Researchers’ perspectives on pediatric obesity research participant recruitment

Abstract

Background Childhood obesity prevalence has tripled over the last three decades. Pediatric obesity has important implications for both adult health as well as the United States economy. In order to combat pediatric obesity, exploratory studies are necessary to create effective interventions. Recruitment is an essential part of any study, and it has been challenging for all studies, especially pediatric obesity studies. The objective of this study was to understand barriers to pediatric obesity study recruitment and review facilitators to overcome recruitment difficulties. Methods Twenty four childhood obesity researchers were contacted. Complete data for 11 researchers were obtained. Interviews were transcribed and analyzed using content analysis. Grounded Theory methodological approach was used, as this was an exploratory study. Investigators YP and MM coded the interviews using 28 codes. Results Barriers to recruitment included: family and study logistics, family economics, lack of provider interest, invasive protocols, stigma, time restraints of clinicians, lack of patient motivation/interest, groupthink of students in a classroom, and participants who do not accept his or her own weight status. Facilitators to enhance recruitment practices included accommodating participants outside of regular clinic hours, incentivizing participants, cultivating relationships with communities, schools and clinics prior to study recruitment, emphasizing benefits of a study for the patient, and shifting language to focus on health rather than obesity. Conclusions Pediatric obesity researchers face many standard and some unique challenges to recruitment, reflecting challenges common to clinical research as well as some specific to pediatrics and some specific to obesity research. Both pediatric studies as well as obesity studies are an added challenge to the already-difficult task of general study recruitment. Our findings can be used to make researchers more aware of potential difficulties, approaches and on-going needs for enhancing recruitment and enrollment practices, and in turn if applied, may result in increased study efficiency.

Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit

“…Lifestyle change is more likely to occur and be impactful during younger childhood when family dynamics can be leveraged, as opposed to during adolescence, which is often characterized by rebellion. Methodological challenges to conducting pediatric obesity studies have been described ( 172 ). Additionally, treatment of children with serious medical conditions must concurrently address psychosocial and lifestyle-related needs and behaviors of the patient and their family as their traumatic experiences can negatively affect medical compliance and long-term outcomes.…”

A randomized, comparative pilot trial of family‐based interpersonal psychotherapy for reducing psychosocial symptoms, disordered‐eating, and excess weight gain in at‐risk preadolescents with loss‐of‐control‐eating

“…Despite good program participation, in future trials study execution could be improved by reducing burden (e.g., fewer visits and/or at-home assessments) and enhancing contact with families throughout follow-up. Although we were able to compensate youth in the current study for their time and to provide some support for transportation, retention would be bolstered by greater incentives to families for follow-up participation (Parikh et al, 2016). While children reported perceived benefits throughout treatment and families attended the majority of sessions, we did not collect parents’ perceptions of treatment process in their preadolescents or a qualitative post-intervention interview, which could have provided valuable feedback on program development and enhancing follow-up assessment retention.…”

“…Alternatively, less restrictive inclusion/exclusion criteria, such as not requiring that parents have overweight/obesity, would make the program more generalizable with broader reach. Weight management studies have reported significant difficulties in retaining families of disadvantaged racial/ethnic groups (Parikh, Mason, & Williams, 2016). Despite good program participation, in future trials study execution could be improved by reducing burden (e.g., fewer visits and/or at-home assessments) and enhancing contact with families throughout follow-up.…”

Conducting a pediatric randomized clinical trial during a pandemic: A shift to virtual procedures

“…(6) Factors that enhance recruitment of rural participants into pediatric obesity clinical trials include providing monetary time incentives, cultivating relationships with clinics, emphasizing potential benefits to participants, and focusing on healthy lifestyle rather than on obesity. (7,8) Prior to the COVID-19 pandemic, clinical trials were primarily conducted through faceto-face communication. Research coordinators engaged participants via in-person contact for study procedures such as recruiting, consenting, enrolling, and performing study visits.…”