Recruitment and Retention of Children in Behavioral Health Risk Factor Studies: REACH Strategies

Recruitment and Retention of Children in Behavioral Health Risk Factor Studies: REACH Strategies

Stephanie Schoeppe MSocialSc1, Melody Oliver PhD2, Hannah M Badland PhD3, Matthew Burke PhD4, Mitch J Duncan PhD1

1Central Queensland University, Institute for Health and Social Science Research, Centre for Physical Activity Studies, Rockhampton, Australia

2Auckland University of Technology, Human Potential Centre, Auckland, New Zealand

3The University of Melbourne, McCaughey VicHealth Centre for Community Wellbeing, Melbourne, Australia

4Griffith University, Urban Research Program, Brisbane, Australia

Corresponding author:

1Stephanie Schoeppe

Central Queensland University

Institute for Health and Social Science Research

Centre for Physical Activity Studies

Building 18, Bruce Highway

Rockhampton QLD 4702

Australia

Tel: +61 (0)7 4923 2271

Fax: +61 (0)7 4930 6402

E-mail:

Electronic supplementary material (Online Resources 1-4)

Online Resource 1Identification of primary studies and reviews published between January 1990 and January 2012

aSpecific empirical papers/case studies reported on recruitment and retention strategies in the fields of children's physical activity, dietary habits, or weight status (i.e. overweight, obesity). These health risk factors were the specific focus of this research.

bBroad empirical papers/case studies related to recruitment and retention strategies in health areas that were not the specific focus of this research, such as tobacco, alcohol and drug consumption, HIV prevention, mental and physical chronic diseases.

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Online Resource 2Summary findings from the literature review of successful strategies for the recruitment and retention of children in behavioral health risk factor studies

• Advertisements in the media
• Posters and flyers in community settings or neighbourhoods
• Direct mail
• Telephone screening
• Child-specific settings, such as schools, youth organizations and sports clubs

• Settings include, for example, public and private schools, sports clubs and commercial gyms, youth organizations, community, community events, general population

• Schools or other organizations involved may receive positive recognition in the community or monetary incentives/compensations for study participation and assistance with recruitment procedures
• Feed into / guide the school curriculum

• Advertise the study to raise interest in study participation and invite potential participants through various media such as television, radio, newspapers, weekly advertising publications or email newsletters

• Use study or organizational logos in written communications, flyers, posters, information packages, etc

• Circulate visually appealing posters and flyers in the recruitment settings
• Circulate pens with study logo/branding to participants when completing consent forms

• Circulate handouts/flyers that are informative, and linguistically and visually appealing
• Use videos and slide shows for presentation at information sessions

• Ensure informed signed assent from the participating child, and informed signed consent from the child’s parent/guardian
• Where appropriate, gain informed signed consent from setting representatives (e.g. school principal, board of trustees, teachers for school settings).
• Hand out consent and assent forms that are sufficiently informative, linguistically and visually appealing.
• Set up optimal, convenient ways of returning consent forms, such as through collection boxes and personnel support (e.g. teachers, community workers, administrative staff)

• Identify motivating factors for study enrolment for students and parents

• Hand out appropriate incentives or reimbursements to children/families, or school classes that returned signed consent forms

• Follow up on eligible participants (e.g. via email, mail, telephone) who did not return signed parental and child consent forms

• Explain the purpose and benefits of the study. Show enthusiasm, be friendly and use simple language.
• Address potential safety issues raised by children, parents or setting-related personnel. Patiently answer all questions arising

• Identify suitable local advocates (physical education/lead teachers, social workers, general practitioners, etc.) who could reassure children and their parents that this is an important project. Moreover, advocates could explain the benefits from study participation.

• Establish multiple appropriate communication channels for gathering or reminding participants to return forms/equipment, such as school microphones, notice boards, teachers, youth workers, in-class visits, etc.

• Use simple, non-academic language that clearly outlines the research

• Set up cohesive research teams and ensure that they are not overworked with recruitment and data collection tasks.
• Ensure that researchers remain employed on the study to ensure program stability
• Develop one consistent point of contact between participants and the project. This enables relationship building, stability and continuity

• For example, vouchers, monetary incentives/compensations, gifts, school class competitions.
• Remind children, parents and setting-related personnel repeatedly on the benefits of participation for themselves and the broader community

• Address all questions and concerns by children, parents and setting-related personnel
• Mention repeatedly that the information provided will be confidential
• Use study or organizational logos in written and electronic communications/ data collection materials
• Fulfill promises made to children, parents and setting-specific personnel
• Conduct case management/various data collection time points by the same project staff year after year
• Emphasize the benefits of continued participation to children, parents and setting-related personnel
• If possible, use project staff who are known and connected to the community in which the study takes place.

