Skip to main content
Top
Published in: BMC Medical Research Methodology 1/2009

Open Access 01-12-2009 | Research article

Recruitment to a physical activity intervention study in women at increased risk of breast cancer

Authors: Larissa A Korde, Amy Micheli, Ashley W Smith, David Venzon, Sheila A Prindiville, Bart Drinkard, Nancy Sebring, Marcia D Smith, Jo Anne Zujewski, Jennifer Eng-Wong

Published in: BMC Medical Research Methodology | Issue 1/2009

Login to get access

Abstract

Background

Physical activity is being studied as a breast cancer prevention strategy. Women at risk of breast cancer report interest in lifestyle modification, but recruitment to randomized physical activity intervention studies is challenging.

Methods

We conducted an analysis of recruitment techniques used for a prospective, randomized pilot study of physical activity in women at risk of breast cancer. We evaluated differences in proportion of eligible patients, enrolled patients, and successful patients identified by each individual recruitment method. The Fisher-Freeman-Halton test (an extension of Fisher's exact test from 2 × 2 tables to general row by column tables) was used to compare the success of different recruitment strategies.

Results

We received 352 inquiries from women interested in participating, of whom 171 (54%) were eligible. Ninety-nine women completed a baseline activity evaluation, and 58 (34% of eligible; 16% of total inquiries) were randomized. Recruitment methods fell into three broad categories: media techniques, direct contact with potential participants, and contacts with health care providers. Recruitment strategies differed significantly in their ability to identify eligible women (p = 0.01), and women who subsequently enrolled in the study (p = 0.02).

Conclusion

Recruitment techniques had varying success. Our data illustrate the challenges in recruiting to behavior modification studies, and provide useful information for tailoring future recruitment efforts for lifestyle intervention trials.

Trial Registration No(s)

