Research network relies on shoe-leather recruiting

Being there is half the job

When clinical research sites need to recruit pregnant women, it can be a time-consuming and challenging task.

However, the Obstetrics and Gynecology Research Network (OGRN) of the University of Utah School of Medicine in Salt Lake City, UT, has found that the old-fashioned method of hitting the pavement and meeting repeatedly with referral sources works best.

"We go out in the community and establish relationships with physicians to show them what we can offer their patients if they were to enroll in our studies," says Tonya K. Edvalson, BS, CIP, research compliance manager of obstetrics and gynecology at the University of Utah School of Medicine.

Research nurses or assistants will visit a clinic and spend a day there, working with the clinic's staff to let them know which studies are enrolling and who might be a candidate for the study, says Michael W. Varner, MD, a professor of obstetrics and gynecology and vice-chair for research at the University of Utah School of Medicine in Salt Lake City, UT.

These visits need to accomplish two important goals: one, they inform the clinic staff and obtain some buy-in to finding potential subjects, and, two, they do not interfere with the clinic's workflow.

"The key is you can't slow down the clinic staff," Varner says.

"We let them know that their role is important," Edvalson says. "It takes a lot of work, space, and time to go out to the clinics, and we keep reinforcing and reminding our employees that they cannot impact the workflow of the clinics."

It's also important that the recruitment person who visits a clinic is the same person each time, to build continuity and to reduce confusion, she notes.

"We want this to be the same person as much as possible for all the studies," Edvalson says. "We don't want to have one nurse from each study showing up."

By developing a long-term relationship with the clinic staff, the research nurse sometimes is offered a small corner of the office or a cubicle where she can speak with patients about the study, Edvalson explains.

"The clinic staff might say, 'This person has five minutes before Dr. Smith is coming in, do you want to talk with her?'" she adds.

In addition, the recruitment nurse leaves fliers in the offices for patients to review.

"The fliers are generic and talk about our studies in a snapshot way," Edvalson says. "We've gotten a lot of response from those."

The recruitment process is time-consuming and labor intensive, but it's also effective.

For instance, for one study, there might be one in 50% women who would meet the enrollment criteria, Varner says.

"So we'll screen 100-plus pregnant women a week between the different clinics," he says.

One point that helps with the referral sources' buy-in is that collaborating on a National Institutes of Health-funded research study is a prestigious enterprise, Varner notes.

Also, there's an educational incentive.

"One thing we've done is put on a continuing medical education program at no charge for the people who allow us into their offices and give us access to their patients," Varner says. "We bring food and do this as a token of appreciation for their allowing us to access their patients."