Lucas Alexander R, Focht Brian C, Cohn David E, Klatt Maryanna D, Buckworth Janet
Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Kinesiology, Department of Human Sciences, The Ohio State University, Columbus, OH, 43201, USA.
J Cancer Educ. 2018 Aug;33(4):857-864. doi: 10.1007/s13187-017-1187-6.
There are a growing number of cancer survivors in the USA. Despite lifestyle behaviors being strongly associated with morbidity and mortality following primary treatment, recruitment to clinical research studies that aim to improve such behaviors remains a significant challenge. Furthermore, pilot and feasibility studies are critical for the refinement of research methods and form an important training opportunity for early career scientists. This report details the challenges faced and lessons learned in the process of recruiting a population of overweight/obese endometrial cancer survivors (ECS) to two separate studies focused on lifestyle behaviors: a survey study and a randomized behavioral intervention study that aimed to improve diet, physical activity, and quality of life. We used in-clinic and mail-based approaches to reach eligible patients identified from clinic records. Surveys were offered via paper or online. To evaluate the recruitment process, we compared clinic records and enrollment data over time and location. Chi-squared tests were also used to compare recruitment strategies. We address specific challenges at the patient level, the clinic/provider level, and the organizational level. Overall response rate was 13.9% to the survey and 4% to the intervention. Responses to in-clinic offers were greater than to mail-based approaches for the survey with no difference for the intervention. Identifying the unique characteristics of each survivorship population, adequate planning, resource allocation, and involvement of key staff are essential to supporting recruitment efforts to research studies. Having the support of physicians and nurses is especially critical to the success of recruitment.
美国癌症幸存者的数量日益增加。尽管生活方式行为与初次治疗后的发病率和死亡率密切相关，但招募旨在改善此类行为的临床研究仍面临重大挑战。此外，试点研究和可行性研究对于完善研究方法至关重要，也是早期职业科学家的重要培训机会。本报告详细介绍了在招募超重/肥胖子宫内膜癌幸存者（ECS）参与两项分别聚焦于生活方式行为的研究过程中所面临的挑战和吸取的经验教训：一项调查研究和一项旨在改善饮食、身体活动及生活质量的随机行为干预研究。我们采用了诊所内和邮寄两种方式来联系从诊所记录中确定的符合条件的患者。调查问卷通过纸质或在线方式提供。为评估招募过程，我们比较了不同时间和地点的诊所记录与入组数据。还使用卡方检验来比较招募策略。我们在患者层面、诊所/提供者层面和组织层面解决了具体挑战。调查的总体回复率为13.9%，干预的回复率为4%。对于调查，诊所内提供方式的回复率高于邮寄方式，而对于干预则没有差异。识别每个幸存者群体的独特特征、进行充分规划、合理分配资源以及关键工作人员的参与对于支持研究招募工作至关重要。获得医生和护士的支持对招募成功尤为关键。
