Present:

1)      Reviewed Recruitment and Retention Tables for edits/updates by site. Changes have been made and are attached to this posting along with a growing Roster (22 committee representatives!).  5 sites continue recruiting.

2)      Facilitated problem-solving site-specific issues/concerns with recruitment and retention by population subgroups (e.g. older adults 55+, adults w/ risk 18-54, adults w/ low SES 18-54, healthy adults 18-54, adolescents 12-17, and children <12). We gave extra time for brainstorming for 5 sites still working on recruitment. 

a.       Recruitment Problem-solving: First, relax exclusion criteria with aim to be more inclusive and thus representative of broader population.   Example, large # of participants were excluded due high over reporting bias of criterion behavior (e.g. physical activity).  Second, design less intensive interventions at the individual level and consider making multi-level intervention changes so there is less participant burden and more buy-in to the program.

b.      Major and minor life events by age groups leading to study withdrawal, loss to follow-up, and/or missed visits were discussed.  Reviewed 8 life-course problem-solving strategies previously outlined and presented to BCC at July 2001 meeting (e.g. enhance prioritizing skills, provide opportunities for flexibility, exercise patience, offer instrumental problem-solving, practice persistence, keep boundaries, suggest streamlining, and enlist support).

3)      Life-course Themes Affecting Retention by Subgroups:

1. Older Adults: 1) Co-morbidity/illness/health status, 2) family concerns, 3) transportation, and 4) retirement.
2. Adults’ w/ Disease: 1) Higher rate co-morbidity, 2) family concerns/demands especially if in caretaker role, and 3) transportation.
3. Adults, general: 1) Time/priorities by particular age group (career, family, or school) and 2) family concerns/demands.
4. Adults, low SES: 1) Time/sacrifices by age group, 2) family concerns/demands, 3) higher rate co-morbidity, 4) cultural barriers (transient, transportation, & appointment keeping).
5. Children/Adolescents: We ran out of time and did not discuss this age group.

4)    Came up with a Solution-oriented Process to guide the problem-solving experience:

            -Assess Commitment based on above life-course themes

            -Determine Barriers with the participant as active collaborator

            -Evaluate Responsiveness of participant to the strategies (see 8 strategies)

            -Triage to other levels in your system (e.g. fellow staff, investigators, PI)

            -Incentivize (new word) the plan for them, earning something meaningful

1. Reviewed paper “The Real World: When Research Meets Reality”.  Group agreed that taking retention focus was preferable as presented in Draft #2. Carla wrote introduction, Tammy wrote methods and working on results, Mace to write discussion. Jennifer volunteered to spearhead the site survey to obtain our table data. Jennifer will be sending out the survey requests soon so get ready!  You can refer to the updated tables in this posting to help you get started on your reply.  Molly agreed to review intro and add ecological approach to really beef up our retention as being a multi-level process (e.g. individual, provider, and institution).  Judy S. volunteered to do some heavy editing of manuscript and work on journals to submit to (Controlled Clinical Trials, Preventive Medicine, and American Journal of Public Health were favored suggestions). 
   
   The outline for a Table 1 is as follows: Problem list (see Hunt & White for example) and solutions list (obtained from site surveys).  Table 2: Population specific problems by site, sites rate solutions used by 8 life-course categories, indicating subjectively best/worst strategies, compare subjective rating to retention rates per site.  (I hope my notes about this plan are accurate! If not, please correct me and we will clarify on next conference call to be scheduled for January 2002).

2. Cross-site proposal circulated by Tammy, Lynn, Jennifer (IIT) was discussed.  Details regarding suggested changes will be discussed on our next conference call. Mace and Tammy will make revisions and submit by 12/21/01 cross-site proposal deadline.

3. SBM seminar accepted that Barbara Resnick (U Maryland) coordinated. Mace will be final presenter in seminar line-up and will speak for 40 minutes on R&R strategies in the BCC using the frameworks outlined above. The site surveys going out will give me the level of detail I will need to give this presentation on behalf of our committee, and will include some handouts for the audience, and audience participation during the presentation will be encouraged.
   
   Our committee adjourned early so we did not give the final days report.  These minutes and the revised tables and roster will be posted on BCC website.  I will be sending out a message to schedule our January call early next month.