Effective and cost-effective strategies for recruiting rural adults into a civic engagement and health behavior change research study.

BACKGROUND

Rural populations have worse health outcomes than urban populations. Community-based health interventions can help to improve these outcomes, but rural populations are underrepresented in research. The goals of the study were to describe and examine the effectiveness and cost-effectiveness of strategies to recruit into a rural, community-based health intervention study.

METHODS

The Change Club study is a community-based health intervention conducted in medically underserved rural communities in Texas and New York to assess whether a civic engagement program improves health among intervention participants and their communities. The study was promoted online, via mailings, email, educators, flyers/posters, and traditional media, and encouraged referrals from friends and family members. For each recruitment strategy, the resulting number of enrolled participants and costs were compiled.

RESULTS

The most effective recruitment strategy was letters, which contributed 37.7% of participants, followed by friends/family (23.2%), postcards (22.3%), social media advertisements (13.3%), and flyers/posters (8.4%). The overall cost per enrolled participant was 12.36). The least cost-effective strategy was local educators' phone calls and texts, which cost $6,803 and yielded no enrollments.

CONCLUSIONS

Mailing of recruitment letters, word-of-mouth referrals from family and friends, advertisements on social media, and the distribution and posting of flyers/posters were effective and cost-effective strategies and we recommend them for future studies in similar locations. Leveraging the close-knit social ties in rural communities to recommend study participation may be particularly fruitful, but researchers should investigate potential selection bias.

TRIAL REGISTRATION: Clinicaltrials.gov, NCT05002660 Registered on 04 August 2021.