Enrollment Challenges: Recruiting Men to Weight Loss Interventions

Abstract

Obese men are at an increased risk of chronic disease and are far less likely than women to attempt weight loss. There is a need to successfully recruit men to weight loss clinical trials. Overweight and obese men were recruited to a 6-month, randomized, controlled weight loss trial. Initial recruitment efforts were aimed at men in the workplace with less than or equal to 2 years of college education. After unsatisfactory interest from men and businesses alike, recruitment strategy shifted to enroll men outside the workplace with any educational background. Recruitment methods included word of mouth, email and website advertisements, printed posters in local businesses and doctors’ offices, Facebook ads, and a 1-week newspaper ad campaign. Initial interest and enrollment was negligible with only 35 men enrolled in the first 7 months. The launch of a 1-week newspaper advertisement was the most useful recruitment technique and 102 overweight/obese men were successfully enrolled. Study retention remained high throughout the Gutbusters program, indicating targeted, effective recruitment, and not weight loss interest, may be the largest barrier to trial participation for overweight and obese men.

Recruitment and reach in a pragmatic behavioral weight loss randomized controlled trial: implications for real-world primary care practice

“…Representativeness is rarely reported in weight loss trials, but our findings are largely consistent with a previous trial in 3 health maintenance organization (HMO) settings where enrollees were more likely to be female, non-smokers, and had a lower disease risk score [47]. There is a long history of men being under-represented in behavioral weight loss trials, [48,49] and surface-level tailoring of recruitment materials, e.g. including pictures of men as we did in this study, is likely insufficient.…”

Energy Restriction Enhances Adult Hippocampal Neurogenesis-Associated Memory after Four Weeks in an Adult Human Population with Central Obesity; a Randomized Controlled Trial

“…Another limitation to consider is that a significantly larger number of females participated in this study compared to males. Men are notoriously difficult to recruit for nutrition related research giving rise to potentially gender-biased results [73]. Therefore, future studies should consider having an equal balance in genders or alternatively be powered to investigate effects in men and women separately.…”

Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial

“…The Game of Stones sample was more disadvantaged than most men-only weight management interventions [20,[25][26][27][28]. Disadvantage is linked to having reduced confidence and being less likely to seek health information [52], hence, recruitment strategies specifically targeting disadvantaged communities are required to recruit socioeconomically diverse samples.…”

“…For example, whilst two men-only weight-loss trials reported efficacy at 6 months; only one participant (of 65) recruited for the SHED-IT trial in Australia resided in the most disadvantaged quintile area [28], and the sample recruited for the Rethinking Eating and FITness (REFIT) intervention in the US was highly educated (83.2% university educated) [26]. Building on REFIT, the Gutbusters trial sought to recruit less educated men; but after initial poor recruitment rates, altered the inclusion criteria to include men from any educational background, resulting in another highly educated sample (80.4% university educated) [25].…”