Recruitment rate and retention of stroke subjects in cross-sectional studies

Polese, Janaíne Cunha; Faria‐Fortini, Iza; Basílio, Marluce Lopes; Faria, Giselle Silva e; Teixeira-Salmela, Luci Fuscaldi

doi:10.1590/1413-81232017221.14262015

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…The use of online advertisement also demands research staff training on adequate collection of subjects contact information and management of operational systems. These were essential requirements applied in our trial to ensure appropriate manipulation of internet ads, which has also been mentioned in a recent stroke study [19]. In line with this view, Gomes et al has reported that clinical trials applying telephone and/or in-person interviews should plan in advance a content-analysis technique, as to be able to extract useful and correct information from interviews [20].…”

Section: Discussionmentioning

confidence: 69%

“…This is a major recruitment issue mentioned in other stroke trials, especially due to the natural evolution of stroke that causes multiple disabilities on affected individuals [20,26]. A study of Polese et al has reported that lack of transportation was one of the most frequent reasons for refusals, which accounted for 20% of their potential participants [19]. When investigators choose to apply medical records review as a recruitment strategy, transportation issues can highly interfere in the success of this method, as registered patients often have mobility deprivation and difficulties to reach healthcare services without support.…”

Section: Discussionmentioning

confidence: 99%

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Recruitment challenges in stroke neurorecovery clinical trials

Ferreira

Pinto

Velez

et al. 2019

Contemporary Clinical Trials Communications

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There are multiple available treatments to enhance stroke rehabilitation, although few interventions have confirmed significant clinical improvements on motor function in pivotal Randomized Clinical Trials. Development of large Randomized Clinical Trials is limited by several barriers and low enrollment rate is considered an important factor. Consequently, most of the evidence comes from small sample size studies, often leading to limited conclusions. According to the National Institute of Health (NIH), about 80% of clinical trials in the United States do not achieve their timelines, increasing research costs and postponing regulatory approval of new therapies. Given that the success of a Randomized Clinical Trial is dependent on enrolling an adequate number of subjects, effective strategies to enhance recruitment rates are highly desirable. In addition, given the resources and time limitations, it is important to understand which strategies are most cost-effective. In this manuscript, we summarize and discuss nine recruitment strategies used in an NIH R21 sponsored clinical trial, including medical records review and online advertising, among others. In addition, we developed an index to compare the time spent benefit of each approach and guide the allocation of the recruitment efforts. For this trial, online advertising and referral from health care professionals other than physicians were the strategies with greater time-benefit, leading to the largest number of stroke subjects enrolled.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Recruitment challenges in stroke neurorecovery clinical trials

Ferreira

Pinto

Velez

et al. 2019

Contemporary Clinical Trials Communications

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“…Although earlier research has documented that there are several challenging factors regarding recruitment to stroke research [ 7 – 9 , 11 ], an encouraging result in our study is that among our participants, there is a strong interest for participating in rehabilitation research. Still, there might be a gap between being interested and actually attending.…”

Section: Discussionmentioning

confidence: 72%

“…Challenges to study participant recruitment are related to individual and societal expectations, for example, stroke survivors’ lack of interest and transport possibilities, health issues [ 7 , 8 ], old age [ 8 ] and inability to give informed consent [ 8 , 9 ]. Challenges can also be related to those who provide the intervention, and the requirements for their work, and to the study as such.…”

Section: Introductionmentioning

confidence: 99%

Stroke survivors’ preferences regarding study participation in rehabilitation research