CDR0000393790, NCI-04-C-0276, NCI-NAVY-B05-001
Appendix
Available only for authorised users
Literature
1.
go back to reference Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al: Cancer statistics, 2008. CA Cancer J Clin. 2008, 58 (2): 71-96. 10.3322/CA.2007.0010.CrossRefPubMed Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al: Cancer statistics, 2008. CA Cancer J Clin. 2008, 58 (2): 71-96. 10.3322/CA.2007.0010.CrossRefPubMed
2.
go back to reference Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al: Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998, 90 (18): 1371-88. 10.1093/jnci/90.18.1371.CrossRefPubMed Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al: Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998, 90 (18): 1371-88. 10.1093/jnci/90.18.1371.CrossRefPubMed
3.
go back to reference Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS, Atkins JN, et al: Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. Jama. 2006, 295 (23): 2727-41. 10.1001/jama.295.23.joc60074.CrossRefPubMed Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS, Atkins JN, et al: Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. Jama. 2006, 295 (23): 2727-41. 10.1001/jama.295.23.joc60074.CrossRefPubMed
4.
go back to reference Port ER, Montgomery LL, Heerdt AS, Borgen PI: Patient reluctance toward tamoxifen use for breast cancer primary prevention. Ann Surg Oncol. 2001, 8 (7): 580-5. 10.1007/s10434-001-0580-9.CrossRefPubMed Port ER, Montgomery LL, Heerdt AS, Borgen PI: Patient reluctance toward tamoxifen use for breast cancer primary prevention. Ann Surg Oncol. 2001, 8 (7): 580-5. 10.1007/s10434-001-0580-9.CrossRefPubMed
5.
go back to reference Tchou J, Hou N, Rademaker A, Jordan VC, Morrow M: Acceptance of tamoxifen chemoprevention by physicians and women at risk. Cancer. 2004, 100 (9): 1800-6. 10.1002/cncr.20205.CrossRefPubMed Tchou J, Hou N, Rademaker A, Jordan VC, Morrow M: Acceptance of tamoxifen chemoprevention by physicians and women at risk. Cancer. 2004, 100 (9): 1800-6. 10.1002/cncr.20205.CrossRefPubMed
6.
go back to reference Albanes D, Blair A, Taylor PR: Physical activity and risk of cancer in the NHANES I population. Am J Public Health. 1989, 79 (6): 744-50. 10.2105/AJPH.79.6.744.CrossRefPubMedPubMedCentral Albanes D, Blair A, Taylor PR: Physical activity and risk of cancer in the NHANES I population. Am J Public Health. 1989, 79 (6): 744-50. 10.2105/AJPH.79.6.744.CrossRefPubMedPubMedCentral
7.
go back to reference McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, et al: Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study. Jama. 2003, 290 (10): 1331-6. 10.1001/jama.290.10.1331.CrossRefPubMed McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, et al: Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study. Jama. 2003, 290 (10): 1331-6. 10.1001/jama.290.10.1331.CrossRefPubMed
8.
go back to reference Rockhill B, Willett WC, Hunter DJ, Manson JE, Hankinson SE, Colditz GA: A prospective study of recreational physical activity and breast cancer risk. Arch Intern Med. 1999, 159 (19): 2290-6. 10.1001/archinte.159.19.2290.CrossRefPubMed Rockhill B, Willett WC, Hunter DJ, Manson JE, Hankinson SE, Colditz GA: A prospective study of recreational physical activity and breast cancer risk. Arch Intern Med. 1999, 159 (19): 2290-6. 10.1001/archinte.159.19.2290.CrossRefPubMed
9.
go back to reference Thune I, Brenn T, Lund E, Gaard M: Physical activity and the risk of breast cancer. N Engl J Med. 1997, 336 (18): 1269-75. 10.1056/NEJM199705013361801.CrossRefPubMed Thune I, Brenn T, Lund E, Gaard M: Physical activity and the risk of breast cancer. N Engl J Med. 1997, 336 (18): 1269-75. 10.1056/NEJM199705013361801.CrossRefPubMed
10.
go back to reference Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA: Physical activity and survival after breast cancer diagnosis. Jama. 2005, 293 (20): 2479-86. 10.1001/jama.293.20.2479.CrossRefPubMed Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA: Physical activity and survival after breast cancer diagnosis. Jama. 2005, 293 (20): 2479-86. 10.1001/jama.293.20.2479.CrossRefPubMed
11.
go back to reference Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L, et al: Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007, 25 (17): 2345-51. 10.1200/JCO.2006.08.6819.CrossRefPubMedPubMedCentral Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L, et al: Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007, 25 (17): 2345-51. 10.1200/JCO.2006.08.6819.CrossRefPubMedPubMedCentral
12.
