Successfully Recruiting Adults with a Low Socioeconomic Position into Community-Based Lifestyle Programs: A Qualitative Study on Expert Opinions
Abstract
:1. Introduction
2. Methods
2.1. Setting and Recruitment of Experts
2.2. Interviews
2.3. Data Analysis
2.4. Research Team
3. Results
3.1. Challenges
3.1.1. Contextual Challenges
“Simply, as a researcher you also have to account for these things [laborious scientific study procedures, e.g., informed consent]. (…) But it also relates to the fact that lengthy questionnaires are often needed in studies—you don’t make friends with that either.”(R1)
“In hindsight, [thinking we could recruit within] half a year was too optimistic. A number of issues played a role there. First, our team lacked experience with recruiting this target group at the time of writing the recruitment plan. Second, it [the program] was part of a PhD program which had to fit within the allocated four years.”(R1)
3.1.2. Psychosocial Barriers Towards Health-Related Programs or Program Leaders
“Sometimes questions were just too difficult or at a level of detail that people cannot connect with at all. They really do not understand that it is all necessary.”(R4)
“Placing recruitment responsibility with other people can be dangerous because you lose control over the information. They can say the craziest things.”(R3)
3.1.3. Practical Barriers Towards Participation
“For the lowest socioeconomic groups, sending e-mails does not work. Nine out of ten times they have no e-mail address or they do not read their e-mail.”(R9)
3.1.4. Reasons to Decline Participation
“My experience is that the harder you work to include individuals in your trial, the more people you lose eventually. So, then you actually invest a lot of time for nothing. That is a bit of a trade-of.”(R3)
“They view themselves as cash cow.”(R4)
3.2. Success Factors
3.2.1. Program Context and Actors
“I think it is important that you also know the history of the neighborhood and what is going on at that moment for those living in the neighborhood.”(R6)
“That [news item on a large national news website] was of course highly successful. That did really well. Though you cannot enforce something like that.”(R2)
3.2.2. Methods to Reach the Target Group
“If you really want to reach the most vulnerable groups, you cannot just enter the arena like that. An intermediary person is crucial.”(R4)
3.2.3. Ways to Increase Engagement
“I think personal and informal contact is the most important factor for successful recruitment. Once they have met you, as a researcher, barriers towards participation are much lower.”(R7)
“Ask yourself: What could be your target groups’ ‘wow-factor’ with regard to participation?”(R2)
“The point is that you have to connect. You have to listen to your target group and you have to synchronize with them. It doesn’t matter what someone’s background is like, as long as you communicate with and involve the target group.”(R6)
3.2.4. Making Participation Easier
“We decided that interested participants could start immediately [with the program], because once you have them interested—you don’t want to make them wait.”(R1)
“Most groups have a fixed moment in the week when they have a coffee together. You could request to extend that moment [to use for you program].”(R5)
3.2.5. Incentives for Participation
“The group activity was something we considered as an advantage of our intervention. The social aspect thereof. We noticed participants were going to pick each other up for the meeting to go together.”(R1)
4. Discussion
4.1. Multi-Layered Recruitment Approach
4.2. Underlying Barriers Hindering Successful Recruitment
4.3. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Introduction | |
---|---|
1 | Scope and structure of the interview |
First part: Specific Program | |
2 | General program recruitment information (e.g., target sample size versus included sample size, planned versus actual duration of recruitment period) |
3 | Applied recruitment strategies (e.g., amount and type of recruitment strategies, adjustment recruitment strategies during recruitment period, response to (individual) recruitment strategies, (un)expected (un)successful strategies, most (un)effective strategies, feedback by (potential) participants) |
4 | (Un)expected challenges (e.g., (un)expected challenges during recruitment, strategies to handle the (un)expected challenges and retrospective approach) |
