Abstract
Despite the lifelong health benefits of physical activity, frailer older adults have typically been excluded from studies promoting more active lifestyles. This study documents the recruitment process and costs from a multisite study to identify effective strategies for recruiting older adults in frailty/injury prevention research. Randomized controlled clinical trials were conducted at 7 sites; an 8th site was a compliance study. Interventions reflected center- and home-based health promotion programs. Site objectives, eligibility criteria, and contact and screening methods were obtained from manuals of operation. Recruitment results (number screened, eligibility rates, randomized to screened ratios) were ascertained from recruitment data. Sites furnished estimated recruitment costs (nonlabor expenses, investigator and staff time, fringe benefits) up to signing the consent form. The sites targeted diverse populations and sample sizes. The majority revised recruitment methods to meet their recruitment goals. Most sites estimated costs of recruitment at over $300 per participant randomized. Recruitment costs were affected by staff time spent alleviating concerns about participants' health, essential interactions with family members, and arranging for transportation. Neither frailty nor intervention intensity was found to be a major predictor of recruitment outcomes. Recruitment expense was associated with selection criteria and frailty status of the target population. Older people can be successfully recruited into beneficial health promotion programs, but it is often challenging. In planning health promotion studies, investigators need to be aware of the numbers of older people they may need to screen and different strategies for increasing recruitment success.
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REFERENCES
Ander, L. A., Fogler, J., & Dedrick, R. F. (1995). Recruiting from the community: Lessons learned from the Diabetes Care for Older Adults Project. Gerontology, 35, 395-401.
Anderson, R. T., Ory, M. G., Cohen, S., & McBride, J. S. (2000, October). Issues of aging and adherence to heath interventions. Controlled Clinical Trials, 21, 171S-183S.
Applegate, W. B., & Curb, J. D. (1990). Designing and executing randomized clinical trials involving elderly persons. Journal of the American Geriatric Society, 38, 943-950.
Arean, P. A., & Gallagher-Thompson, D. (1996). Issues and recommendations for the recruitment and retention of older ethnic minority adults into clinical research. Journal of Consulting and Clinical Psychology, 64, 875-880.
Buchner, D. M., Cress, M. E., Wagner, E. H., deLateur, B. J., Price, R., & Abrass, I. B. (1993). The Seattle FICSIT/Move It Study: The effect of exercise on gait and balance in older adults. Journal of the American Geriatric Society, 41, 321-325.
Carter, W. B., Elward, K., Malmgren, J., Martin, M. L., & Larson, E. (1991). Participation of older adults in health programs and research: A critical review of the literature. Gerontologist, 31, 584-592.
Centers for Disease Control and Prevention. (1996). Surgeon general's report on physical activity and health.Washington, DC: U.S. Department of Health and Human Services.
Davis, L., & Wykle, M. L. (1998). Self-care in minority and ethnic populations: The experience of older black Americans. In M. G. Ory & G. H. DeFriese (Eds.), Self care in later life (pp. 170-179). New York: Springer.
Fiatarone, M. A., O'Neill, E. F., Doyle, N., Clements, K. M., Roberts, S. B., Kehayias, J. J., Lipsitz, L. A., & Evans, W. J. (1993). The Boston FICSIT Study: The effects of resistance training and nutritional supplementation on physical frailty in the oldest old. Journal of the American Geriatric Society, 41, 333-337.
Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions-the RE-AIM framework. American Journal of Public Health, 89, 1322-1327.
Grant, R.W. (1995). Interventions with ethnic minority elderly. In J. F. Aponte, R. F. Rivers, & J. Wohl (Eds.), Psychological interventions and cultural diversity (pp. 199-214). Boston: Allyn and Bacon.
Hornbrook, M. C., Stevens, V. J., & Wingfield, D. J. (1993). Seniors' program for injury control and education (SPICE). Journal of the American Geriatric Society, 41, 309-314.
Hunninghake, D. B., Darby, C. A., & Probstfield, J. L. (1987). Recruitment experience in clinical trials: Literature summary and annotated bibliography. Controlled Clinical Trials, 8, 6s-30s.
International Longevity Center. (2000). Maintaining healthy lifestyles: A lifetime of choices. A workshop co-sponsored by Canyon Ranch Health Resort. New York: International Longevity Center.
Ives, D. G., Kuller, L. H., Schulz, R., Traven, N. D., & Lave, J. R. (1992). Comparison of recruitment strategies and associated disease prevalence for health promotion in rural elderly. Preventive Medicine, 21, 582-591.
Kelty, M. F., Hoffman, R. R., Harden, J. Y., & Ory, M. G. (1999). Behavioral and sociocultural aspects of aging, health, and ethnicity. In R. Eisler & M. Hersen (Eds.), Handbook of gender, culture, and health. Hillsdale, NJ: Erlbaum.
King, A. C., Taylor, C. B., & Haskell, W. L. (1993). Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychology, 12, 292-300.
Levkoff, S. E., Prohaska, T. R., Weitzman, P. F., & Ory, M. G. (2000). Recruitment and retention in minority populations. New York: Springer.