go back to reference Rundle A: Molecular epidemiology of physical activity and cancer. Cancer Epidemiol Biomarkers Prev. 2005, 14 (1): 227-36.PubMed Rundle A: Molecular epidemiology of physical activity and cancer. Cancer Epidemiol Biomarkers Prev. 2005, 14 (1): 227-36.PubMed
13.
go back to reference Church TS, Earnest CP, Skinner JS, Blair SN: Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. Jama. 2007, 297 (19): 2081-91. 10.1001/jama.297.19.2081.CrossRefPubMed Church TS, Earnest CP, Skinner JS, Blair SN: Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. Jama. 2007, 297 (19): 2081-91. 10.1001/jama.297.19.2081.CrossRefPubMed
14.
go back to reference Daley AJ, Crank H, Mutrie N, Saxton JM, Coleman R: Patient recruitment into a randomised controlled trial of supervised exercise therapy in sedentary women treated for breast cancer. Contemp Clin Trials. 2007, 28 (5): 603-13. 10.1016/j.cct.2007.02.009.CrossRefPubMed Daley AJ, Crank H, Mutrie N, Saxton JM, Coleman R: Patient recruitment into a randomised controlled trial of supervised exercise therapy in sedentary women treated for breast cancer. Contemp Clin Trials. 2007, 28 (5): 603-13. 10.1016/j.cct.2007.02.009.CrossRefPubMed
15.
go back to reference Irwin ML, Cadmus L, Alvarez-Reeves M, O'Neil M, Mierzejewski E, Latka R, et al: Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial: the Yale Exercise and Survivorship Study. Cancer. 2008, 112 (11 Suppl): 2593-606. 10.1002/cncr.23446.CrossRefPubMed Irwin ML, Cadmus L, Alvarez-Reeves M, O'Neil M, Mierzejewski E, Latka R, et al: Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial: the Yale Exercise and Survivorship Study. Cancer. 2008, 112 (11 Suppl): 2593-606. 10.1002/cncr.23446.CrossRefPubMed
16.
go back to reference Rhew I, Yasui Y, Sorensen B, Ulrich CM, Neuhouser ML, Tworoger SS, et al: Effects of an exercise intervention on other health behaviors in overweight/obese post-menopausal women. Contemp Clin Trials. 2007, 28 (4): 472-81. 10.1016/j.cct.2007.01.002.CrossRefPubMed Rhew I, Yasui Y, Sorensen B, Ulrich CM, Neuhouser ML, Tworoger SS, et al: Effects of an exercise intervention on other health behaviors in overweight/obese post-menopausal women. Contemp Clin Trials. 2007, 28 (4): 472-81. 10.1016/j.cct.2007.01.002.CrossRefPubMed
17.
go back to reference Tudor-Locke C, Bassett DR: How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med. 2004, 34 (1): 1-8. 10.2165/00007256-200434010-00001.CrossRefPubMed Tudor-Locke C, Bassett DR: How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med. 2004, 34 (1): 1-8. 10.2165/00007256-200434010-00001.CrossRefPubMed
18.
go back to reference Welk GJ, Differding JA, Thompson RW, Blair SN, Dziura J, Hart P: The utility of the Digi-walker step counter to assess daily physical activity patterns. Med Sci Sports Exerc. 2000, 32 (9 Suppl): S481-8.CrossRefPubMed Welk GJ, Differding JA, Thompson RW, Blair SN, Dziura J, Hart P: The utility of the Digi-walker step counter to assess daily physical activity patterns. Med Sci Sports Exerc. 2000, 32 (9 Suppl): S481-8.CrossRefPubMed
19.
go back to reference Iwane M, Arita M, Tomimoto S, Satani O, Matsumoto M, Miyashita K, et al: Walking 10,000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension. Hypertens Res. 2000, 23 (6): 573-80. 10.1291/hypres.23.573.CrossRefPubMed Iwane M, Arita M, Tomimoto S, Satani O, Matsumoto M, Miyashita K, et al: Walking 10,000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension. Hypertens Res. 2000, 23 (6): 573-80. 10.1291/hypres.23.573.CrossRefPubMed
20.
go back to reference Moreau KL, Degarmo R, Langley J, McMahon C, Howley ET, Bassett DR, et al: Increasing daily walking lowers blood pressure in postmenopausal women. Med Sci Sports Exerc. 2001, 33 (11): 1825-31. 10.1097/00005768-200111000-00005.CrossRefPubMed Moreau KL, Degarmo R, Langley J, McMahon C, Howley ET, Bassett DR, et al: Increasing daily walking lowers blood pressure in postmenopausal women. Med Sci Sports Exerc. 2001, 33 (11): 1825-31. 10.1097/00005768-200111000-00005.CrossRefPubMed
21.
go back to reference Swartz AM, Strath SJ, Bassett DR, Moore JB, Redwine BA, Groer M, et al: Increasing daily walking improves glucose tolerance in overweight women. Prev Med. 2003, 37 (4): 356-62. 10.1016/S0091-7435(03)00144-0.CrossRefPubMed Swartz AM, Strath SJ, Bassett DR, Moore JB, Redwine BA, Groer M, et al: Increasing daily walking improves glucose tolerance in overweight women. Prev Med. 2003, 37 (4): 356-62. 10.1016/S0091-7435(03)00144-0.CrossRefPubMed
22.
