Annals of Behavioral Medicine

, Volume 24, Issue 2, pp 157–166 | Cite as

Challenges to improving the impact of worksite cancer prevention programs: Comparing reach, enrollment, and attrition using active versus passive recruitment strategies

  • Laura A. Linnan
  • Karen M. Emmons
  • Neil Klar
  • Joseph L. Fava
  • Robert G. LaForge
  • David B. Abrams
Article

Abstract

Objective: The impact of worksite intervention studies is maximized when reach and enrollment are high and attrition is low. Differences in reach, enrollment, and retention were investigated by comparing 2 different employee recruitment methods for a home-based cancer-prevention intervention study. Methods: Twenty-two worksites (N = 10,014 employees) chose either active or passive methods to recruit employees into a home-based intervention study. Reach (e.g., number of employees who gave permission to be called at home), Enrollment (e.g., number of employees who joined the home intervention study), and Attrition (e.g., number who did not complete the 12- and 24-month follow-ups) were determined. Analysis at the cluster level assessed differences between worksites that selected active (n =12) versus passive (n = 10) recruitment methods on key outcomes of interest. Employees recruited by passive methods had significantly higher reach (74.5% vs. 24.4% for active) but significantly lower enrollment (41% vs. 78%) and retention (54% vs. 70%) rates (all ps = .0001). Passive methods also successfully enrolled a more diverse, high-risk employee sample. Passive (vs. active) recruitment methods hold advantages for increased reach and the ability to retain a more representative employee sample. Implications of these results for the design of future worksite studies that involve multilevel recruitment methods are discussed.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. (1).
    Glasgow RE, Vogt TM, Boles SM: Evaluating the public health impact of health promotion interventions: The RE-AIM framework.American Journal of Public Health. 1999,89:1322–1327.PubMedGoogle Scholar
  2. (2).
    Sorensen G, Emmons K, Hunt MK, Johnston D: Implications of the results of community intervention trials.Annual Review of Public Health. 1998,19:379–416.PubMedCrossRefGoogle Scholar
  3. (3).
    Wilson M, Holman PB, Hammock A: A comprehensive review of the effects of worksite health promotion on health-related outcomes.American Journal of Health Promotion. 1996,10:429–435.PubMedGoogle Scholar
  4. (4).
    Jeffrey RW, Forster JL, French SA, et al.: The Healthy Worker project: A worksite intervention for weight control and smoking cessation.American Journal of Public Health. 1993,83:395–401.Google Scholar
  5. (5).
    Glasgow RE, Terborg JR, Hollis JF, Severson HH, Boles SM: Take Heart: Results of the initial phase of a worksite wellness program.American Journal of Public Health. 1995,85:209–216.PubMedGoogle Scholar
  6. (6).
    Sorensen G, Thompson B, Glanz K, et al.: Worksite based cancer prevention: Primary results from the Working Well trial.American Journal of Public Health. 1996,86:939–947.PubMedCrossRefGoogle Scholar
  7. (7).
    Glasgow RE, McKaul KD, Fisher KJ: Participation in worksite health promotion: A critique of the literature and recommendations for future practice.Health Education Quarterly. 1993,20:391–408.PubMedGoogle Scholar
  8. (8).
    Resnicow K, Davis M, Smith M, et al.: Results of the Teachwell worksite wellness program.American Journal of Public Health. 1998,88:250–257.PubMedGoogle Scholar
  9. (9).
    Chapman LS: Maximizing program participation.The Art of Health Promotion. 1998,2(2): 1–8.Google Scholar
  10. (10).
    Crump CE, Earp JL, Kozma CM, Hertz-Picciotto I: Effect of or ganization-level variables on differential employee participation in 10 federal worksite health promotion programs.Health Education Quarterly. 1996,23:204–223.PubMedGoogle Scholar
  11. (11).
    Grosch JW, Alterman T, Peterson MR, Murphy LR: Worksite health promotion programs in the US: Factors associated with availability and participation.American Journal of Health Promotion. 1998,13:36–45.PubMedGoogle Scholar
  12. (12).
    Capaldi DM, Chamberlain P, Fetrow RA, Wilson JE: Conducting ecologically valid prevention research: Recruiting and retaining a “whole village” in multimethod, multiagent studies.American Journal of Community Psychology. 1997,25:471–492.PubMedCrossRefGoogle Scholar
  13. (13).
    Bjornson-Benson WM, Stibolt TB, Manske KA, et al.: Monitoring recruitment effectiveness and cost in a clinical trial.Controlled Clinical Trials. 1993,14:52S-67S.PubMedCrossRefGoogle Scholar
  14. (14).
    Altman D: Sustaining interventions in community systems: On the relationship between researchers and communities.Health Psychology. 1995,14:526–536.PubMedCrossRefGoogle Scholar
  15. (15).
    Conrad K: Threats to internal validity in worksite health promotion research: Common problems and possible solutions.American Journal of Health Promotion. 1991,6:74–81.Google Scholar
  16. (16).