McNeilly, M., Musick, M., Efland, J. R., Baughman, J. T., Toth, P. S., Saulter, T. D., Sumner, L., Sherwood, A., Weitzman, P. F., Levkoff, S. E., Williams, R. B., & Anderson, N. B. (2000). Minority populations and pathophysiological research: Challenges in trust building and recruitment. In S. E. Levkoff, T. R. Prohaska, P. F. Weitzman, & M. G. Ory (Eds.), Recruitment and retention in minority populations (pp. 91-102). New York: Springer.
Mulrow, C. D., Gerety, M. B., Kanten, D., DeNino, L. A., & Cornell, J. E. (1993). Effects of physical therapy on functional status of nursing home residents. Journal of the American Geriatric Society, 41, 326-328.
Ory, M. G., Schechtman, K., Miller, J. P., Hadley, E., Fiatarone, M., Province, M., Arfken, C., Morgan, D., & Weiss, S. (1993). Frailty and injuries in later life: The FICSIT trials. Journal of the American Geriatric Society, 41, 238-296.
Petrovitch, H., Byington, R., Bailey, G., Borhani, P., Carmody, S., Goodwin, L., Harrington, J., Johnson, H. A., Johnson, P., Jones, M., et al. (1991). Part 2: Screening and recruitment. Hypertension Supplement II, 17, II16-II23.
Prohaska, T. (1998). The research basis for the design and implementation of self-care programs. In M. G. Ory & G. H. DeFriese (Eds.), Self care in later life (pp. 62-84). New York: Springer.
Province, M. A., Hadley, E. C., Hornbrook, M. C., Lipsitz, L. A., Miller, J. P., Mulrow, C. D., Ory, M. G., Sattin, R. W., Tinetti, M. E., & Wolf, S. L., for the FICSIT group. (1995). The effects of exercise on falls in elderly patients: A preplanned meta-analysis of the FICSIT trials. JAMA, 273, 1341-1347.
Robert Wood Johnson Foundation. (2001). National blueprint: Increasing physical activity among adults age 50 and older. Princeton, NJ.
Silagy, C. A., Campion, K., McNeil, J. J., Worsam, B., & Donnan, G. A. (1991). Comparison of recruitment strategies for a largescale clinical trial in the elderly. Journal of Clinical Epidemiology, 44, 1105-1114.
Tarlow, B., & Mahoney, D. (2000). The cost of recruiting Alzheimer's Disease caregivers for research. Journal of Aging and Health, 12, 490-510.
Tell, G. S., Fried, L. P., Hermanson, B., Manolio, T. A., Newman, A. B., Borhani, N. O., & the Cardiovascular Health Study (CHS) Collaborative Research Group (1993). Recruitment of adults 65 years and older as participants in the Cardiovascular Health Study. Annals of Epidemiology, 3, 358-366.
Thompson, M. G., Heller, K., & Rody, C. A. (1994). Recruitment challenges in studying late-life depression: Do community samples adequately represent depressed older adults? Psychology and Aging, 9, 121-125.
Tinetti, M. E., Baker, D. I., Garret, P. A., Gottschalk, M., Koch, M. L., & Horwitz, R. I. (1993). Yale FICSIT: Risk factor abatement strategy for fall prevention. Journal of the American Geriatric Society, 41, 315-320.
Wallace, R. B., Ross, J. E., Huston, J. C., Kundel, C., & Woodworth, G. (1993). Iowa FICSIT trial: The feasibility of elderly wearing a hip joint protective garment to reduce hip fracture. Journal of the American Geriatric Society, 41, 338-340.
Whelton, P. K., Bahnson, J., Appel, L. J., Charleston, J., Cosgrove, N., Espeland, M. A., Folmar, S., Hoagland, D., Krieger, S., Lacy, C., Lichtermann, L., Oates-Williams, F., Tayback, M., & Wilson, A. C. (1997). Recruitment in the trial of nonpharmacologic intervention in the elderly (TONE). Journal of the American Geriatric Society, 45, 185-193.
Wolfe, S. L., Kutner, N. G., Green, R. C., & McNeely, E. (1993). The Atlanta FICSIT study: Two exercise interventions to reduce frailty in elders. Journal of the American Geriatric Society, 41, 329-332.
Wolfson, L., Whipple, R., Judge, J., Amerman, P., Derby, C., & King, M. (1993). Training balance and strength in the elderly to improve function. Journal of the American Geriatric Society, 41, 341-343.
Young, R. F., Solakumni, E., Young, J. H., & Peters, J. (1996). Issues of recruitment and retention in Alzheimer's research among African andWhite Americans. Journal of Aging and Ethnicity, 1, 19-25.
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Ory, M.G., Lipman, P.D., Karlen, P.L. et al. Recruitment of Older Participants in Frailty/Injury Prevention Studies. Prev Sci 3, 1–22 (2002). https://doi.org/10.1023/A:1014610325059
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DOI: https://doi.org/10.1023/A:1014610325059