Second Part: Program Leaders General View | |
5 | General opinion on challenges and success factors, including recommendations for future researchers |
Final Part: | |
6 | Additional points and closing interview |
Work Setting: | Focus of the Program: | ||
---|---|---|---|
Interventional Program | Observational Program | Implemented Program | |
University or Academic Hospital | Improving dietary behaviors and physical activity levels (n = 3) | Dietary behaviors (n = 1) | |
Improving physical activity levels only (n = 3) | Health literacy (n = 1) | ||
Expertise Center on Health Disparities | Smoking behaviors (n = 1) | ||
Community Health Services | Health monitoring (n = 1) | Improving dietary behaviors (n = 1) |
Theme | Sub-Theme | Number of Times Mentioned (by Number of Respondents) | |
---|---|---|---|
Challenges | 1. Contextual challenges | 49 (10) | |
Limited program resources and time | 12 (7) | ||
Barriers program leaders’ perception | 8 (6) | ||
Program design | 21 (5) | ||
Limited capacity program leader | 4 (4) | ||
Overburdened target group | 6 (3) | ||
2. Psychosocial barriers towards health-related programs or program leaders | 36 (10) | ||
Lack of awareness or understanding health related program | 16 (8) | ||
Mistrust or skepticism | 11 (7) | ||
Incomplete/indiscreet program information dissemination | 14 (6) | ||
3. Practical barriers towards participation | 43 (11) | ||
Other priorities | 13 (7) | ||
Practical challenges | 12 (7) | ||
Language barrier | 12 (6) | ||
Lack of transport or limited financial resources | 7 (5) | ||
Low literacy or unable to understand methods/questions | 7 (5) | ||
Health related issues | 3 (3) | ||
Resistance by others | 1 (1) | ||
4. Reasons to decline participation | 16 (6) | ||
Lack of motivation and interest | 7 (4) | ||
Shame or anxiety | 6 (4) | ||
Seeing no (personal) benefit or value | 4 (2) | ||
Success Factors | 1. Program context and actors | 64 (10) | |
Program design | 23 (8) | ||
Program leaders’ perception and attitude | 19 (6) | ||
Strategic location or setting | 10 (5) | ||
Multiple strategies | 9 (3) | ||
Context sensitivity | 6 (3) | ||
Fortunate circumstances | 3 (2) | ||
2. Methods to reach the target group | 96 (11) | ||
Use existing networks | 52 (11) | ||
Visit location target group (not via or with key-member) | 21 (10) | ||
Involvement community key-members | 32 (9) | ||
(Social) media channels | 16 (4) | ||
Word of mouth | 3 (3) | ||
Mail-out | 2 (2) | ||
3. Ways to increase engagement | 107 (11) | ||
Make yourself known and personal approach | 32 (11) | ||
Identify potential personal benefit | 30 (8) | ||
Ask and involve target group in program process | 26 (8) | ||
Relationship building | 21 (8) | ||
Communicate program outcomes and value | 19 (8) | ||
Involvement target group in recruiting others | 7 (5) | ||
Limiting sensitive topics | 4 (3) | ||
4. Making participation easier | 54 (11) | ||
Reduce effort and costs | 18 (8) | ||
Tailor communication and material to target group and gender | 12 (7) | ||
Make material understandable | 14 (6) | ||
Short time-span recruitment and data collection | 7 (4) | ||
Use existing groups of target population | 8 (3) | ||
5. Incentives for participation | 19 (9) | ||
Social incentive | 9 (5) | ||
Personal incentive | 6 (5) | ||
Financial incentive | 9 (4) |
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Share and Cite
Stuber, J.M.; Middel, C.N.H.; Mackenbach, J.D.; Beulens, J.W.J.; Lakerveld, J. Successfully Recruiting Adults with a Low Socioeconomic Position into Community-Based Lifestyle Programs: A Qualitative Study on Expert Opinions. Int. J. Environ. Res. Public Health 2020, 17, 2764. https://doi.org/10.3390/ijerph17082764
Stuber JM, Middel CNH, Mackenbach JD, Beulens JWJ, Lakerveld J. Successfully Recruiting Adults with a Low Socioeconomic Position into Community-Based Lifestyle Programs: A Qualitative Study on Expert Opinions. International Journal of Environmental Research and Public Health. 2020; 17(8):2764. https://doi.org/10.3390/ijerph17082764
Chicago/Turabian StyleStuber, Josine M., Cédric N. H. Middel, Joreintje D. Mackenbach, Joline W. J. Beulens, and Jeroen Lakerveld. 2020. "Successfully Recruiting Adults with a Low Socioeconomic Position into Community-Based Lifestyle Programs: A Qualitative Study on Expert Opinions" International Journal of Environmental Research and Public Health 17, no. 8: 2764. https://doi.org/10.3390/ijerph17082764