Retention strategies for health disparities preventive trials: findings from the Early Childhood Caries Collaborating Centers

Abstract

Objectives To identify successful strategies for retention of participants in multi-year, community-based randomized controlled trials (RCTs) aiming to reduce early childhood caries in health disparities populations from diverse racial/ethnic backgrounds and across diverse geographic settings. Methods Four RCTs conducted by the Early Childhood Caries Collaborating Centers (EC4), an initiative of the National Institute of Dental and Craniofacial Research, systematically collected information on the success of various strategies implemented to promote participant retention in each RCT. The observational findings from this case series of four RCTs were tabulated and the strategies rated by study staff. Results Participant retention at 12 months of follow-up ranged from 52.8% to 91.7%, and at 24 months ranged from 53.6% to 85.9, across the four RCT. For the three RCT that had a 36 month follow-up, retention ranged from 53.6% to 85.1%. Effectiveness of different participant retention strategies varied widely across the RCT. Conclusions Findings from this case series study may help to guide the design of future RCTs to maximize retention of study participants and yield needed data on effective interventions to reduce oral health disparities.

Acculturation and Pediatric Minority Oral Health Interventions

“…Involving stakeholders from immigrant community in action research increases the cross-cultural understanding and thus provides an opportunity for both the investigator and community to work together to implement prevention intervention successfully. Recent oral health interventions have successfully used CBPR methodologies to involve stakeholders in research design and implementation of research and in recruiting and retaining study participants in longitudinal studies (53–55). …”

“…They have been used extensively to reach some groups, such as migrant farm workers, Latino and some Asian communities (47, 56, 58). Several studies have successfully used community health workers or lay community members (who have been trained to deliver interventions) to engage immigrant parents in dialogue about accessing oral health prevention services, providing oral health counseling, and helping in initiating oral health behavior change through Motivation Interviewing (54, 55–59). A study that used a Vietnamese lay health counselor to provide oral health counseling to Vietnamese mothers of preschool children, emphasized that similar cultural background of the counselor was an essential part of adoption of healthy oral health behaviors (58).…”

“…In the Latino community, Promotora -based pediatric interventions for oral health prevention are readily accepted and have been shown to ease recruitment of participants in oral health interventions, increase attendance for intervention activities, and retain the participants for a longer period of time (55, 56, 59). Participating parents seem more comfortable in these setting and, therefore, may ask more questions than in a dental clinic setting, which in turn may help increase the understanding of oral health of their children and could also transform some cultural beliefs that do not support oral health.…”

Facilitators and barriers to pediatric clinical trial recruitment and retention in rural and community settings: A scoping review of the literature

“…In most cases, these articles were narrative summaries of investigator experiences, 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 although, in some cases, the conclusions were supported by completing analysis of study records or interviews or by conducting focus groups or surveys with study staff, site personnel, or participants. 33 , 34 , 35 , 36 , 37 , 38 Two articles compared recruitment or retention outcomes across similar studies that used different recruitment or retention methods or frameworks. 39 , 40 One article compared recruitment and retention rates for participants who initiated contact with the study via different strategies (in clinics, in the community, or via informatics).…”

The VidaSana Study: Recruitment Strategies for Longitudinal Assessment of Egocentric Hispanic Immigrant Networks

“…Upholding the importance of engaging the community in the development of our outreach plan [23,28,29], we preserved a fluid interaction with the community. We contacted active leaders in the community who had been instrumental in helping our previous studies gain momentum.…”