Saturday, July 13, 2024

Strategies for Successful Recruitment in Pragmatic Trials: Insights from the SMARTER CRC Study

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Recruitment of organizations, such as health plans and clinical practices, plays a critical role in the execution of implementation science. Despite its importance, there has been limited research on effective strategies for engaging these entities in pragmatic studies. This article delves into the recruitment efforts for the SMARTER CRC trial, which aimed to enhance colorectal cancer (CRC) screening rates in rural populations by engaging rural primary care practices within Medicaid health plans. The study tracked various recruitment activities and analyzed factors influencing organizational participation, providing valuable insights into the complexities and strategies for successful recruitment.

The SMARTER CRC trial focused on recruiting 30 rural primary care practices across Medicaid health plans to improve CRC screening rates. The recruitment process, spanning from January 2020 to April 2021, involved extensive outreach efforts. Five out of nine approached health plans agreed to participate, leading to the involvement of three health plan sites due to network structures. Out of 101 identified practices, 76 met the eligibility criteria, with 39 practices enrolling. However, adjustments during the trial reduced the number to 29 randomized sites.

Recruitment Activities and Challenges

Recruitment required multiple touchpoints with clinical practices, ranging from 2 to 17 encounters per practice. The process included diverse outreach methods, such as phone calls, emails, and meetings. The iterative nature of recruitment highlighted the need for persistent and flexible strategies to engage potential participants.

Key Facilitators of Participation

Several factors facilitated successful recruitment in the SMARTER CRC trial. These included leveraging existing relationships with health plans and practices, employing effective messaging tailored to the audience, and maintaining flexibility in engagement approaches. Timing also played a crucial role, as outreach efforts needed to align with the schedules and priorities of the target organizations.

Concrete Strategies for Effective Recruitment

  • Utilize a multi-modal outreach approach to engage potential participants through various channels.
  • Build and leverage existing relationships with key stakeholders to foster trust and collaboration.
  • Tailor messaging to address the specific needs and concerns of the target organizations.
  • Ensure flexibility in recruitment strategies to adapt to different organizational structures and circumstances.
  • Allocate sufficient time and resources to maintain ongoing engagement with potential participants.

The SMARTER CRC trial underscores the complexities and iterative nature of recruiting health plans and rural clinical practices for pragmatic implementation research. By leveraging relationships, dedicating time and resources, and employing flexible engagement strategies, researchers can enhance the diversity and generalizability of trial findings. These insights are invaluable for future efforts aiming to recruit diverse clinical practices in implementation science.

Original Article: J Prim Care Community Health. 2024 Jan-Dec;15:21501319241259915. doi: 10.1177/21501319241259915.

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