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      Lessons learnt in recruiting disadvantaged families to a birth cohort study

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          Abstract

          Background

          Dental decay in early childhood can be prevented by a model based on shared care utilising members of primary care team such as Child and Family Health Nurses (CFHNs) in health promotion and early intervention. The aims of this study were to identify the facilitators and barriers faced by CFHNs in recruiting research participants from disadvantaged backgrounds to a birth cohort study in South Western Sydney, Australia.

          Methods

          Child and Family Health Nurses recruited mothers-infants dyads ( n = 1036) at the first post-natal home visit as part of Healthy Smiles Healthy Kids Study, an ongoing birth cohort study in South Western Sydney. The nurses ( n = 19) were purposively selected and approached for a phone based in-depth semi-structured interview to identify the challenges faced by them during the recruitment process. Interviews were audio-recorded, subsequently transcribed verbatim and analysed by thematic analysis.

          Results

          The nurses found the early phase of parenting was an overwhelming stage for parents as they are pre-occupied with more immediate issues such as settling and feeding a newborn. They highlighted some key time-points such as during pregnancy and/or around the time of infant teething may be more appropriate for recruiting families to dental research projects. However, they found it easier to secure the family’s attention by offering incentives, gifts and invitations for free oral health services. The use of web-based approaches and maintaining regular contact with the participants was deemed crucial for long-term research. Cultural and linguistic barriers were seen as an obstacle in recruiting ethnic minority populations and the need for cultural insiders in the research team was deemed important to resolve the challenges associated with conducting research with diverse cultures. Finally, nurses identified the importance of inter-professional collaboration to provide easier access to recruiting research participants.

          Conclusions

          This study highlighted the need for multiple time-points and incentives to facilitate recruitment and retention of disadvantaged communities in longitudinal research. The need for cultural insiders and inter-professional collaboration in research team are important to improve research participation.

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          Most cited references45

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          Systematic review identifies number of strategies important for retaining study participants.

          Loss to follow-up threatens internal and external validity yet little research has examined ways to limit participant attrition. We conducted a systematic review of studies with a primary focus on strategies to retain participants in health care research. We completed searches of PubMed, CINAHL, CENTRAL, Cochrane Methodology Register, and EMBASE (August 2005). We also examined reference lists of eligible articles and relevant reviews. A data-driven thematic analysis of the retention strategies identified common themes. We retrieved 3,068 citations, 21 studies were eligible for inclusion. We abstracted 368 strategies and from these identified 12 themes. The studies reported a median of 17 strategies across a median of six themes. The most commonly reported strategies were systematic methods of participant contact and scheduling. Studies with retention rates lower than the mean rate (86%) reported fewer strategies. There was no difference in the number of different themes used. Available evidence suggests that investigators should consider using a number of retention strategies across several themes to maximize the retention of participants. Further research, including explicit evaluation of the effectiveness of different strategies, is needed.
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            Performing Qualitative Cross-Cultural Research

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              Factors influencing recruitment to research: qualitative study of the experiences and perceptions of research teams

              Background Recruiting the required number of participants is vital to the success of clinical research and yet many studies fail to achieve their expected recruitment rate. Increasing research participation is a key agenda within the NHS and elsewhere, but the optimal methods of improving recruitment to clinical research remain elusive. The aim of this study was to identify the factors that researchers perceive as influential in the recruitment of participants to clinically focused research. Methods Semi-structured interviews were conducted with 11 individuals from three clinical research teams based in London. Sampling was a combination of convenience and purposive. The interviews were audio recorded, transcribed verbatim and analysed using the framework method to identify key themes. Results Four themes were identified as influential to recruitment: infrastructure, nature of the research, recruiter characteristics and participant characteristics. The main reason individuals participate in clinical research was believed to be altruism, while logistical issues were considered important for those who declined. Suggestions to improve recruitment included reducing participant burden, providing support for individuals who do not speak English, and forming collaborations with primary care to improve the identification of, and access to, potentially eligible participants. Conclusions Recruiting the target number of research participants was perceived as difficult, especially for clinical trials. New and diverse strategies to ensure that all potentially eligible patients are invited to participate may be beneficial and require further exploration in different settings. Establishing integrated clinical and academic teams with shared responsibilities for recruitment may also facilitate this process. Language barriers and long journey times were considered negative influences to recruitment; although more prominent, these issues are not unique to London and are likely to be important influences in other locations.
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                Author and article information

                Contributors
                + 61 2 4620 3475 , a.arora@westernsydney.edu.au
                narendar.manohar@hotmail.com
                dinabedros@gmail.com
                david.hua3@gmail.com
                syou1082@uni.sydney.edu.au
                Victoria.Blight@health.nsw.gov.au
                Shilpi.Ajwani@health.nsw.gov.au
                John.Eastwood@health.nsw.gov.au
                Sameer.Bhole@health.nsw.gov.au
                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central (London )
                1472-6955
                26 February 2018
                26 February 2018
                2018
                : 17
                : 7
                Affiliations
                [1 ]ISNI 0000 0000 9939 5719, GRID grid.1029.a, School of Science and Health, , Western Sydney University, ; 24.2.97 Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
                [2 ]Sydney Dental Hospital and Oral Health Services, Sydney Local Health District, Surry Hills, NSW Australia
                [3 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, Discipline of Paediatrics and Child Health, Sydney Medical School, ; Westmead, NSW Australia
                [4 ]GRID grid.429098.e, Collaboration for Oral Health Outcomes Research, Translation, and Evaluation (COHORTE) Research Group, Ingham Institute for Applied Medical Research, ; Liverpool, NSW Australia
                [5 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, Faculty of Dentistry, , The University of Sydney, ; Surry Hills, NSW Australia
                [6 ]ISNI 0000 0001 2105 7653, GRID grid.410692.8, Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, ; Narellan, NSW Australia
                [7 ]Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
                [8 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, Sydney Medical School, The University of Sydney, ; Sydney, NSW Australia
                [9 ]ISNI 0000 0004 4902 0432, GRID grid.1005.4, School of Women’s and Children’s Health, UNSW Australia, ; Kensington, NSW Australia
                [10 ]ISNI 0000 0004 0437 5432, GRID grid.1022.1, School of Medicine, Griffith University, ; Gold Coast, QLD Australia
                Article
                276
                10.1186/s12912-018-0276-0
                5828325
                4124b7db-c1ea-4ef8-bd15-130880b91e11
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 June 2017
                : 6 February 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Award ID: 1033213
                Award ID: 1069861
                Award ID: 1134075
                Award Recipient :
                Funded by: Sydney Local Health District
                Funded by: Western Sydney University
                Funded by: FundRef http://dx.doi.org/10.13039/501100004799, Australian Dental Research Foundation;
                Funded by: Oral Health Foundation
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Nursing
                oral health,longitudinal research,cohort study,nurses,children,early childhood caries
                Nursing
                oral health, longitudinal research, cohort study, nurses, children, early childhood caries

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