The National Children’s Study: Recruitment Outcomes Using the Provider-Based Recruitment Approach

Abstract

OBJECTIVE: In 2009, the National Children's Study (NCS) Vanguard Study tested the feasibility of household-based recruitment and participant enrollment using a birth-rate probability sample. In 2010, the NCS Program Office launched 3 additional recruitment approaches. We tested whether provider-based recruitment could improve recruitment outcomes compared with household-based recruitment. METHODS:The NCS aimed to recruit 18-to 49-year-old women who were pregnant or at risk for becoming pregnant who lived in designated geographic segments within primary sampling units, generally counties. Using provider-based recruitment, 10 study centers engaged providers to enroll eligible participants at their practice. Recruitment models used different levels of provider engagement (full, intermediate, information-only). RESULTS:The percentage of eligible women per county ranged from 1.5% to 57.3%. Across the centers, 3371 potential participants were approached for screening, 3459 (92%) were screened and 1479 were eligible (43%). Of those 1181 (80.0%) gave consent and 1008 (94%) were retained until delivery. Recruited participants were generally representative of the county population. CONCLUSIONS:Provider-based recruitment was successful in recruiting NCS participants. Challenges included time-intensity of engaging the clinical practices, differential willingness of providers to participate, and necessary reliance on providers for participant identification. The vast majority of practices cooperated to some degree. Recruitment from obstetric practices is an effective means of obtaining a representative sample.

Comparison of Recruitment Strategy Outcomes in the National Children’s Study

“…This is expected because DO participants were volunteers who wanted to participate in the study and PBR participants may have been influenced to participate by some providers who actively endorsed the study in their referral. 22 One important result to be noted across all the strategies, however, is that large variations in the recruitment rates occurred across the study sites. This variation may be because of characteristics of the target populations and other community and contextual factors but also because of the capabilities of individual study centers in operationalizing the recruitment procedures.…”

“…21 The PBR protocol abandoned householdbased canvassing in favor of partnering with obstetric and other health care providers in the community to identify, screen, and recruit women residing in the target SSUs to provide a sample. 22 The DO strategy used passive recruitment methods, such as study mailings, to conduct pregnancy screenings and allowed participants to choose 1 of 2 initial intensity levels of data collection. 23 This strategy expanded the geographic eligibility area by adding SSUs contiguous to the target SSUs.…”

Effectiveness of community outreach and engagement in recruitment success for a prebirth cohort

“…Based on early results, a decision was made to evaluate additional recruitment strategies in an Alternate Recruitment Substudy (ARS), which began November 2010. The ARS evaluated three different recruitment strategies in 30 additional locations: Direct Outreach (DO) [15], Enhanced Household-Based Recruitment (EHBR) [16], and Provider-Based Recruitment (PBR) [17]. The DO strategy recruited women using community outreach and engagement, including direct mailing.…”

The National Children’s Study: Recruitment Outcomes Using an Enhanced Household-Based Approach

“…A total of 568 preconception women at the initial pregnancy screener enrolled in the study, representing 40.5% of all EHBR consented women at the initial pregnancy screening. Given the difficulty in identifying preconceptional women, this outcome can be considered one of the strengths of a householdbased recruitment approach, as the EHBR strategy was more successful at recruiting prepregnant women compared with provider-based recruitment 11 and recruitment using direct-to-consumer marketing. 12 Targeted follow-up of the population of women who screened as actively trying to conceive ultimately led to a greater number of children born into the study and provided an opportunity to measure important preconception and early pregnancy exposures.…”