Strategies for Recruiting Low- Income Minority Fathers into an Adverse Childhood Experiences (ACE) Study Khalida Saalim SUMR Scholar Georgetown University Mentor: Roy Wade Jr., MPH, PhD, MD, MSHP
Overview Our Paternal ACE Study My Project Appreciation
Our Paternal ACE Study
Background on Adverse Childhood Experiences (ACE) In 1995-1997, the CDC and Kaiser Permanente conducted an ACE study which surveyed 17,000 adults in Southern California about their childhood experiences of abuse, neglect, and household challenges. The study showed the correlation between ACE and poor health outcomes across their life course. Research has shown that mothers ACE can impact their child s health outcomes. However, the effects of fathers ACE have not been studied.
The Paternal ACE Study Purpose: To study the impact of a father s ACE on their child s behavioral health Our study population: 500 children seen across CHOP primary care network between 2007-2015 Study Design: Both biological parents complete our survey about their parenting practices and their childhood experiences Survey responses will be merged with clinical data to examine the association between paternal ACE, parenting practices, and child behavioral disorders
Survey Completion Surveys Completed Since January 2018
Demographics of the Current Study Population Demographics of Respondent Fathers
My Project: Strategies for Recruiting Low- Income Minority Fathers into an Adverse Childhood Experiences (ACE) Study
Introduction Purpose: To enhance recruitment of low-income minority fathers in our paternal ACE study and to summarize the literature on effective recruitment methods for low-income minority fathers Our study population: Fathers who have not completed survey
Methods
Literature Review PubMed Searches: Recruitment AND low-income AND participation AND surveys (30 results) Recruitment AND minorities AND participation AND surveys (59 results) Recruitment AND men AND participation AND surveys (79 results) Recruitment AND parents AND participation AND surveys (69 results) Recruitment AND fathers AND participation AND surveys (5 results) Electronic mail AND surveys AND non-response (8 results) Telephone AND surveys AND nonresponse (94 results) Postal Services AND surveys AND non-response (60 results)
Conceptual Framework Conceptual Framework: Strategies to Increasing Recruitment in Low-Income Minority Males Who Are Fathers
Aim 1: Develop recruitment strategies to increase participation in our ACE study through literature review and conceptual framework Aims Aim 2: Revise these recruitment strategies based on input of low-income minority fathers Aim 3: Test the different recruitment strategies on our survey population
Intervention 1: Addressing Timing of Recruitment and Email Inaccessibility Intervention 1: Using postal mail as a survey contact method
Intervention 2a: Addressing Fathers Feelings of Insignificance Intervention 2a: A personalized card expressing our team s appreciation of fathers
Intervention 2b: Addressing Fathers Feelings of Insignificance Intervention 2b: An introduction paragraph on why their responses are significant to our study in the initial recruitment letter The Children s Hospital of Philadelphia is honored to invite fathers like you to participate in our research study. This research will help us understand how childhood stress can affect health. You have been asked to participate because your child, [CHILD NAME], visited one of the CHOP primary care locations between 2007 and 2015. As of today, most mothers have responded, but we are still missing information from some fathers. By completing the survey, your responses as a father may be used to create new ways to make our children healthier. Without your input, we will not be able to complete this study.
Intervention 2c: Addressing Fathers Feelings of Insignificance Intervention 2c: A modified version of the survey that includes only the questions relevant to fathers
Intervention 3: Addressing Insufficient Incentives and Medical Distrust Intervention 3: A pre-incentive with an initial $10-20 on a reloadable gift card allotted through postal mail upon providing their consent
Intervention 4: Addressing Unappealing Recruitment Materials Intervention 4: More noticeable postal letter with a solid color and IMPORTANT read on it to prevent it from being viewed as junk mail Original Letter Proposed Letter
Talk to an opportunistic sample of low-income minority fathers whose children are being seen at one of CHOPs pediatric care sites in West Philadelphia to: Next Steps: Review the wording of our recruitment materials Provide feedback on appearance of recruitment materials Revise and test our new recruitment strategies in our study population
Appreciation
How to conduct an in-depth and extensive literature review Lessons Learned Experience drafting a conceptual framework and specific aims The importance of understanding our study population and using this knowledge to strategize recruitment methods
Thank you... Dr. Roy Wade Macy Marcucci Danielle Collins The Leonard Davis Institute and the SUMR program
Questions?
Alexander, Gwen L., George W. Divine., Mick P. Couper, Jennifer B. McClure., Melanie A. Stopponi., Kristine K. Fortman., Dennis D. Tolsma Victor J. Strecher., Christine Cole Johnson Effect of Incentives and Mailing Features on Online Health Program Enrollment. American Journal of Preventive Medicine. Vol 37.: S195-200 Askelson, Natoshia M., Elizabeth H. Golembiewski., Barbara Baquero., Elizabeth T. Momany., Julia Friberg., Doris Montgomery. (2017). The importance of matching the evaluation population to the intervention population: Using Medicaid data to reach hard-to-reach intervention populations. Evaluation and Program Planning. Vol 60: 64-71. References Davidson, Kirsten K., Jo N. Charles., Neha Khandpur., Timothy J. Nelson. (2017). Fathers Perceived Reasons for Their Underrepresentation in Child Health Research and Strategies to Increase Their Involvement. Maternal and Child Health Journal. Vol 21: 267-274 Edwards, PJ., I. Roberts, MJ. Clarke; C., Diguiseppi., R. Wentz., I. Kwan., R. Cooper.,; LM Felix., S. Pratap. (2009) Methods to increase response to postal and electronic questionnaires. Cochrane Database. System Review. Vol 3: 3 Felitti, Vincent J., Robert F. Anda, Dale Nordenberg, David F. Williamson., Alison M. Spitz., Valerie Edwards., Mary P. Koss., James S. Marks. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine. Vol 14: 245-258
Kiezebrink, Kirsty., Iain K. Crombie., Linda Irvine., Vivien Swanson., Kevin Power., Wendy L. Wrieden., Peter W. Slane. (2009). Strategies for achieving a high response rate in a home interview survey. BMC Medical Research Methodology. Vol 9: 46 Lang R., VA Kelkar, JR Byrd., CL Edwards., M Pericak-Vance., GS Byrd. (2013). African American participation in health-related research studies: indicators for effective recruitment. Journal of Public Health Management and Practice. Vol 19: 110-8 References (Cont.) Ofstedal, Mary B. and David R. Weir. (2011). Recruitment and Retention of Minority Participants in the Health and Retirement Study. Gerontologist. Vol 51: S8-20 Rocheleau, CM., PA Romitti., SH Sherlock, WT Sanderson., EM Bell., C. Druschel. (2012). Effect of survey instrument on participation in a follow-up study: a randomization study of a mailed questionnaire versus a computer-assisted telephone interview. BMC Public Health. Vol 12: 579. Stern, Michael J., Bilgen, Ipek., and Dillman, Don A. (2014). The State of Survey Methodology: Challenges, Dilemmas, and New Frontiers in the Era of the Tailored Design. Field Methods. Vol 26: 286-301 Williams MT., D Proetto., D Casiano., ME Franklin. (2012). Recruitment of a hidden population: African Americans with obsessive-compulsive disorder. Contemporary Clinical Trials. Vol ;33:67 75