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Recruiting and retaining postpartum women from areas of social disadvantage in a weight-loss trial – an assessment of strategies employed in the WeighWell feasibility study

Macleod, Maureen and Craigie, Angela M. and Barton, Karen L. and Treweek, Shaun and Anderson, Annie S. and Kirk, Alison (2013) Recruiting and retaining postpartum women from areas of social disadvantage in a weight-loss trial – an assessment of strategies employed in the WeighWell feasibility study. Maternal and Child Nutrition, 9 (3). pp. 322-331.

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Little is known about the response of post-partum women from deprived backgrounds to weight management interventions, however behavioural intervention trials in disadvantaged communities are often characterised by recruitment difficulties. Recruitment and retention is key to the robust conduct of an effective trial, and exploratory work is essential prior to a definitive randomised controlled trial. This paper describes strategies used to recruit to the WeighWell feasibility study, which aimed to recruit 60 overweight or obese post-partum women living in areas of deprivation to a trial of a weight-loss intervention. Recruitment strategies included the following: (1) distribution of posters and ‘business cards’; (2) newspaper advertisements; (3) visits to community groups; and (4) personalised letters of invitation sent via the National Health Service (NHS). Potential participants were screened for eligibility following response to a Freephone number. Body mass index was calculated using self-reported body weight and height. Over 6 months, 142 women responded of whom 65 (46%) met the eligibility criteria. The most effective methods for recruiting eligible women and those who went on to complete the study (n = 36) were visits to community groups (37% and 42%, respectively), personalised letters (26% and 17%, respectively) and posters and ‘business cards’ (22% and 31%, respectively). These results emphasise the need to utilise a range of strategies beyond traditional NHS settings. Current approaches might be enhanced by sending personal contact letters via their General Practitioner to women identified as eligible at post-natal discharge. Under-reporting of body weight by self-report suggests that a threshold lower than 25 kg/m2 should be utilised for screening purposes.