The Tribulations of Trials: Lessons Learnt Recruiting 777 Older Adults Into REtirement in ACTion (REACT), a Trial of a Community, Group-Based Active Aging Intervention Targeting Mobility Disability
BACKGROUND: Challenges of recruitment to randomized controlled trials (RCTs) and successful strategies to overcome them should be clearly reported to improve recruitment into future trials. REtirement in ACTion (REACT) is a United Kingdom-based multicenter RCT recruiting older adults at high risk of mobility disability to a 12-month group-based exercise and behavior maintenance program or to a minimal Healthy Aging control intervention. METHODS: The recruitment target was 768 adults, aged 65 years and older scoring 4-9 on the Short Physical Performance Battery (SPPB). Recruitment methods include the following: (a) invitations mailed by general practitioners (GPs); (b) invitations distributed via third-sector organizations; and (c) public relations (PR) campaign. Yields, efficiency, and costs were calculated. RESULTS: The study recruited 777 (33.9% men) community-dwelling, older adults (mean age 77.55 years (SD 6.79), mean SPPB score 7.37 (SD 1.56)), 95.11% white (n = 739) and broadly representative of UK quintiles of deprivation. Over a 20-month recruitment period, 25,559 invitations were issued. Eighty-eight percent of the participants were recruited via GP invitations, 5.4% via the PR campaign, 3% via word-of-mouth, and 2.5% via third-sector organizations. Mean recruitment cost per participant was £78.47, with an extra £26.54 per recruit paid to GPs to cover research costs. CONCLUSIONS: REACT successfully recruited to target. Response rates were lower than initially predicted and recruitment timescales required adjustment. Written invitations from GPs were the most efficient method for recruiting older adults at risk of mobility disability. Targeted efforts could achieve more ethnically diverse cohorts. All trials should be required to provide recruitment data to enable evidence-based planning of future trials.
Citation
@article{j.2020,
author = {Withall, J. and Greaves, C. J. and Thompson, J. L. and de
Koning, J. L. and Bollen, J. C. and Moorlock, S. J. and Fox, K. R.
and Western, M. J. and Snowsill, T. and Medina-Lara, A. and Cross,
R. and Ladlow, P. and Taylor, G. and Zisi, V. and Clynes, J. and
Gray, S. and Agyapong-Badu, S. and Guralnik, J. M. and Rejeski, W.
J. and Stathi, A.},
title = {The {Tribulations} of {Trials:} {Lessons} {Learnt}
{Recruiting} 777 {Older} {Adults} {Into} {REtirement} in {ACTion}
{(REACT),} a {Trial} of a {Community,} {Group-Based} {Active}
{Aging} {Intervention} {Targeting} {Mobility} {Disability}},
journal = {J Gerontol A Biol Sci Med Sci},
volume = {75},
number = {12},
pages = {2387-2395},
date = {2020-11-01},
url = {https://tristansnowsill.co.uk/the-tribulations-of-trials-lessons-learnt-recruiting.html},
doi = {10.1093/gerona/glaa051},
langid = {en},
abstract = {BACKGROUND: Challenges of recruitment to randomized
controlled trials (RCTs) and successful strategies to overcome them
should be clearly reported to improve recruitment into future
trials. REtirement in ACTion (REACT) is a United Kingdom-based
multicenter RCT recruiting older adults at high risk of mobility
disability to a 12-month group-based exercise and behavior
maintenance program or to a minimal Healthy Aging control
intervention. METHODS: The recruitment target was 768 adults, aged
65 years and older scoring 4-9 on the Short Physical Performance
Battery (SPPB). Recruitment methods include the following: (a)
invitations mailed by general practitioners (GPs); (b) invitations
distributed via third-sector organizations; and (c) public relations
(PR) campaign. Yields, efficiency, and costs were calculated.
RESULTS: The study recruited 777 (33.9\% men) community-dwelling,
older adults (mean age 77.55 years (SD 6.79), mean SPPB score 7.37
(SD 1.56)), 95.11\% white (n = 739) and broadly representative of UK
quintiles of deprivation. Over a 20-month recruitment period, 25,559
invitations were issued. Eighty-eight percent of the participants
were recruited via GP invitations, 5.4\% via the PR campaign, 3\%
via word-of-mouth, and 2.5\% via third-sector organizations. Mean
recruitment cost per participant was £78.47, with an extra £26.54
per recruit paid to GPs to cover research costs. CONCLUSIONS: REACT
successfully recruited to target. Response rates were lower than
initially predicted and recruitment timescales required adjustment.
Written invitations from GPs were the most efficient method for
recruiting older adults at risk of mobility disability. Targeted
efforts could achieve more ethnically diverse cohorts. All trials
should be required to provide recruitment data to enable
evidence-based planning of future trials.}
}