• Carefully consider total time, days of the week or time of the day children and/or parents are required to devote to study participation
• Use age-appropriate surveys that are as short and clear as possible
• Allow flexibility in the data collection date/times/site for participants

• Avoid collisions of data collection/intervention implementation with other activities, such as children’s social activities, school events (e.g. camps, sports days), parent’s daily schedules, personal work duties, etc.
• Conduct data collection/intervention implementation at sites where children are located (e.g. the home), or can easily travel to.

• Between data collection visits, maintain contact with participating children, parents and setting-related personnel, for example through a study website or regular newsletters reporting on study progress

• Use multiple and continual reminders of participation and upcoming data collection time points
• Follow up on participants who have not completed measurements, intervention steps or returned equipment (e.g. reminders via email, mail, phone or visits at schools/home/other organizations involved)
• Ask teachers to remind the children to return forms, measurements and equipment
• Explore reasons for non-participation and drop outs, for example, by talking to the children, parents or setting-related personnel. If possible, efforts should be made to address identified barriers.

• For example, the child’s sex, age, developmental level, language ability, ethnicity and socio-economic status may influence study recruitment and retention. Suitable information materials, communications, data collection methods (including researchers) and intervention implementation methods should be applied.

• Suitable information materials, communications, data collection methods and intervention implementation methods should be used that can be used across diverse groups

• Secure ethical approval prior to commencing the study.
• Ensure that sensitive issues around research with children are being addressed in ethics applications

• For example, whole community, neighbourhoods, public/private schools, sports clubs, youth organizations
• Ensure the data collection site is safe, convenient to reach and appropriate in appearance for children, their parents and the research team
• Ensure that children’s parents can be reached easily, either through the site or directly. For example, in school-based studies, researchers may have limited access to parents, if they do not have their contact details. Limited access to parents may impede consent processes and data collection follow-ups.
• Be aware of any site-specific policies or guidelines related to data collection

• Schedule data collection dates/times convenient for children, their parents or setting-related personnel
• Ensure that project staff can act flexibly regarding data collection dates, time points and sites (e.g. consider home visits)

• Conduct a pilot study in the target population to test the recruitment strategy and materials, data collection process and measurements.

• Conduct focus groups or interviews with targeted children and parents/caregivers to ask questions regarding best ways to recruit and retain targeted children.

• Get feedback from key setting-related personnel about issues regarding recruitment and data collection
• Include key setting-related personnel or the community in recruitment and data collection processes.

• Calculate the costs and in-kind resources needed for the recruitment and retention procedures prior to commencement of the study (e.g. in grant applications)
• Allow for additional timeframes and costs due to unexpected recruitment issues

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Online Resource 3Delphi study procedure (adapted from Vandelanotte et al. 2010)

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Online Resource4 Results of the Round 2 and Round 3 Delphi study

1. Invest time in developing relationships with study partners, parents and children (e.g. through personal, face-to-face contacts; trust-building efforts)

1. Clearly explain the study purpose, requirements, and benefits in participating for children, parents and study partners

1. Create enthusiasm about the study among children, parents and study partners

1. Have support from key stakeholders (e.g. parents, school, sports coaches, sports club presidents, Government department/ministry)

1. Advertise the study in the local media (e.g. newspaper, radio, television, university newsletter/website)

1. Organize other publicity activities (e.g. publishing study information in newsletters of community-based organizations such as schools

1. Use a passive consent process (opt-out option)

1. Use participatory approaches in the study planning and implementation (e.g. with children, parents, teachers)

1. Have a project champion who promotes the recruitment and implementation of the study (e.g. school teacher, celebrity, community leader)

1. Ensure that there is sufficient funding for recruitment

1. Conduct long-term recruitment (including follow-up of non-recruited children)

1. Investigate the geographic, demographic and socio-economic profile of targeted settings for recruitment (e.g. schools, child care centers, sports clubs) prior to data collection

1. Identify key stakeholders relevant for study recruitment and implementation

1. Translate study materials if eligible participants are from culturally and linguistically diverse groups

1. Hold information sessions for children, parents, and study partners prior to and during data collection

1. Provide a study website or video

1. Minimise additional burden to staff based in the settings where recruitment takes place (e.g. school teachers, sports club coaches, admin staff)

1. Use attractive venues for data collection (e.g. museum, sports center)