Lead/Presenter: Jennifer Funderburk,
VA Center for Integrated Healthcare
All Authors: Funderburk JS (VA Center for Integrated Healthcare), Shepardson, RS VA Center for Integrated Healthcare Pigeon, W Center of Excellence for Suicide Prevention
Longitudinal and clinical trial research depends on successful engagement of Veterans as participants. This can be challenging, especially when recruiting Veterans with mental health symptoms. We implemented a multi-site randomized controlled trial that screened 1183 Veterans from primary care across 4 years yielding 140 Veterans with depressive symptoms engaging in the trial and meeting the projected sample size with no extension. This presentation will share the lessons learned on Veteran engagement via recruitment, enrollment, and retention practices.
Pilot work (n = 222) was conducted to help determine initial strategies to use to improve recruitment, enrollment, and retention. Two different recruitment methods (e.g., direct referrals and case finding followed by a letter from the primary care provider) were used to recruit Veterans from primary care. Specific tracking systems were created to assist investigators in identifying patterns in recruitment, enrollment, and retention rates. After identifying a high decline rate to phone screens in the pilot (46%), meetings with a Veteran Engagement Board were used to help re-design our recruitment letter. Based on findings from a survey of Veteran interest in research and reasons to participate (n = 319), training was conducted with staff on how to approach Veterans on the phone when following up from a letter.
Initial pilot work had a 46% decline rate when Veterans were called following a letter sent by their primary care provider, a 41% enrollment rate, and an 81% retention rate pre/post intervention. Results from the multi-site trial revealed a 38% decline rate when Veterans were called following a letter sent by their primary care provider, a 61% enrollment rate, an 86% retention rate pre/post intervention, and a 72% retention rate at 24-week follow-up. The difference between the pilot trial and RCT trial was statistically significant for retention rate (?2 = 9.99, p < .01) and decline rate (?2 = 4.09, p < .05, but not enrollment rate (?2 = 2.89, p = .09).
Strategies employed did help to decrease decline rates and improve retention rates in the clinical trial.
Lessons learned can help inform other health services researchers on strategies for successful veteran engagement in research as participants, especially those with mental health symptoms.