Challenges faced in recruiting patients from primary care practices into a physical activity intervention trial

Susan Margitić, Mary Ann Sevic, Michael Miller, Cheryl Albright, Joyce Banton, Kelley Callahan, Melissa Garcia, Larry Gibbons, Benjamin J. Levine, Roger Anderson, Walter Ettinger

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Background. Special challenges are encountered when clinical trial recruitment targets a physician practice-based population, as opposed to recruiting from the community. Since most published information about recruitment has focused on the latter group, summation of successful primary- care-based recruitment strategies could prove useful for future trials recruiting from this population. Methods. The Activity Counseling Trial (ACT) is a multicenter, randomized clinical trial that evaluated approaches to primary care-based interventions to increase physical activity in sedentary adults 35-75 years of age. Fifty-four clinicians from eight practices recruited 874 participants from three U.S. sites. Recruitment challenges that related, in great part, to the primary care setting included: (1) focusing on patients from ACT physician practices who had regularly scheduled or intend- to-schedule appointments within the next year; (2) placing trial staff in the clinical offices for recruitment purposes; and (3) placing trial interventionists in the physicians' offices. Other challenges were related to recruitment of minorities and men. Results. Patient mailing yielded 43.4% of all randomized participants, followed by office-based questionnaires (32.5%) and direct telephone contact (21.6%). Based on a retrospective cost-effective analysis (indirect costs excluded), the self-administered office-based questionnaire was the least costly strategy for one site ($14/randomized participant), followed by patient mailing at another site ($58). The direct telephone contact method utilized at one site serving primarily a minority population yielded a per randomized participant cost of $80. Conclusions. Recruitment of clinical trial participants from practice-based populations requires modification of the strategies used to recruit from the community. Multiple strategies should be employed, followed closely for their respective yields, and adapted as needed.

Original languageEnglish (US)
Pages (from-to)277-286
Number of pages10
JournalPreventive Medicine
Issue number4
StatePublished - Oct 1999


  • Behavioral intervention
  • Clinical trial
  • Clinical trial recruitment
  • Cost- effective analysis
  • General practice
  • Physical activity
  • Primary care
  • Recruitment

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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