Experiments in Participant Recruitment for Effectiveness Research

1. Experiments in Participant Recruitment for Effectiveness Research Sanford L. Braver Arizona State University Prevention Research Center

2. Recruitment of Participants is a Huge Issue in Voluntary Preventive Interventions • Non Captive Audience • Generally Very Low Participation Rates (p) Reported in the Literature • Actually, Often Hard to Know Participation Rate for Published Studies, Since Often Unreported • Or Participants Recruited in a Way Impossible to Compute Rates of Refusal, Participation, etc.

3. Why Is Recruitment Rate Important? • Need to Mount Effectiveness Trial • Population Impact Fraction PIF=p X effect size (ES) for treated participants • For Greater Population Impact, Want to Recruit More (Raise p) Without Jeopardizing ES

4. Problematic Later Outcome ES Control Smaller ES Low p Intervention Condition High p Initial Level of Problems Baseline X Treatment Interactions Might Imply the More Who Participate, the Smaller the Effect Size

5. Effectiveness Research on Divorce Intervention: New Beginnings • Under New Funding, Want to Evaluate Recruitment Methods in Preparation for a Multi-Site Trial • Two Variants • Group Recruitment Method • Individual Recruitment Method • Need Both for Different Kinds of Settings • Evaluate Each One Separately • Not Trying to Compare

6. Group Recruitment Method • A Majority of Counties Require People Requesting a Divorce to Come to a Short Mandatory Parent Education “Course” • Maricopa: PIP • Much More Common in Large Counties

7. Experiment 1: Short-to-Long (STL) • Recruitment Attempt Within PIP Session Requesting Later Voluntary Participation in Longer NBP • Four Conditions, Administered to About 8 PIP Sessions Each, Randomly Selected, Each Session Containing About 25 Individuals • Recruitment Via Videotape, to Standardize, Easily Export, “Jazz Up” • Video Recruitment Has Been Used Successfully in Several Past Prevention Studies

8. Experimental Conditions • Control: Business-As-Usual Recruitment • Pass out Info Pamphlet • Video Control • Same as Pamphlet, But Presented on Video • Motivational Video, With Compliance Techniques • Motivational Video, With Compliance Techniques Plus “Examined Participation” Techniques

9. Motivational Video • Informed by Robert Cialdini’s Analysis of Motivational Principles of Effective Recruitment • Social Validation • Liking • Legitimate Authority • Scarcity • Reciprocation • Commitment/Consistency • Cialdini is a Co-Investigator

10. Examined Participation Video • All of the Above Plus: • An additional component (based on the commitment/consistency principle) that guides parents through active identification and public declaration of worries about child. • Parents will be informed that if they have these worries, participation in NBP has been shown to be of benefit.

11. Proposed Analysis Outcome (Participation) Variables • level of interest in participating • verbally agreed to participate • attended first NBP session • completed the NBP • number of NBP sessions attended Level of Risk will also be assessed, and Participation by Risk Level By Condition Will Be Examined

12. Individual Recruitment: Family Transitions Guide (FTG) At-Risk Families Divided at Random Into Two Groups • Control: Business-As-Usual: Pamphlet • Experimental: Get Assigned to FTG • Ordered or Encouraged By Judge In Case To Meet With FTG, A Court Employee • Each Parent Meets FTG Twice, Individually

13. Meetings With FTG • Helps Parent to Self-Assess Goals and Needs of Family • Uses Variation of Motivational Interviewing • Helps Family Identify Programs To Participate in That Meet Needs • Refers to Programs that Meets Needs • NBP and 2 Other Evidence-Based Programs Yet to Be Chosen • All 3 Programs Provided By Community Providers, Under Contract to Court According to Usual Procurement System • Variety of Locations, Times, and Providers • Free of Cost Initially

14. Proposed Analysis • Main Outcome is Participation, Relative to Control • Very Important Secondary Set of Outcomes Involve Family and Child Functioning Indexes • Assessed By Standardized Telephone Interviews, Blind to Condition • Conducted By Independent ASU Assessment Team “to Help Court Evaluate How Citizens React to Court Programs”

15. Analysis Issue • What is “The Treatment”? • Is Any Improvement in Outcomes of Experimental Group Relative to Control Due to: • Participation in the 3 Programs? • If so, Which Ones? • The FTG Itself? • The Combination of All of the Above: The System? • Not Randomly Assigned, So How to Tease Out?

16. It’s A Compound or “Adaptive” Intervention (Collins, Murphy & Bierman, 2004) • “The intervention” is construed to “consist of not only the treatment components, but the treatment components inextricably coupled with the entire system of assigning [components]” • “It is straightforward to address the overall question of ‘is the intervention efficacious?’…. [However,] absent additional assumptions it is not possible …to isolate the effects of one component within a single adaptive intervention treatment condition.” • Aren’t All Interventions, At Some Level, Compound?