Recruitment of men to a multi-centre diabetes prevention trial: An evaluation of traditional and online promotional strategies

Karen Bracken, Wendy Hague, Anthony Keech, Ann Conway, David J. Handelsman, Mathis Grossmann, David Jesudason, Bronwyn Stuckey, Bu B. Yeap, Warrick Inder, Carolyn Allan, Robert McLachlan, Kristy P. Robledo, Gary Wittert

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Effective interventions are required to prevent the current rapid increase in the prevalence of Type 2 diabetes. Clinical trials of large-scale interventions to prevent Type 2 diabetes are essential but recruitment is challenging and expensive, and there are limited data regarding the most cost-effective and efficient approaches to recruitment. This paper aims to evaluate the cost and effectiveness of a range of promotional strategies used to recruit men to a large Type 2 diabetes prevention trial. Methods: An observational study was conducted nested within the Testosterone for the Prevention of Type 2 Diabetes (T4DM) study, a large, multi-centre randomised controlled trial (RCT) of testosterone treatment for the prevention of Type 2 diabetes in men aged 50-74 years at high risk of developing diabetes. Study participation was promoted via mainstream media - television, newspaper and radio; direct marketing using mass mail-outs, publicly displayed posters and attendance at local events; digital platforms, including Facebook and Google; and online promotions by community organisations and businesses. For each strategy, the resulting number of participants and the direct cost involved were recorded. The staff effort required for each strategy was estimated based on feedback from staff. Results: Of 19,022 men screened for the study, 1007 (5%) were enrolled. The most effective recruitment strategies were targeted radio advertising (accounting for 42% of participants), television news coverage (20%) and mass mail-outs (17%). Other strategies, including radio news, publicly displayed posters, attendance at local events, newspaper advertising, online promotions and Google and Facebook advertising, each accounted for no more than 4% of enrolled participants. Recruitment promotions cost an average of AU$594 per randomised participant. The most cost-effective paid strategy was mass mail-outs by a government health agency (AU$745 per participant). Other paid strategies were more expensive: mail-out by general practitioners (GPs) (AU$1104 per participant), radio advertising (AU$1081) and newspaper advertising (AU$1941). Conclusion: Radio advertising, television news coverage and mass mail-outs by a government health agency were the most effective recruitment strategies. Close monitoring of recruitment outcomes and ongoing enhancement of recruitment activities played a central role in recruitment to this RCT. Trial registration: ANZCTR, ID: ACTRN12612000287831. Registered on 12 March 2012.

Original languageEnglish
Article number366
JournalTrials
Volume20
Issue number1
DOIs
Publication statusPublished - 19 Jun 2019

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Postal Service
Radio
Type 2 Diabetes Mellitus
Newspapers
Television
Government Agencies
Costs and Cost Analysis
Posters
Testosterone
Randomized Controlled Trials
Personnel Selection
Health
Marketing
General Practitioners
Cost-Benefit Analysis
Observational Studies
Clinical Trials
Organizations

