Abstract
Background Although early childhood obesity prevention programs are needed in primary care to address the growing pediatric obesity epidemic, recruitment remains particularly challenging.AimsTo describe opt-in versus opt-out recruitment strategies to invite parents of overweight/obese 4–8 year olds to participate in a family lifestyle modification obesity prevention study in primary care.
Methods Following IRB approval, traditional recruitment strategies were employed including flyers, doctor referrals, and public ads to invite parents of 4–8 year olds with a Body Mass Index (BMI) > 85th percentile for age and sex to call (Opt-IN) about participating in a 5-month primary care obesity prevention intervention. Electronic Health Records were searched and physician letters were sent to parent/guardian of eligible children who resided at zip codes within 1-hour commute of treatment site to invite them to call about the study. Opt In letters were mailed over 13-months for Cohorts 1–3 recruitment. For Cohort 4, identical physician letters were mailed except parents were asked to call if they were NOT interested in information about the study (Opt-OUT). After 10 days, study staff called to explain the study and schedule an in person screening.
Results In 2008–2009, over 15,000 children ages 4–8 had at least one height and one weight recorded in the EHR at the same visit with BMI> 85th % for age, sex. 11,276 physician letters were mailed: 9,954 opt in letters over 13-months (Cohorts 1–3) and1,322 opt out letters in 2-months (Cohort 4). Of the 170 families screened, 58/107 (54%) identified opt in letters as recruitment source; 49/63 (78%) families in Cohort 4 reported opt out letters introduced them to the study. Fifty-six families gave written informed consent and/or assent and were randomized to one of two groups – Group Family Behavior Modification (FBM) or Enhanced Information Mailing (EIM) group. Three FBM and two EIM families dropped before treatment started.
Conclusions Physician letters to parents of eligible children identified in the EHR were the most successful recruitment strategies for the primary care obesity prevention study. Opt-out physician letters shortened recruitment time and doubled the number of participants recruited for the final cohort.
