Planning efficient recruitment

1. Planning efficient recruitment EHES Training material

2. Recruitment process • Needs to be specified in each country according to: • National and regional legislation • Ethical acceptance • Cultural norms • Survey budget

3. Participation rate • High participation is the basis for reliable results which represent the target population • Participation rates have been declining • Some groups are often under-represented (young adults, men and those from lower socioeconomic class) →Recruitment should be carefully planned, monitored during fieldwork and adapted whenever needed

4. Written materials • Potential participants’ response to invitation highly depend on the contents and format of written materials • Written materials may include • Information leaflet • Invitation letter • Letter with instructions to participant • Information sheet

5. Information leaflet • Usually sent with the invitation letter • Less formal • Basic information in a concise form • Interesting; pictures and colors • Easy to understand • Main goal is to raise interest and to motivate people to participate

6. Contents of information leaflets The leaflet should give answers: • What is this survey about? Why is it needed? • Why am I selected? • Why is it important to participate? • How do I benefit by participating? • What measurements are included? • Is my information really confidential? • Is my participation compulsory? • Where can I get more information?

7. Contents of invitation letters A personal invitation • Short description of survey and selection of participants • Description of measurements • Pre-scheduled appointment time (with possibility to change time) or instructions for scheduling • Importance of participation explained • Benefits for participant • Signed by a survey leader (or other notable person) • Confidentiality explained • Contact information

8. Instructions to participant Separate letter or in the invitation letter • How to prepare for the examination visit, e.g. • Instructions for fasting • Need to show an ID-card • Practical issues, e.g. • Travel instructions and map of the examination site

9. Information sheet • Includes detailed information on survey • Must be provided to participants before obtaining informed consent • Given at the examination site or sent home with the invitation

10. Inviting participants • Invitation letter is usually the first contact attempt • Invitation letter without appointment time • Survey personnel call to schedule a visit or participant books time after receiving the letter • Problems: Missing phone numbers, people not answering to phone calls, people who need more motivation to book appointment • Invitation letter with appointment time • Problems: If the appointment is not confirmed, many people will not show up, no possibility for extra motivation if needed

11. Scheduling appointments • Personal contact and reminders increase participation • Direct contact (phone call or home visit) • Possibility to answer questions and to motivate people • Possibility to change appointment times • Reminders • Reduce forgotten appointment times • A day – one week before appointment by a letter/ text message/ phone call / e-mail • May include instructions for participants

12. Re-contacts • Neededif previous invitations were not successful • At least one re-invitation even if participation rate is high (70-80%) • At least two re-invitations if participation rate < 70% • By letter or card, phone calls, e-mails, text messages, home visits • Check accuracy of addresses, phone numbers • Mailed and/or web-basednon-participant questionnaire or phone interview offered for all who refuse to participate

13. The value of competent personnel • Competent and well trained personnel • Understand the importance of high participation • Familiar with frequently asked questions • Know how to motivate persons • Have good social skills • Motivating the personnel • Satisfaction of staff is important for the work quality • Positive work environment, supervision, support and feedback increase staff satisfaction

14. Other means to increase participation • Local media campaigns before examinations • To raise interest towards the survey • TV and radio interviews, articles in newspapers, posters etc. • Pre-notification of the survey • Flexibilityin scheduling appointments • Home visits, if participation is not possible otherwise • Using several languages in information material and questionnaires

15. What motivates participants? Benefits • Information on their own health • Incentives or reimbursements of travel expenses • Appreciation for serving public health and giving benefits for future generations

16. Improving participation through co-operation • Discussions in focus groups with representatives of potential participants • To gain information: what motivates participation • Provide information to • Health authorities and health professionals • Local government, communities • Cooperate with • Hospitals, non-governmental organizations, research centers and universities • Other places/groups which are important for the community

17. Acknowledgements • Slides • Sanna Ahonen, Päivikki Koponen, Hanna Tolonen • Photographs • Hanna Tolonen