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Bracken, K., Hague, W., Keech, A., Conway, A., Handelsman, D. J., Grossmann, M., ... Wittert, G. (2019). Recruitment of men to a multi-centre diabetes prevention trial: An evaluation of traditional and online promotional strategies. Trials, 20(1), [366]. https://doi.org/10.1186/s13063-019-3485-2
Bracken, Karen ; Hague, Wendy ; Keech, Anthony ; Conway, Ann ; Handelsman, David J. ; Grossmann, Mathis ; Jesudason, David ; Stuckey, Bronwyn ; Yeap, Bu B. ; Inder, Warrick ; Allan, Carolyn ; McLachlan, Robert ; Robledo, Kristy P. ; Wittert, Gary. / Recruitment of men to a multi-centre diabetes prevention trial : An evaluation of traditional and online promotional strategies. In: Trials. 2019 ; Vol. 20, No. 1.
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abstract = "Background: Effective interventions are required to prevent the current rapid increase in the prevalence of Type 2 diabetes. Clinical trials of large-scale interventions to prevent Type 2 diabetes are essential but recruitment is challenging and expensive, and there are limited data regarding the most cost-effective and efficient approaches to recruitment. This paper aims to evaluate the cost and effectiveness of a range of promotional strategies used to recruit men to a large Type 2 diabetes prevention trial. Methods: An observational study was conducted nested within the Testosterone for the Prevention of Type 2 Diabetes (T4DM) study, a large, multi-centre randomised controlled trial (RCT) of testosterone treatment for the prevention of Type 2 diabetes in men aged 50-74 years at high risk of developing diabetes. Study participation was promoted via mainstream media - television, newspaper and radio; direct marketing using mass mail-outs, publicly displayed posters and attendance at local events; digital platforms, including Facebook and Google; and online promotions by community organisations and businesses. For each strategy, the resulting number of participants and the direct cost involved were recorded. The staff effort required for each strategy was estimated based on feedback from staff. Results: Of 19,022 men screened for the study, 1007 (5{\%}) were enrolled. The most effective recruitment strategies were targeted radio advertising (accounting for 42{\%} of participants), television news coverage (20{\%}) and mass mail-outs (17{\%}). Other strategies, including radio news, publicly displayed posters, attendance at local events, newspaper advertising, online promotions and Google and Facebook advertising, each accounted for no more than 4{\%} of enrolled participants. Recruitment promotions cost an average of AU$594 per randomised participant. The most cost-effective paid strategy was mass mail-outs by a government health agency (AU$745 per participant). Other paid strategies were more expensive: mail-out by general practitioners (GPs) (AU$1104 per participant), radio advertising (AU$1081) and newspaper advertising (AU$1941). Conclusion: Radio advertising, television news coverage and mass mail-outs by a government health agency were the most effective recruitment strategies. Close monitoring of recruitment outcomes and ongoing enhancement of recruitment activities played a central role in recruitment to this RCT. Trial registration: ANZCTR, ID: ACTRN12612000287831. Registered on 12 March 2012.",
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author = "Karen Bracken and Wendy Hague and Anthony Keech and Ann Conway and Handelsman, {David J.} and Mathis Grossmann and David Jesudason and Bronwyn Stuckey and Yeap, {Bu B.} and Warrick Inder and Carolyn Allan and Robert McLachlan and Robledo, {Kristy P.} and Gary Wittert",
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Bracken, K, Hague, W, Keech, A, Conway, A, Handelsman, DJ, Grossmann, M, Jesudason, D, Stuckey, B, Yeap, BB, Inder, W, Allan, C, McLachlan, R, Robledo, KP & Wittert, G 2019, 'Recruitment of men to a multi-centre diabetes prevention trial: An evaluation of traditional and online promotional strategies' Trials, vol. 20, no. 1, 366. https://doi.org/10.1186/s13063-019-3485-2

Recruitment of men to a multi-centre diabetes prevention trial : An evaluation of traditional and online promotional strategies. / Bracken, Karen; Hague, Wendy; Keech, Anthony; Conway, Ann; Handelsman, David J.; Grossmann, Mathis; Jesudason, David; Stuckey, Bronwyn; Yeap, Bu B.; Inder, Warrick; Allan, Carolyn; McLachlan, Robert; Robledo, Kristy P.; Wittert, Gary.

In: Trials, Vol. 20, No. 1, 366, 19.06.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recruitment of men to a multi-centre diabetes prevention trial

T2 - An evaluation of traditional and online promotional strategies

AU - Bracken, Karen

AU - Hague, Wendy

AU - Keech, Anthony

AU - Conway, Ann

AU - Handelsman, David J.

AU - Grossmann, Mathis

AU - Jesudason, David

AU - Stuckey, Bronwyn

AU - Yeap, Bu B.

AU - Inder, Warrick

AU - Allan, Carolyn

AU - McLachlan, Robert

AU - Robledo, Kristy P.