    Abrams DB, Boutwell W, Grizzle J, et al.: Cancer control at the workplace: the Working Well Trial.Preventive Medicine. 1994,23:15–27.PubMedCrossRefGoogle Scholar
  17. (17).
    Prochaska JO, Redding CA, Evers KE: The transtheoretical model and stages of change. In Glanz K, Rimer B, Lewis F (eds),Health Behavior and Health Education (2nd Ed.). San Francisco: Jossey-Bass, 1997, 60–84.Google Scholar
  18. (18).
    Thompson B, VanLeynseele J, Beresford S: Recruiting worksites to participate in a health promotion research study.American Journal of Health Promotion. 1997,11:344–351.PubMedGoogle Scholar
  19. (19).
    Biener L, DePue J, Emmons K, Linnan L, Abrams D: Recruitment of worksites to a health promotion research trial.Journal of Occupational Medicine. 1994,36:631–636.PubMedGoogle Scholar
  20. (20).
    Emmons KM, Thompson B, Sorensen G, et al.: The relationen organizational characteristics and the adoption of workplace smoking policies.Health Education and Behavior.27:483-501.Google Scholar
  21. (21).
    Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: Toward an integrative model of change.Journal of Consulting and Clinical Psychology. 1983,51:390–395.PubMedCrossRefGoogle Scholar
  22. (22).
    Greene G, Rossi S: Stages of change for dietary fat reduction over 18 months.Journal of the American Dietetic Association. 1998,98:529–534.PubMedCrossRefGoogle Scholar
  23. (23).
    Greene GW, Rossi SR, Rossi JR, et al.: Dietary applications of the Stages of Change Model.Journal of the American Dietetic Association.99:673–678.Google Scholar
  24. (24).
    Rossi JS, Blais LM, Redding CA, Weinstock MA: Behavior change for reducing sun and ultraviolet light exposure: Implications for interventions.Dermatologic Clinics. 1995,13:613–622.PubMedGoogle Scholar
  25. (25).
    Marcus BM, Rossi JS, Selby V: The stages and processes of exercise adoption and maintenance in a worksite sample.Health Psychology. 1992,11:386–395.PubMedCrossRefGoogle Scholar
  26. (26).
    Donner A, Klar N: Methods for comparing event rates in intervention studies when the unit of allocation is a cluster.American Journal of Epidemiology. 1994,140:279–289.PubMedGoogle Scholar
  27. (27).
    Prochaska JO: A stage paradigm for integrating clinical and public health approaches to smoking cessation.Addictive Behaviors. 1996,21:721–732.PubMedCrossRefGoogle Scholar
  28. (28).
    Linnan LA, Abrams DB, Papandonatos GD, Emmons KE: Every Person Counts : Results of a randomized trial designed to increase employee participation in a comprehensive worksite health promotion program. Manuscript under review.Google Scholar
  29. (29).
    Thompson B, Bowen DJ, Croyle RT, Hopp HP, Fries E: Maxi mizing worksite survey response rates through community organization strategies and multiple contacts.American Journal of Health Promotion. 1991,6:130–136.PubMedGoogle Scholar
  30. (30).
    Sarkin JA, Marshall SJ, Larson KA, Calfas KJ, Sallis JF: A comparison of methods of recruitment to a health promotion program for university seniors.Preventive Medicine. 1998,27:562–571.PubMedCrossRefGoogle Scholar
  31. (31).
    Lee RE, McGinnis KA, Sallis JF, Castro CM, Chen AH: Active vs. passive methods of recruiting ethnic minority women to a health promotion program.Annals of Behavioral Medicine. 1997,19:378–384.PubMedGoogle Scholar
  32. (32).
    Baker EA, Israel BA, Schurman SJ: A participatory approach to worksite health promotion.Journal of Ambulatory Care Management. 1994,17(2):68–81.PubMedGoogle Scholar
  33. (33).
    Heaney CA, Israel BA, Schurman SJ, et al.: Industrial relations, worksite stress reduction and employee well-being: A participatory action research investigation.Journal of Organizational Behavior. 1993,14:495–510.CrossRefGoogle Scholar
  34. (34).
    Fisher E: Editorial: The results of the COMMIT trial.AmericanJournal of Public Health. 1995,85:159–160.Google Scholar
  35. (35).
    Abrams DB, Emmons KE, Linnan LA: Health behavior and health education: The past, present, and future. In Glanz K, Rimer B, Lewis F (eds),Health Behavior and Health Education (2nd Ed.). San Francisco: Jossey-Bass, 1997, 453–478.Google Scholar
  36. (36).
    Schensul JJ: Organizing community research partnerships in the struggle against AIDS.Health Education and Behavior. 1999,26:266–283.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2002

Authors and Affiliations

  • Laura A. Linnan
    • 1
    • 2
  • Karen M. Emmons
    • 3
  • Neil Klar
    • 3
  • Joseph L. Fava
    • 4
  • Robert G. LaForge
    • 4
  • David B. Abrams
    • 5
  1. 1.Center for Behavioral & Preventive MedicineBrown University Medical School and The Miriam Hospital, a Lifespan PartnerUSA
  2. 2.University of North Carolina-Chapel Hill School of Public HealthChapel Hill
  3. 3.Harvard School of Public Health and the Dana Farber Cancer InstituteUniversity of Rhode IslandUSA
  4. 4.University of Rhode IslandUSA
  5. 5.Center for Behavioral & Preventive MedicineBrown University Medical School and The Miriam Hospital, a Lifespan partnerUSA

Personalised recommendations