Carlstedt

Lexell

Ståhl

et al. 2022

BMC Med Res Methodol

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Background To pursue high quality research, successful participant recruitment is essential, but recruitment rates are often low. This is specifically true in target populations with impairments, for instance, among stroke survivors. Previous studies focusing on recruitment have mainly relied on information from professionals, and there is therefore a need to contribute with new methodological insights to how potential rehabilitation research participants describe their interest and preferences to participate in research. The purpose of this study was to generate knowledge about stroke survivors’ interest in participating in rehabilitation research, reasons for being interested or not, and preferred forms and foci of rehabilitation interventions. An additional aim was to describe preferences regarding survey administration modes and processes for recruitment to studies. Method This cross-sectional study recruited Swedish residents who had sustained a stroke, initially by using advertisement on the National Stroke Association’s website, flyers posted at local occupational and physical therapy offices and at local stroke/senior organization meetings. Secondly, participants were recruited through a local stroke register. The survey, administered either in a paper form returned by postal mail; online or as a phone interview with 128 stroke survivors. Results Most of the participants were interested in participating in rehabilitation research, particularly younger persons (p = 0.001) and those closer to stroke onset (p = 0.047). Contribution to research, possibility to try new rehabilitation interventions and meeting others in the same situation were reasons that attracted an interest to participate. Other important aspects were related to motivation, individual needs, as well as how skilled the people who provided the intervention were. Participants preferred group-based programs, and programs focusing on regaining lost functions were highly requested. A majority wanted to be contacted through postal mail (70%) and most of them (90%) used the paper form to respond to the survey. Conclusions A range of personal and external aspects, including challenges related to digitized administration modes, should be considered to achieve high participation rates in rehabilitation research targeting stroke survivors. The importance of addressing individual needs and prerequisites in an individualized manner should not be underestimated and might be a useful strategy to recruitment success.

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“…Recruiting stroke survivors to research projects is challenging with many trials either not meeting the target sample size or extending the recruitment time period in an attempt to meet the target sample size [ 44 ]. Commonly cited issues regarding recruitment include stroke-related impairments [ 45 ], delayed ethical or site approval and trial staff appointments [ 44 ], and slow recruitment rates due to patient eligibility, agreement to participate, or staffing issues [ 44 – 46 ]. This trial was not without these issues, and only recruited two-thirds of our planned sample but was still successful in recruiting approximately one-third of all stroke survivors admitted to the participating units.…”

Section: Discussionmentioning

confidence: 99%

High-intensity treadmill training and self-management for stroke patients undergoing rehabilitation: a feasibility study

Brauer

Kuys

Paratz

et al. 2021

Pilot Feasibility Stud

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Background Physical activity undertaken by stroke survivors is generally low. This trial investigated the feasibility of delivering a high-intensity treadmill and self-management program to people with stroke undergoing inpatient rehabilitation and determine whether physical activity, walking ability and cardiorespiratory fitness could be increased. Method A phase I, single-group, pre-post intervention study was conducted with stroke survivors undergoing inpatient rehabilitation who could walk. Participants undertook a high-intensity treadmill and self-management program for up to 30 min, three times a week for 8 weeks under the supervision of their usual physiotherapist. Feasibility was determined by examining compliance, satisfaction and adverse events. Clinical outcomes were amount of physical activity, walking ability, and cardiorespiratory fitness collected pre-training (week 0), post-training (week 8), and at follow-up (week 26). Results Forty stroke survivors participated, completing 10 (SD 6) sessions, 94% at the specified training intensity, with high satisfaction and no adverse events related to the intervention. At week 8, participants completed 2749 steps/day (95% CI 933 to 4564) more physical activity than at week 0. Walking distance increased by 110 m (95% CI 23 to 196), walking speed by 0.24 m/s (95% CI 0.05 to 0.42), and VO2 peak by 0.29 ml/kg/min (95% CI 0.03 to 0.56). At week 26, increases in physical activity, walking distance and speed, and cardiorespiratory fitness were maintained. Conclusions A high-intensity treadmill training program embedded within a self-management approach during inpatient rehabilitation appears feasible and potentially may offer sustained improvements in physical activity, walking ability, fitness, and quality of life. A randomised trial is warranted. Trial registration This feasibility study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000764730).

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Recruitment rate and retention of stroke subjects in cross-sectional studies

Abstract: Recruitment rate and retention of stroke subjects in cross-sectional studies

Cited by 9 publications

References 24 publications

Recruitment challenges in stroke neurorecovery clinical trials

Recruitment challenges in stroke neurorecovery clinical trials

Stroke survivors’ preferences regarding study participation in rehabilitation research

High-intensity treadmill training and self-management for stroke patients undergoing rehabilitation: a feasibility study

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