Abstract
BACKGROUND: Although early childhood obesity prevention programs are needed in primary care to address the growing pediatric obesity epidemic, recruitment remains particularly challenging.AimsTo describe opt-in versus opt-out recruitment strategies to invite parents of overweight/obese 4–8 year olds to participate in a family lifestyle modification obesity prevention study in primary care. METHODS: Following IRB approval, traditional recruitment strategies were employed including flyers, doctor referrals, and public ads to invite parents of 4–8 year olds with a Body Mass Index (BMI) > 85th percentile for age and sex to call (Opt-IN) about participating in a 5-month primary care obesity prevention intervention. Electronic Health Records were searched and physician letters were sent to parent/guardian of eligible children who resided at zip codes within 1-hour commute of treatment site to invite them to call about the study. Opt In letters were mailed over 13-months for Cohorts 1–3 recruitment. For Cohort 4, identical physician letters were mailed except parents were asked to call if they were NOT interested in information about the study (Opt-OUT). After 10 days, study staff called to explain the study and schedule an in person screening. RESULTS: In 2008–2009, over 15,000 children ages 4–8 had at least one height and one weight recorded in the EHR at the same visit with BMI> 85th % for age, sex. 11,276 physician letters were mailed: 9,954 opt in letters over 13-months (Cohorts 1–3) and1,322 opt out letters in 2-months (Cohort 4). Of the 170 families screened, 58/107 (54%) identified opt in letters as recruitment source; 49/63 (78%) families in Cohort 4 reported opt out letters introduced them to the study. Fifty-six families gave written informed consent and/or assent and were randomized to one of two groups – Group Family Behavior Modification (FBM) or Enhanced Information Mailing (EIM) group. Three FBM and two EIM families dropped before treatment started. CONCLUSIONS: Physician letters to parents of eligible children identified in the EHR were the most successful recruitment strategies for the primary care obesity prevention study. Opt-out physician letters shortened recruitment time and doubled the number of participants recruited for the final cohort.