# Presentation: 216763

## When Reality Collides with Research: Combating Life's Intrusions During Follow-Up

**BCC Recruitment & Retention Workgroup**
**Presenters:**M.Coday (University of Tennessee, Memphis)T. Sher (Illinois Institute of Techology)L. Strycker (Oregon Research Institute)

## Life Stages Framework (e.g. cohorts span age 25-75)- Pre to Young Family, Older Children, Aging Parents, & Grandparents

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## Determine life stage participant/population faces. Select strategies below  which best assist in promoting movement despite situational constraints.

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## Enhance Prioritizing Skills

- Help participant decide what’s most important right now versus in the future
- 54 year-old wife of cardiac patient. Ill mother lives with them and sabotages new behaviors
- 63 year-old male patient and wife failing to come to group because wanting retirement years to be “their time”

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## Provide Opportunities for Flexibility

- Seek ways to make special arrangements for visits
- Truncating follow-up visit to include “absolutely critical” measure(s)
- 44 year-old woman works two jobs and has a family: solution to schedule Saturday visits

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## Exercise Patience

- Life changes and family situations may be chronic and not amenable to simple solutions
- 50 year-old teacher working many hours during School zoning changes was given two-month “vacation from program.” Started back with stretching at home, graduated to neighborhood walking. Back at facility

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## Offer Instrumental Problem-Solving 

- If simple solution is beneficial, then help find way to make it happen
- Helping participant problem solve regarding childcare, insurance paper work, etc.
- 65 year-old female does not know how to drive. Peers and staff assist with rides to and from facility

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## Practice Persistence 

- Familiarity can be endearing, develop phone and mail contact strategies that are based on this principle
- Suggested intervention contact attempts is 3xs and suggested follow up visit contact attempts is 10-12xs
- “You didn’t give up on me, so I didn’t give up on this program”

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## Keep Boundaries 

- Establish acceptable boundaries of contact with participant, obtain understanding
- Even though OK to attempt call 8xs for an appointment, it may not be OK to leave a message every time!

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## Suggest Streamlining 

- Negotiate what portion of visit(s), intervention, contact type they are willing to do
- “I’ll come to clinic for follow up, but please don’t send me that questionnaire in the mail”

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## Enlist Support 

- Recognize that study staff don’t have all the answers or all the resources and can draw on participant assistance by asking for help with chain calls, opinion polls, neighborhood gatherings, advisory panel
- Has anyone has tried any of these?!

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## Open Discussion

- Retention is something you work on before, during, and after the project.
- Retention can be affected by dynamic outside influences not controlled by the project design.
- Strategies must be multi-faceted enough to deal with "real life” in a humane way.

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## Controversial Issues

- Defining dropouts revisited
- Broad versus narrow goals
- Staff  time: effort versus burden
- Modifying protocol adherence
- Retention decisions and generalizability
- Implications of retention decisions on data analyses

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