Recruiting and engaging new mothers in nutrition research studies: lessons from the Australian NOURISH randomised controlled trial

Abstract

BackgroundDespite important implications for the budgets, statistical power and generalisability of research findings, detailed reports of recruitment and retention in randomised controlled trials (RCTs) are rare. The NOURISH RCT evaluated a community-based intervention for first-time mothers that promoted protective infant feeding practices as a primary prevention strategy for childhood obesity. The aim of this paper is to provide a detailed description and evaluation of the recruitment and retention strategies used.MethodsA two stage recruitment process designed to provide a consecutive sampling framework was used. First- time mothers delivering healthy term infants were initially approached in postnatal wards of the major maternity services in two Australian cities for consent to later contact (Stage 1). When infants were approximately four months old mothers were re-contacted by mail for enrolment (Stage 2), baseline measurements (Time 1) and subsequent random allocation to the intervention or control condition. Outcomes were assessed at infant ages 14 months (Time 2) and 24 months (Time 3).ResultsAt Stage 1, 86% of eligible mothers were approached and of these women, 76% consented to later contact. At Stage 2, 3% had become ineligible and 76% could be recontacted. Of the latter, 44% consented to full enrolment and were allocated. This represented 21% of mothers screened as eligible at Stage 1. Retention at Time 3 was 78%. Mothers who did not consent or discontinued the study were younger and less likely to have a university education.ConclusionsThe consent and retention rates of our sample of first time mothers are comparable with or better than other similar studies. The recruitment strategy used allowed for detailed information from non-consenters to be collected; thus selection bias could be estimated. Recommendations for future studies include being able to contact participants via mobile phone (particularly text messaging), offering home visits to reduce participant burden and considering the use of financial incentives to support participant retention.Trial registrationAustralian and New Zealand Clinical Trials Registry Number ACTRN12608000056392

Development and evaluation of an intervention for the prevention of childhood obesity in a multiethnic population: the Born in Bradford applied research programme

“…Our experiences of recruitment are in line with those in other similar studies [168][169][170][171] and our process evaluation has identified valuable areas to consider to improve intervention attendance. For example, participants allocated to the intervention who engaged early (i.e.…”

Reducing childhood obesity: opportunities to influence transitional infant feeding

“…23,27 While longitudinal studies are increasing, intervention retention and outcomes would suggest possible limitations in sample size, intervention length and program delivery. [28][29][30] While acknowledgement of the current childhood obesity dilemma has received political support for action and the growth of obesity prevention activity in the early years, further evidence is required to guide future investment. This evidence should inform both policy development and health professional practices to nurture early childhood settings supportive of healthy lifestyle behaviours.…”

“…28,29 Other than those studies specifically targeting minority groups, 113 many studies struggled to achieve a sample from a mixture of socioeconomic backgrounds, ending up with older, more educated participants. 28,29 Whether this is due to the intervention delivery or to the burden of study involvement it is not clear, although one study identified time and return to work as reasons for non-consent. 28 Retention rates were also an issue in some studies, with higher rates of withdrawal from intervention samples suggesting participation burden.…”

“…28,29 Whether this is due to the intervention delivery or to the burden of study involvement it is not clear, although one study identified time and return to work as reasons for non-consent. 28 Retention rates were also an issue in some studies, with higher rates of withdrawal from intervention samples suggesting participation burden.…”

“…Current early childhood nutrition interventions are frequently based on responsive feeding practices, 80,205,206 however recruitment and participation issues 28,186 suggest a lack of appreciation of the context in which feeding behaviours develop and/or the needs of parents. The origins of feeding practices are inextricably intertwined with the social and cultural factors that govern family life.…”