Optimizing Phone Recruitment in a National Cluster-randomized Controlled Trial of Centeringparenting

Background: Recruitment and retention is essential for the success of longitudinal research studies. Given the challenges posed to in-person communication during the pandemic, understanding factors that enhance participant recruitment and engagement via phone, text, or electronic survey is critical. In order to facilitate improved participant recruitment and retention in a national cluster-RCT of CenteringParenting, a pediatric group well-child care intervention, a personalized telephone outreach system was implemented to recruit and retain 600 participants across 10 clinical sites in the two-year CK Ready Study (CKR).

Methods: CKR sites and participants are recruited on a rolling basis, allowing time to pilot recruitment strategies. Telephone contact and response data is tracked in a Microsoft Access database with built-in reporting. The initial site employed a limited, opt-out recruitment protocol and generic recruitment procedures, providing parents the opportunity to decline prior to contact. We analyzed initial contact data to identify optimal times of contact and varied call times to account for participant obligations and time zone differences. The implementation of a personalized telephone outreach system with subsequent sites included an opt-in model where parents are first informed of the study by clinic staff and agree to be contacted by CKR. Personalized messaging includes daily tailored text messages and scripted calls. Participants have the option to schedule to complete surveys, elect their preferred contact method, and have the survey texted or emailed in lieu of verbal completion. To improve retention between survey time points (i.e., 12 months and 24 months), participants are asked to update their contact information to be entered into a $100 raffle.

Results: Between 2019 and 2021, 603 parents have been contacted for participation and 327 have been enrolled into CKR. Prior to the personalized outreach system, the initial site took an average of 19±29 days to enroll participants via generic outreach. After implementation of a personalized outreach system, days to recruitment decreased to 5±7 days, a 73% improvement. The first CKR participants had an 83% completion rate for the one year survey (n=50/60), but personalized sites had 90% (n=54/60), 91% (n=55/60), and 88% (n=53/60) survey completion rates. Further, 43% of participants updated their contact information via the voluntary raffle. To date, 10,124 telephone calls have been completed. 1,834 of those were pre-scheduled via text message with 92% of scheduled calls resulting in spoken contact.

Conclusion: A personalized outreach system improved our ability to recruit and retain parent participants across multiple pediatric sites in this national cluster-RCT of CenteringParenting. A tailored, multi-component recruitment strategy maximizes efficiency while contributing to timely recruitment and retention with low attrition.