Challenges to be overcome using population-based sampling methods to recruit veterans for a study of post-traumatic stress disorder and traumatic brain injury

Abstract

BackgroundMany investigators are interested in recruiting veterans from recent conflicts in Afghanistan and Iraq with Traumatic Brain Injury (TBI) and/or Post Traumatic Stress Disorder (PTSD). Researchers pursuing such studies may experience problems in recruiting sufficient numbers unless effective strategies are used. Currently, there is very little information on recruitment strategies for individuals with TBI and/or PTSD. It is known that groups of patients with medical conditions may be less likely to volunteer for clinical research. This study investigated the feasibility of recruiting veterans returning from recent military conflicts— Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) - using a population-based sampling method.MethodsIndividuals were sampled from a previous epidemiological study. Three study sites focused on recruiting survey respondents (n = 445) who lived within a 60 mile radius of one of the sites.ResultsOverall, the successful recruitment of veterans using a population-based sampling method was dependent on the ability to contact potential participants following mass mailing. Study enrollment of participants with probable TBI and/or PTSD had a recruitment yield (enrolled/total identified) of 5.4%. We were able to contact 146 individuals, representing a contact rate of 33%. Sixty-six of the individuals contacted were screened. The major reasons for not screening included a stated lack of interest in the study (n = 37), a failure to answer screening calls after initial contact (n = 30), and an unwillingness or inability to travel to a study site (n = 10). Based on the phone screening, 36 veterans were eligible for the study. Twenty-four veterans were enrolled, (recruitment yield = 5.4%) and twelve were not enrolled for a variety of reasons.ConclusionsOur experience with a population-based sampling method for recruitment of recent combat veterans illustrates the challenges encountered, particularly contacting and screening potential participants. The screening and enrollment data will help guide recruitment for future studies using population-based methods.

Using Facebook to Recruit Young Adult Veterans: Online Mental Health Research

“…In general, recruitment of individuals into treatment studies on mental health has traditionally been difficult, with barriers to enrollment related to inconvenient scheduling times, lack of transportation to research sites, and stigma related to discussing sensitive matters with an unknown interviewer in a face-to-face setting [ 51 ]. Studies targeting active duty service members and young adult veterans with mental health concerns such as PTSD or TBI have similarly struggled with recruitment [ 52 , 53 ]. Yet, another study using Facebook recruitment has also been successful at obtaining OEF/OIF veteran participants in need of help for PTSD and hazardous alcohol use for an online intervention study [ 21 ].…”

How can we get Iraq- and Afghanistan-deployed US Veterans to participate in health-related research? Findings from a national focus group study

“…There is a paucity of research into best practices for recruiting Veterans for research studies [ 12 – 17 ], particularly with respect to those who served in OEF/OIF, research involving observational cohort studies (vs. clinical trials), and for Veterans who are not using VA for their health care. Prior studies in Veterans have noted altruism [ 17 ] as an important factor for recruitment whereas difficulty contacting target participants (possibly related to the fact that younger Veterans are highly mobile and military contact information may be outdated) [ 13 ], lack of interest [ 13 ], and research “burn-out” due to multiple requests [ 16 ] were barriers to participation. Bayley et al hypothesized that participation in their study may have been low due to a low perceived compensation rate ($200 for a full day of assessments) [ 13 ].…”

“…Prior studies in Veterans have noted altruism [ 17 ] as an important factor for recruitment whereas difficulty contacting target participants (possibly related to the fact that younger Veterans are highly mobile and military contact information may be outdated) [ 13 ], lack of interest [ 13 ], and research “burn-out” due to multiple requests [ 16 ] were barriers to participation. Bayley et al hypothesized that participation in their study may have been low due to a low perceived compensation rate ($200 for a full day of assessments) [ 13 ].…”

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care

“…Our response rates for the overall pilot trial and for this qualitative study (60%) and the low dropout rates for each met our feasibility goals. This pilot evaluated 3 participant recruitment strategies, including personalized letters sent to veterans who were screened through the electronic health record, focused recruitment from the chiropractic clinic, and provider referrals, along with standard techniques such as study-branded brochures [ 74 , 75 ]. Veterans endorsed these strategies, which proved useful in other VA-based studies of non-pharmacological interventions [ 76 ].…”