Present:

Action Item: Mace to e-mail Barb Resnick (University of Maryland) to see if she would provide a representative from her project to the group.  

• As projects are funded by a variety of institutes (NICHD, NIAID, Office of Dietary Supplements, etc.), and projects encompass a variety of conditions, it was suggested that the introduction be broadened to reflect more than cardiac risk populations.
• It was suggested that the emphasis on behavior change be more clearly represented.
• Mace mentioned difficulties in retention that could be mentioned, as people who go in & out of treatment centers, how to keep track of them when they leave.
• Tammy offered to obtain table and text from BCC presentation, and attempt to draft results section.

ITT (A Couples’ Intervention for Cardiac Risk Reduction): Tammy Sher provided the following verbal report.

The project plans to be recruiting until the end of the funding period, and would consider a no-cost extension or competitive renewal.  The intervention runs for 18 weeks, in a group format.  In the summer, they broadened recruitment criteria, and as a result, recruitment has doubled since July.  Recruitment is approximately 1/3 complete.  The project is recruiting at four hospitals.

Retention: Retention has varied – out of 32 recruited they have lost 5.  Most (?) of these dropped out before the intervention.  Once participants are enrolled in a class they are retained more easily.  Strategies to enhance retention have included sending anniversary cards, birthday cards, etc.

CHAT Study at Stanford (Exercise Advice by Human or Computer: Testing Two theories): Cynthia Castro provided the following summary.

Recruitment Summary: We had a disappointing and slow summer for recruitment due to some staff turn-over, staff vacations, and diminishing responses to our standard recruitment method (newspaper ads).  We recently jump-started recruitment by taking a stab at weekend radio advertisements, and got an overwhelmingly enthusiastic response. There is a local news radio personality and fitness celebrity (Joannie Greggains) who hosts a Saturday morning health and fitness radio talk show.  We placed two ads during a two-hour show and got over 60 calls from prospective participants!  We waited two weeks and placed one ad during another show and got over 40 calls that time.  Approximately 50% of callers are eligible, and we project that 80% of the eligible pool will make it through to randomization. We are now focusing our recruitment dollars solely on radio ads.   If they continue to work their magic, we may be done with recruitment before our projected end date.

Retention Summary: Six participants have dropped out of the study.  Early indications show some differential drop-out in the automated telephone system intervention condition. This was not surprising to us because we were aware of some early technical problems with that intervention that turned off some participants. Our study design has frequent intervention contacts (minimum of one telephone contact per month, plus one mail contact per month), and frequent assessment visits (phone interview every three months, and clinic exam every six months), so we keep close tabs on participants throughout the trial.  At this point, we are not too concerned about our drop-out rate, and continue to monitor "at-risk" participants closely for potential signs that we may lose them.

Emory University (Health Promotion through Black Churches):  Dhana Blissett provided the following summary.

Target goal was 1000 participants, 65 per church across 16 churches.   Currently above target with 1065 participants. Five churches were randomized to control, five to treatment 1, five to treatment 2.   Completed pretest 6/2000, first post-test recently completed. Pretest and post-test are one year apart.  A “handful” of participants dropped out, mostly those from phone call condition. Project is targeting 85% retention through post-test phase.

Recruitment Strategies: Hired church liaison for each church, who put posters up internally regarding a health fair.  Liaison was paid approx $10/hr.

Retention Strategies: sent gospel music audiotape, potholder with logo.

Health Opportunities with Physical Exercise (HOPE): Mace Coday provided the following summary.

Summary: A 3 arm randomized physical activity behavior change prevention trial targeting sedentary overweight (BMI>25) men and women age 25-65. Did not screen out for diabetes, HTN, etc....Target number is 360. 120 per arm. Three arms are Standard Care (membership to Hope and Healing), H&H plus assignment to a peer mentor, H&H plus assignment to a health provider. Briefly, Hope and Healing is 80,000 sq. ft. facility located in an urban setting. This program/building was privately funded and is a ministry of The Church Health Center, Memphis. We collaborate with CHC to do the HOPE trial.

Retention Goal: 90% at each follow up time-point (baseline we have 100%, 6-month, 12-month, and 24-month follow ups).

Recruitment Summary: Enrolled 361 of 360 expected to recruit. Recruited from three medical clinics located in underserved areas and also recruited directly from H&H. So participants were either doctor referred or self-referred. Completed enrollment in approx. 13 months. Predominantly targeted Women and AA's. Enrolled 88% female and 72% AA.

Biggest recruitment challenge: enrolling the clinic patients (working poor), they tended to me worse off health-wise and many economic barriers and were less likely to show up at H&H even thought got referred. Even less likely to do the exercise and movement assessment at H&H which they had to do first before could screen for HOPE study. So, we tended to draw most of our population from H&H walk-ins who were sedentary and overweight but healthier overall than our clinic folks.

Retention Summary: Goal is 90% at each time-point. Have 88% for 6-month follow-up with over 90% of total at their window for this visit. Sign. challenges have been locating by phone (transient pop.) and substance use issues (locating after admission to half-way house) and GUILT over not being on exercise program so don't want to come in for a test! Using staff skills, rapport, PI involvement, and $50 shopping mall certificates to help. These all help some but not fool-proof. 12-month follow-up is 100% so far. Only have 47% at window to be seen so inflated estimation right now. At this point have no knowledge of differential drop out. Have 9 on our Investigator call list (at some point the person has said want to drop, but no adamants never call me again, that's when they go to me for calling, some respond to CO-I or PI, some don't).

Brown University/Miriam Hospital: Motivating the Parents of Asthmatics to Quit Smoking (PAQS): Beth McQuaid provided the following report.

Project Summary: Project is compares the efficacy of two different interventions based on different theoretical models, one based on social cognitive theory, and the other based on risk perception.  Smokers who have a child with asthma are recruited through their Medicaid managed care plan.  Interventions are provided in-home by visiting nurses.

Recruitment Summary: We are actively recruiting, and expect to do so until the end, and will likely apply for a no cost extension.  After a long pilot phase, we have actively recruited approximately 40 into our intervention phase. Since the end of our pilot, we have been recruiting approximately one to two families per week. As this is shy of our 288 proposed, we have reviewed various recruitment strategies, and are pursuing IRB approval currently to recruit directly through the ER.

Retention Update: As we are currently in the middle of treatment for many of our participants, we do not have even preliminary figures on retention yet.  Our goal is approximately 75% retention, given members come in & out of the health plan.  We have implemented several strategies to increase retention, including distributing incentives across visits, giving phone cards for completion of certain visits, giving participants project “gifts” such as memo boards, and obtaining any and all phone #’s where participants may be tracked down if they move or withdraw from the health plan.