AU - Wittert, Gary

PY - 2019/6/19

Y1 - 2019/6/19

N2 - Background: Effective interventions are required to prevent the current rapid increase in the prevalence of Type 2 diabetes. Clinical trials of large-scale interventions to prevent Type 2 diabetes are essential but recruitment is challenging and expensive, and there are limited data regarding the most cost-effective and efficient approaches to recruitment. This paper aims to evaluate the cost and effectiveness of a range of promotional strategies used to recruit men to a large Type 2 diabetes prevention trial. Methods: An observational study was conducted nested within the Testosterone for the Prevention of Type 2 Diabetes (T4DM) study, a large, multi-centre randomised controlled trial (RCT) of testosterone treatment for the prevention of Type 2 diabetes in men aged 50-74 years at high risk of developing diabetes. Study participation was promoted via mainstream media - television, newspaper and radio; direct marketing using mass mail-outs, publicly displayed posters and attendance at local events; digital platforms, including Facebook and Google; and online promotions by community organisations and businesses. For each strategy, the resulting number of participants and the direct cost involved were recorded. The staff effort required for each strategy was estimated based on feedback from staff. Results: Of 19,022 men screened for the study, 1007 (5%) were enrolled. The most effective recruitment strategies were targeted radio advertising (accounting for 42% of participants), television news coverage (20%) and mass mail-outs (17%). Other strategies, including radio news, publicly displayed posters, attendance at local events, newspaper advertising, online promotions and Google and Facebook advertising, each accounted for no more than 4% of enrolled participants. Recruitment promotions cost an average of AU$594 per randomised participant. The most cost-effective paid strategy was mass mail-outs by a government health agency (AU$745 per participant). Other paid strategies were more expensive: mail-out by general practitioners (GPs) (AU$1104 per participant), radio advertising (AU$1081) and newspaper advertising (AU$1941). Conclusion: Radio advertising, television news coverage and mass mail-outs by a government health agency were the most effective recruitment strategies. Close monitoring of recruitment outcomes and ongoing enhancement of recruitment activities played a central role in recruitment to this RCT. Trial registration: ANZCTR, ID: ACTRN12612000287831. Registered on 12 March 2012.

AB - Background: Effective interventions are required to prevent the current rapid increase in the prevalence of Type 2 diabetes. Clinical trials of large-scale interventions to prevent Type 2 diabetes are essential but recruitment is challenging and expensive, and there are limited data regarding the most cost-effective and efficient approaches to recruitment. This paper aims to evaluate the cost and effectiveness of a range of promotional strategies used to recruit men to a large Type 2 diabetes prevention trial. Methods: An observational study was conducted nested within the Testosterone for the Prevention of Type 2 Diabetes (T4DM) study, a large, multi-centre randomised controlled trial (RCT) of testosterone treatment for the prevention of Type 2 diabetes in men aged 50-74 years at high risk of developing diabetes. Study participation was promoted via mainstream media - television, newspaper and radio; direct marketing using mass mail-outs, publicly displayed posters and attendance at local events; digital platforms, including Facebook and Google; and online promotions by community organisations and businesses. For each strategy, the resulting number of participants and the direct cost involved were recorded. The staff effort required for each strategy was estimated based on feedback from staff. Results: Of 19,022 men screened for the study, 1007 (5%) were enrolled. The most effective recruitment strategies were targeted radio advertising (accounting for 42% of participants), television news coverage (20%) and mass mail-outs (17%). Other strategies, including radio news, publicly displayed posters, attendance at local events, newspaper advertising, online promotions and Google and Facebook advertising, each accounted for no more than 4% of enrolled participants. Recruitment promotions cost an average of AU$594 per randomised participant. The most cost-effective paid strategy was mass mail-outs by a government health agency (AU$745 per participant). Other paid strategies were more expensive: mail-out by general practitioners (GPs) (AU$1104 per participant), radio advertising (AU$1081) and newspaper advertising (AU$1941). Conclusion: Radio advertising, television news coverage and mass mail-outs by a government health agency were the most effective recruitment strategies. Close monitoring of recruitment outcomes and ongoing enhancement of recruitment activities played a central role in recruitment to this RCT. Trial registration: ANZCTR, ID: ACTRN12612000287831. Registered on 12 March 2012.

KW - Advertising

KW - Diabetes prevention

KW - Men's health

KW - Participant recruitment

KW - Randomised controlled trials

KW - Recruitment strategies

KW - Social media

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U2 - 10.1186/s13063-019-3485-2

DO - 10.1186/s13063-019-3485-2

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VL - 20

JO - Trials

JF - Trials

SN - 1745-6215

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M1 - 366

ER -