage further (n=527). A small proportion of patients (n=98) completed the 15-minute assessment before their appointment. Major reasons for non-approach included previous approach, patients called to the exam room, and appearing ill. The major reason for nonparticipation was "not interested"; a few patients did not want to share contact information. Some participants exited the assessment mid-way due to further ineligibility or time limitations. Best practice recommendations for recruitment in primary care are discussed.
BMC Medical Research Methodology, 2014
Background: Recruiting cancer patients is a barrier often encountered in research trials. However, very few randomized trials explore strategies to improve participation rates. The purpose of this study was to evaluate the effectiveness of a pre-recruitment primer letter to recruit persons diagnosed with colorectal cancer for a research trial. Methods: Potentially eligible participants were identified by the Victorian Cancer Registry. A total of 1,062 participants were randomized to receive either a mailed explanatory primer letter designed to encourage research participation, or no primer letter. Two weeks after the intervention, the Victorian Cancer Registry sought permission from patients to release their contact details to researchers. Those who agreed were contacted and invited to the study. Results: Pre-recruitment encouragement was not effective at increasing recruitment, with no significant differences demonstrated between experimental groups. Overall, 40% (n = 425) consented to participate, 25% (n = 243) refused and 35% (n = 394) did not respond. Conclusions: While this study demonstrated disappointing outcomes, pre-recruitment letters should not be ruled out as an approach altogether. Rather, future research should explore whether other factors to increase motivation, such as intensity and timing, are feasible and acceptable for contacting cancer patients. Trial registration: Australian and New Zealand Clinical Trials Registry, ACTRN12609000628246
BMC Medical Research Methodology, 2010
Background: While some research has been conducted examining recruitment methods to engage physicians and practices in primary care research, further research is needed on recruitment methodology as it remains a recurrent challenge and plays a crucial role in primary care research. This paper reviews recruitment strategies, common challenges, and innovative practices from five recent primary care health services research studies in Ontario, Canada. Methods: We used mixed qualitative and quantitative methods to gather data from investigators and/or project staff from five research teams. Team members were interviewed and asked to fill out a brief survey on recruitment methods, results, and challenges encountered during a recent or ongoing project involving primary care practices or physicians. Data analysis included qualitative analysis of interview notes and descriptive statistics generated for each study. Results: Recruitment rates varied markedly across the projects despite similar initial strategies. Common challenges and creative solutions were reported by many of the research teams, including building a sampling frame, developing front-office rapport, adapting recruitment strategies, promoting buy-in and interest in the research question, and training a staff recruiter.
Recruitment and retention of physicians for primary care research
Journal of community health, 2002
The primary objective of this report is to examine factors associated with recruitment of physicians in community-based primary care research. Reported results are based on an observational study of physician recruitment efforts undertaken in a randomized controlled trial designed to improve primary care physicians' cancer screening and counseling activities. The Partners for Prevention project was a statewide randomized controlled trial of primary care physicians selected from the state of Colorado. Two-hundred and ten eligible internal medicine and family medicine practices in both rural and urban community settings of the state of Colorado were selected into this study and a sentinel physician was chosen to represent each practice. Only 6% (13/210) of recruited practices initially declined to participate in the study, but the total refusal rate had reached 30% (59/210) by the time the intervention was implemented five months later. Study participants (n = 136) were younger (m...
A qualitative evaluation of strategies to increase colorectal cancer screening uptake
Canadian family physician Medecin de famille canadien
To obtain data that could be used to optimize the content and design of the targeted, mailed invitations that Ontario's provincewide colorectal cancer (CRC) screening program plans to use to increase screening uptake; to identify other strategies to increase CRC screening uptake; and to describe the effects of this qualitative work on a subsequent quantitative pilot study. Qualitative study using semistructured focus groups. Four different Ontario communities. Six focus groups comprising a total of 62 participants. Six focus groups were conducted in 4 different Ontario communities. For 3 of the communities, participants were recruited from the general population by a private marketing firm, using random-digit dialing, and received a small honorarium for participating. In Sault Ste Marie, participants were convenience samples recruited from a large primary care practice and were not offered compensation. Responses were elicited regarding various strategies for promoting CRC scree...
ColonCancerCheck Primary Care Invitation Pilot project: Family physician perceptions
Canadian family physician Medecin de famille canadien
To determine family physician perspectives regarding the acceptability and effectiveness of 2 interventions-a targeted, mailed invitation for screening to patients, and family physician audit-feedback reports-and on the colorectal cancer (CRC) screening program generally. This information will be used to guide program strategies for increasing screening uptake. Qualitative study. Ontario. Family physicians (n = 65). Seven 1-hour focus groups were conducted with family physicians using teleconferencing and Web-based technologies. Responses were elicited regarding family physicians' perspectives on the mailing of invitations to patients, the content and design of the audit-feedback reports, the effect of participation in the pilot project on daily practice, and overall CRC screening program function. Key themes included strong support for both interventions and for the CRC screening program generally. Moderate support was found for direct mailing of fecal occult blood testing (FOB...
Journal of Cancer Education, 2013
Objective-Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. Methods-A mixed methods design consisting of in-depth interviews, focus groups, and a short survey. Setting: FQHCs in the Tampa Bay area. Participants: Seventeen health care providers practicing in FQHCs. Results-Test-specific patient impediments and motivations were identified including fear of abnormal findings; importance of offering less invasive fecal occult blood tests; and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. Conclusions-This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education and. Findings are readily inform the design of educational materials and interventions to increase CRCS in FQHCs.
American Journal of Medical Quality, 2013
Screening rates for colorectal cancer (CRC) have improved substantially in the past decade but remain suboptimal. For 1000 plans in 2009, the Healthcare Effectiveness Data and Information Set (HEDIS) rates for CRC screening for individuals ≥50 years of age were 55% for Medicare and 61% for commercial insurance. In contrast, in 2008, the rates for breast cancer screening with mammography (ages 40-69 years) within 2 years were 68% and 70%, and for cervical cancer screening with a Pap test (ages 18-69 years) within 3 years, the rate was 81% for commercial insurance. 1 Increasing CRC screening is an important public health priority. In primary care practice, achieving high CRC screening rates is an important measure of quality of care.
The Need for Office Systems to Improve Colorectal Cancer Screening
Journal of Primary Care & Community Health, 2012
Rates of colorectal cancer (CRC) testing in the United States have been slowly trending up. 1-3 Data based on selfreport indicate that about two-thirds of people aged 50 to 75 years in the United States have had either CRC testing, defined as fecal occult blood test (FOBT), within the past year or lower endoscopy within the past 10 years. 1,3,4 These studies did not distinguish between flexible sigmoidoscopy and colonoscopy, so it is uncertain how many people actually met the most current screening guidelines. 1,5 A study based on chart review completed in the Iowa Research Network in 2004 showed that 46% of patients were up to date on CRC testing and that 62% of these tests were prompted by patient symptoms rather than true screening examinations. 6 Several national organizations have guidelines for CRC screening. 5,7-9 Studies based on previous versions of the guidelines have shown that there is variation among physicians when it comes to recommending CRC screening to their patients. 6,10,11 Physician knowledge of CRC screening guidelines is variable. 12-14 This article reports on the knowledge, perceptions, and practices of Iowa family physicians concerning CRC screening. Our sample comprised Iowa family physicians who attended an initial study meeting held at their medical office to learn about participating in a randomized clinical trial to improve CRC screening. Methods The University of Iowa Institutional Review Board approved the study and methods. Recruitment of family medicine practices was conducted through the Iowa Research Network, a practice-based research network with 307 family 03J PCXXX10.1177/2150131911423103Journal Levy et al.