Recruitment and Retention of Pregnant Women for a Behavioral Intervention: Lessons from the Maternal Adiposity, Metabolism, and Stress (MAMAS) Study

Abstract

IntroductionRecruiting participants for research studies can be challenging. Many studies fall short of their target or must prolong recruitment to reach it. We examined recruitment and retention strategies and report lessons learned in a behavioral intervention developmental trial to encourage healthy pregnancy weight gain and stress reduction in low-income overweight pregnant women.MethodsIn the San Francisco Bay area from February 2010 through March 2011, we used direct and indirect strategies to recruit English-speaking overweight and obese pregnant women who were aged 18 to 45, were in the early stages of pregnancy, and who had an annual household income less than 500% of the federal poverty guidelines. Eligible women who consented participated in focus groups or an 8-week behavioral intervention. We identified successful recruiting strategies and sites and calculated the percentage of women who were enrolled and retained.ResultsOf 127 women screened for focus group participation, 69 were eligible and enrolled. A total of 57 women participated in 9 focus groups and 3 women completed individual interviews for a completion rate of 87%. During recruitment for the intervention, we made contact with 204 women; 135 were screened, 33% were eligible, and 69.1% of eligible women enrolled. At 1 month postpartum, 82.6% of eligible women completed an assessment. Recruiting at hospital-based prenatal clinics was the highest-yielding strategy.ConclusionThe narrow window of eligibility for enrolling early stage pregnant women in a group intervention presents obstacles. In-person recruitment was the most successful strategy; establishing close relationships with providers, clinic staff, social service providers, and study participants was essential to successful recruitment and retention.

Promoting clinical research to medically underserved communities: Current practices and perceptions about clinical trial recruiting strategies

“…Specifically, methods to break down structural barriers to CT accrual were seen as more important methods to recruit from rural and AA populations. These tactics included providing transportation, providing monetary incentives, communicating through printed materials, and providing childcare during appointments [33]. While these incentives are important to study participation, the findings, again, stress PIs' focus on the health care provider/ patient relationship and not CT promotion or community partnerships to help increase awareness about CTs.…”

Pregnant women's interest in a website or mobile application for healthy gestational weight gain

“…Even among women who reported no Internet access over the past four weeks, 2 of 3 women reported interest in using a website or mobile application for pregnancy weight gain. Pregnant women face challenges to in-person behavioral interventions during pregnancy, including conflict with work schedules, lack of transportation, and a need for childcare for older children(4). An intervention delivered via a website or mobile application could overcome these challenges to participation.…”

“…The best strategy for preventing excessive gestational weight gain is unknown(2). The Internet may be an ideal delivery mechanism for pregnant women, given prevalent online information-seeking during pregnancy(3), barriers to in-person interventions during pregnancy(4), and women’s familiarity with the myriad of existing pregnancy-related mobile applications(5). The aim of this study was to examine pregnant women’s interest in using a website or mobile application to help them achieve healthy weight gain during pregnancy.…”

Sugary beverage and food consumption, and leukocyte telomere length maintenance in pregnant women

“…6 The intervention was registered at clinicaltrials.gov as NCT01307683. The analytic sample was comprised of 65 women with complete dietary and telomere length data out of 104 women in the intervention group.…”