Curtan Shelley, Copeland Tashyana, McNamee Erin, Debelnogich Jelena, Kula Taylor, Selvaraj David, Albert Jeffrey, Hertz Andrew, Nelson Suchitra
Case Western Reserve University, Community Dentistry, 10900 Euclid Ave, Cleveland, OH, 44106-4905, USA.
Case Western Reserve University, School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106-7341, USA.
Contemp Clin Trials Commun. 2021 Feb 16;21:100748. doi: 10.1016/j.conctc.2021.100748. eCollection 2021 Mar.
To describe multilevel recruitment strategies for an ongoing clinical trial in pediatric primary care settings, and assess adoption and reach of these strategies via the RE-AIM framework.
This study is part of a larger pragmatic cluster randomized clinical trial focused on the effectiveness of interventions on the practice, provider, and caregiver levels on dental utilization for Medicaid-enrolled 3-6 year old children. Pediatric practices were recruited according to the proportion of Medicaid-eligible children, geographic region, and County. In accordance with the RE-AIM framework, providers reached were those approached directly and consented, and those who participated in the intervention training adopted to deliver the intervention. Caregivers reached were those approached and consented at their child's well-child visit to participate in the trial.
Recruitment goals were met over a 21 month period, with an overall enrollment of 18 practices, 62 providers, and 1024 caregivers-child dyads. The majority of practices enrolled were small, suburban, and located in an urban county. The participation rates among approached providers and caregivers was 93% and 84% respectively. Enablers for recruitment was the one-on-one interaction with the provider and caregivers. Barriers to recruitment for caregivers included no-shows and cancellations at well-child visits. Adoption of intervention among providers was high, and caregiver reached were representative of the eligible target population.
Active approaches to recruitment, such as utilizing opinion leaders, in-person recruitment, and building relationships with practice staff, can result in successful enrollment and imp lementation of a multi-level intervention in pediatric primary care settings.
描述一项正在进行的儿科初级保健机构临床试验的多级招募策略，并通过RE-AIM框架评估这些策略的采用情况和覆盖范围。
本研究是一项更大规模的实用整群随机临床试验的一部分，该试验聚焦于针对参加医疗补助计划的3至6岁儿童，在诊所、医护人员和照料者层面进行干预对牙科服务利用情况的有效性。根据符合医疗补助条件儿童的比例、地理区域和郡县来招募儿科诊所。按照RE-AIM框架，所覆盖的医护人员是那些直接接触并同意参与的人员，以及那些参与了为实施干预而进行的培训的人员。所覆盖的照料者是那些在孩子的健康检查就诊时被接触并同意参与试验的人员。
在21个月的时间里实现了招募目标，总共招募了18家诊所、62名医护人员和1024对照料者-儿童二元组。所招募的大多数诊所规模较小，位于郊区且在一个城市郡县。被接触的医护人员和照料者的参与率分别为93%和84%。招募的促成因素是与医护人员和照料者的一对一互动。照料者招募的障碍包括健康检查就诊时的爽约和取消预约。医护人员对干预的采用率很高，所覆盖的照料者代表了符合条件的目标人群。
积极的招募方法，如利用意见领袖、亲自招募以及与诊所工作人员建立关系，可以成功招募并在儿科初级保健机构实施多级干预。
