UNASSIGNED: We explored recruitment activities and factors associated with organizational enrollment in SMARTER CRC, a randomized pragmatic trial to increase rates of CRC screening in rural populations. We sought to recruit 30 rural primary care practices within participating Medicaid health plans. We tracked recruitment outreach contacts, meeting content, and outcomes using tracking logs. Informed by the Consolidated Framework for Implementation Research, we analyzed interviews, surveys, and publicly available clinical practice data to identify facilitators of participation.
UNASSIGNED: Overall recruitment activities spanned January 2020 to April 2021. Five of the 9 health plans approached agreed to participate (55%). Three of the health plans chose to operate centrally as 1 site based on network structure, resulting in 3 recruited health plan sites. Of the 101 identified practices, 76 met study eligibility criteria; 51% (n = 39) enrolled. Between recruitment and randomization, 1 practice was excluded, 5 withdrew, and 7 practices were collapsed into 3 sites for randomization purposes based on clinical practice structure, leaving 29 randomized sites. Successful recruitment required iterative outreach across time, with a range of 2 to 17 encounters per clinical practice. Facilitators to recruitment included multi-modal outreach, prior relationships, effective messaging, flexibility, and good timing.
UNASSIGNED: Recruiting health plans and rural clinical practices was complex and iterative. Leveraging existing relationships and allocating time and resources to engage clinical practices in pragmatic implementation research may facilitate more diverse representation in future trials and generalizability of research findings.
■我们在SMARTERCRC中探讨了与组织注册相关的招聘活动和因素,一项提高农村人群CRC筛查率的随机实用试验.我们试图在参与的医疗补助健康计划中招募30家农村初级保健机构。我们追踪了招聘外展联系人,会议内容,和使用跟踪日志的结果。由实施研究综合框架通知,我们分析了采访,调查,和公开的临床实践数据,以确定参与的促进者。
■总体招聘活动涵盖2020年1月至2021年4月。9项健康计划中有5项同意参与(55%)。三个健康计划根据网络结构选择集中运营为1个站点,导致3个招募的健康计划站点。在确定的101种做法中,76人符合研究资格标准;51%(n=39)入组。在招募和随机化之间,1实践被排除在外,5退出,根据临床实践结构,将7个实践分为3个地点进行随机化,留下29个随机网站。成功的招聘需要跨时间的迭代推广,每个临床实践有2到17次接触。征聘的促进者包括多模式外联,先前的关系,有效的消息传递,灵活性,和好的时机。
■招募健康计划和农村临床实践是复杂且反复的。利用现有的关系,并分配时间和资源,使临床实践参与务实的实施研究可能有助于在未来的试验和研究结果的普遍性更多样化的代表。