Overcoming barriers to recruitment and retention in adolescent smoking cessation

Abstract

Participant recruitment and retention have been identified as challenging aspects of adolescent smoking cessation interventions. Problems associated with low recruitment and retention include identifying smokers, obtaining active parental consent, protecting participants' privacy, respecting participants' autonomy, and making participation relevant and accessible to adolescents. This paper describes nine strategies for minimizing these recruitment and retention problems via a proactive telephone counseling intervention, and reports on their simultaneous implementation among 1,058 smokers from 25 high schools in Washington state. Results are as follows: (a) 85.9% of parents of minor-age seniors provided active consent for their teen's participation, (b) 89.8% of eligible smokers were successfully contacted by counselors, (c) 86.5% of contacted smokers consented to participate in the cessation counseling, (d) 93.8% of consented smokers participated in smoking cessation counseling calls, and (e) 72.2% of participating smokers completed their full intervention. These results demonstrate that older teens who smoke, and their parents, are receptive to confidential cessation counseling that is personally tailored, supportive of their autonomy, and proactively delivered via the telephone.

Challenging Recruitment of Youth With Type 2 Diabetes Into Clinical Trials

“…Working with minors, researchers found that success in clinical research required a mix of trust, confidentiality, and continuous contact with young patients and their guardians [18,21,24,26,30,32,37,38]. Earning confidence often included earning the trust of the communities from which patients were recruited.…”

Addressing challenges in adolescent smoking cessation: Design and baseline characteristics of the HS Group-Randomized trial

“…In addition, including nonsmokers provides the intervention an opportunity to harness nonsmokers' support in helping their smoking friends to quit and, more important, an opportunity to evaluate the effectiveness of their doing so. Finally, as it turned out, including nonsmokers may have boosted recruitment of smokers to the intervention (Kealey et al, 2007).…”

“…The smoking cessation intervention incorporates multiple strategies to address known intervention obstacles (Kealey et al, 2007), including (1) proactively identify smokers in the population and directly invite their participation; (2) include both smokers and nonsmokers as participants to protect smokers' privacy; (3) use the telephone to proactively deliver the intervention; (4) allow unlimited calls to reach adolescents; (5) tailor the intervention to the individual; and (6) communicate respect for adolescents and their choices.…”

“…Interestingly, despite their self-reported resistance to cessation assistance, smokers in the experimental arm were receptive to proactive intervention recruitment (Kealey et al, 2007). Specifically, among eligible smokers who were successfully contacted, 81% participated in the intervention.…”

Participant- and Study-Related Characteristics Predicting Treatment Completion and Study Retention in an Adolescent Smoking Cessation Trial

“…Additionally, although participants were more likely to attend if they had more positive perceptions of smoking, higher baseline smoking rate, higher baseline nicotine dependence, and were of white race, attendance was not associated with baseline motivation to quit, perceived stress, previous quit attempts, gender, or age. In another study, 72% of participants completed the multiple-session telephone counseling intervention, with lower baseline smoking frequency and later stage of change to quit being associated with higher treatment completion rates [10].…”