Recruitment for a guided self-help binge eating trial: Potential lessons for implementing programs in everyday practice settings

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Abstract

Objective

To explore effects of various recruitment strategies on randomized clinical trial (RCT)-entry characteristics for patients with eating disorders within an everyday health-plan practice setting.

Methods

Randomly selected women, aged 25–50, in a Pacific Northwest HMO were invited to complete a self-report binge-eating screener for two treatment trials. We publicized the trials within the health plan to allow self-referral. Here, we report differences on eating-disorder status by mode and nature of recruitment (online, mail, self-referred) and assessment (comprehensive versus abbreviated) and on possible differences in enrollee characteristics between those recruited by strategy (self-referred versus study-outreach efforts).

Results

Few differences emerged among those recruited through outreach who responded by different modalities (internet versus mail), early-versus-late responders, and those enrolling under more comprehensive or abbreviated assessment. Self-referred were more likely to meet binge-eating thresholds and reported higher average BMI than those recruited by outreach and responding by mail; however, in most respects the groups were more similar than anticipated. Fewer than 1% of those initially contacted through outreach enrolled.

Conclusions

Aggressive outreach and screening is likely not feasible for broader dissemination in everyday practice settings and recruits individuals with more similar demographic and clinical characteristics to those recruited through more abbreviated and realistic screening procedures than anticipated.

Section snippets

Study design

The principal aim of the overall project was to determine the acceptability as well as clinical and cost effectiveness of a cognitive behavioral therapy-based guided self-help program (CBT–GSH) when delivered to a community population of adults with binge eating disorders following large-scale outreach (screening) efforts. We sought to evaluate an intervention that could reach large numbers of adults with eating disorders at a reasonable cost within an everyday health plan practice setting in

Results

Fig. 1 summarizes the recruitment process for those participating in the “comprehensive” (full EDE assessment) and “abbreviated” (abbreviated EDE-Q assessment) phases of the project, respectively, as well as compares these individuals contacted through study outreach efforts to those who self-referred to the study. In both phases a minority of those contacted completed this initial screening (25% in comprehensive assessment phase, 14% in abbreviated assessment phase) yet there were few active

Discussion

In summary, among those recruited using intensive outreach methods (study invitation), we found few differences among those responding by different modalities (Internet versus mail), early and late responders, and those enrolling in the clinical trials when more comprehensive or abbreviated assessment was utilized. Some modest differences emerged between respondents who had been invited into the studies by outreach efforts and those who were self-referred. Those who self referred were more

Acknowledgments

We thank Lynette Rogers, Kristina Booker, Emily Ach, Y. May Chao, and Alexis May. Without their assistance, this study could not have been conducted. This study was supported by NIH Research Grant No. MH066966 (Principal Investigator: Ruth Striegel-Moore, Wesleyan University) funded by the National Institute of Mental Health (NIMH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), awarded to Kaiser Foundation Research Institute. Its contents are solely the

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    This study was supported by NIH Research Grant No. MH066966 (Principal Investigator: Ruth Striegel-Moore, Wesleyan University) funded by the National Institute of Mental Health (NIMH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), awarded to Kaiser Foundation Research Institute.

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