Multisite Recruitment and Data Collection among Older Adults: Exploring Methods to Conserve Human and Financial Resources
McCarthy, Valerie Lander, Cassidy, Karen, Journal of Nursing Measurement
The purpose of this article is to describe strategies that were effective in recruitment and data collection among older adults in 3 quantitative studies while decreasing costs in terms of time and money. Factors effective in reducing use of investigators' time and expenses included limiting exclusion of data because of abnormal Mini-Cog scores by careful initial screening and avoiding repeated reminders or follow-up, collecting data in small groups, collapsing consent, dementia screening, and data collection into single sessions, as well as accommodating for sensory and literacy deficits.
The cross-sectional, descriptive studies were conducted among community-dwelling older adults attending senior citizen centers and among older adults in independent or assisted living apartments within continuing care retirement communities (CCRCs). In the latest study, a convenience sample (N = 152) was recruited and data collection was completed in 4 weeks at a total cost of less than $5,000. Methods common to qualitative research and those commonly used in community-based research were adapted to reduce time and costs for recruitment, screening, and data collection. Given limited availability of research funding, other nursing researchers may find one or more of these methods useful.
Keywords: recruitment; data collection; older adults; small groups; innovation
Recruiting representative samples of older adults for research studies can be challenging (Boles, Getchell, Feldman, McBride, & Hart, 2000; Ory et al., 2002; Sullivan-Bolyai et al., 2011), especially considering the wide range of cognitive and functional abilities among the older adult population (New England States Consortium [NESC] Proceedings, 2000). Recruitment also is a costly process (Blackman, Kamimoto, & Smith, 1999; Ory et al., 2002). As an example, in a study of health promotion among older adults of 746 individuals screened in a baseline visit, only 156 subjects were eligible. Recruitment costs were reported as $2,750 for television advertising, $2,369 for newspaper advertising, $5,691 for radio ads, and $3,931 for postal mailings (McDermott et al., 2009). Even just stafftime and incidental expenses in a multisite study examining effective strategies for recruitment of older adults was estimated at $300 per participant (Ory et al., 2002), whereas another study found these costs totaled $439 per participant (Katula et al., 2007).
Recruiting older adult subjects at the time of hospital discharge or during a visit to a physician's office or clinic may be complicated by immediate health concerns that take priority over participating in a research study and may influence responses for those who do choose to participate (Woodall, Morgan, Sloan, & Howard, 2010). Additionally, significant numbers of older adults fear being victimized by fraud and are reluctant to respond to requests to participate in research studies. This is particularly true among minority and low-income older adults (Meiner & Lueckenotte, 2005).
Recruitment is generally a two-step process that begins with recruiting potential participants, followed by initial screening to determine if inclusion criteria are met before obtaining consent and collecting data. Screening for inclusion criteria is complicated among older adults by the prevalence of dementia in this population. U.S. federal regulations for the conduct of research involving human subjects provide specific guidance when dealing with a population with compromised capacity to consent, such as those with mild dementia (U. S. Department of Health and Human Services [DHHS], 2009). According to the U. S. DHHS, "Impaired decision-making capacity need not prevent participation in research, but additional scrutiny and safeguards are warranted for research involving individuals with such impairments" (U.S. DHHS, 2009, Introduction, para. 1). This additional scrutiny is provided by accredited institutional review boards which are responsible for interpreting federal regulations and approving and monitoring study protocols to ensure compliance with relevant federal regulations. …