go back to reference Croteau KA: A preliminary study on the impact of a pedometer-based intervention on daily steps. Am J Health Promot. 2004, 18 (3): 217-20.CrossRefPubMed Croteau KA: A preliminary study on the impact of a pedometer-based intervention on daily steps. Am J Health Promot. 2004, 18 (3): 217-20.CrossRefPubMed
23.
go back to reference Lindberg R: Active living: on the road with the 10,000 Steps program. J Am Diet Assoc. 2000, 100 (8): 878-9. 10.1016/S0002-8223(00)00251-0.CrossRefPubMed Lindberg R: Active living: on the road with the 10,000 Steps program. J Am Diet Assoc. 2000, 100 (8): 878-9. 10.1016/S0002-8223(00)00251-0.CrossRefPubMed
24.
go back to reference Rooney B, Smalley K, Larson J, Havens S: Is knowing enough? Increasing physical activity by wearing a pedometer. Wmj. 2003, 102 (4): 31-6.PubMed Rooney B, Smalley K, Larson J, Havens S: Is knowing enough? Increasing physical activity by wearing a pedometer. Wmj. 2003, 102 (4): 31-6.PubMed
25.
go back to reference Saunders D, Saunders R: Evaluation, Treatment and Prevention of Musculoskeletal Disorders. Chaska MN. 1993, 3 Saunders D, Saunders R: Evaluation, Treatment and Prevention of Musculoskeletal Disorders. Chaska MN. 1993, 3
26.
go back to reference Program DP: Lifestyle Manuals of Operations. 1996, University of Pittsburgh, Pittsburgh, PA Program DP: Lifestyle Manuals of Operations. 1996, University of Pittsburgh, Pittsburgh, PA
27.
go back to reference Buxton JA, Bottorff JL, Balneaves LG, Richardson C, McCullum M, Ratner PA, et al: Women's perceptions of breast cancer risk: are they accurate?. Can J Public Health. 2003, 94 (6): 422-6.PubMed Buxton JA, Bottorff JL, Balneaves LG, Richardson C, McCullum M, Ratner PA, et al: Women's perceptions of breast cancer risk: are they accurate?. Can J Public Health. 2003, 94 (6): 422-6.PubMed
28.
go back to reference Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR: Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007, 25 (17): 2352-9. 10.1200/JCO.2006.07.9988.CrossRefPubMed Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR: Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007, 25 (17): 2352-9. 10.1200/JCO.2006.07.9988.CrossRefPubMed
29.
go back to reference Ott CD, Twiss JJ, Waltman NL, Gross GJ, Lindsey AM: Challenges of recruitment of breast cancer survivors to a randomized clinical trial for osteoporosis prevention. Cancer Nurs. 2006, 29 (1): 21-31. 10.1097/00002820-200601000-00004.CrossRefPubMed Ott CD, Twiss JJ, Waltman NL, Gross GJ, Lindsey AM: Challenges of recruitment of breast cancer survivors to a randomized clinical trial for osteoporosis prevention. Cancer Nurs. 2006, 29 (1): 21-31. 10.1097/00002820-200601000-00004.CrossRefPubMed
30.
go back to reference Sharp L, Cotton SC, Alexander L, Williams E, Gray NM, Reid JM: Reasons for participation and non-participation in a randomized controlled trial: postal questionnaire surveys of women eligible for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears). Clin Trials. 2006, 3 (5): 431-42. 10.1177/1740774506070812.CrossRefPubMed Sharp L, Cotton SC, Alexander L, Williams E, Gray NM, Reid JM: Reasons for participation and non-participation in a randomized controlled trial: postal questionnaire surveys of women eligible for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears). Clin Trials. 2006, 3 (5): 431-42. 10.1177/1740774506070812.CrossRefPubMed
31.
go back to reference Rubin RR, Fujimoto WY, Marrero DG, Brenneman T, Charleston JB, Edelstein SL, et al: The Diabetes Prevention Program: recruitment methods and results. Control Clin Trials. 2002, 23 (2): 157-71. 10.1016/S0197-2456(01)00184-2.CrossRefPubMed Rubin RR, Fujimoto WY, Marrero DG, Brenneman T, Charleston JB, Edelstein SL, et al: The Diabetes Prevention Program: recruitment methods and results. Control Clin Trials. 2002, 23 (2): 157-71. 10.1016/S0197-2456(01)00184-2.CrossRefPubMed
32.
go back to reference Tworoger SS, Yasui Y, Ulrich CM, Nakamura H, LaCroix K, Johnston R, et al: Mailing strategies and recruitment into an intervention trial of the exercise effect on breast cancer biomarkers. Cancer Epidemiol Biomarkers Prev. 2002, 11 (1): 73-7.PubMed Tworoger SS, Yasui Y, Ulrich CM, Nakamura H, LaCroix K, Johnston R, et al: Mailing strategies and recruitment into an intervention trial of the exercise effect on breast cancer biomarkers. Cancer Epidemiol Biomarkers Prev. 2002, 11 (1): 73-7.PubMed
33.
go back to reference Thoolen B, de Ridder D, Bensing J, Gorter K, Rutten G: Who participates in diabetes self-management interventions?: Issues of recruitment and retainment. Diabetes Educ. 2007, 33 (3): 465-74. 10.1177/0145721707301491.CrossRefPubMed Thoolen B, de Ridder D, Bensing J, Gorter K, