Where’d the dyads go? Enrolling Veteran-centric dyads into virtual Complementary and Integrative Health research studies

Research

Objective: The increase in complementary and integrative health (CIH) treatments and changes to healthcare delivery due to COVID-19 have expanded the need for remotely accessible, non-pharmacological treatments for chronic illnesses.1,2,3 This presentation describes attrition while recruiting dyads of Veterans with chronic pain and PTSD and their partners, to a study of a remotely delivered, CIH program. It also provides baseline characteristics of successfully enrolled participants and offers recommendations for effective enrollment.

Design: This RCT randomized 364 dyads to either an intervention or a wait-list control arm.4Setting: Three Department of Veterans Affairs Medical Centers recruited participants between October 2019 and December 2021.Participants: Veterans with chronic pain and PTSD, and their self-elected partners (e.g., spouse).Interventions: Mission Reconnect is a partnered, self-directed intervention that teaches CIH skills (e.g., meditation, partnered massage) remotely using mobile and web-based platforms.5Main Outcome Measure(s): Reported outcomes include: recruitment methods; number of participants screened and onboarded; and participation barriers. Baseline characteristics of successfully enrolled participants will also be presented.

Results: Of the 364 recruited dyads, 97 (26.6%) failed to complete onboarding activities, including submission of baseline data. Reported reasons for failure to complete onboarding include loss of self-elected partner buy-in (8.2%), difficulties with using remote data collection methods and interventions (30.9%), and adverse health experiences unrelated to study activities (17.5%). Despite the high attrition rate, Veterans were successfully enrolled from 35 states and 1 US territory with nearly a fifth of successfully enrolled participants drawn from rural zip codes (18.0%). Successful enrollees represent a pool of Veterans with diverse socioeconomic characteristics and moderate-to-severe pain severity. Lessons learned from project challenges relate to recruitment, onboarding, intervention delivery, and data collection processes.

Conclusion: Successful enrollment of Veterans with chronic pain and PTSD, and their partners, to studies of remotely delivered CIH treatments requires careful examination of recruitment and onboarding methodologies and simplification of processes. Accommodating the targeted study participants’ symptom burden is essential for identifying and addressing possible sources of attrition.Author Disclosures: None disclosed.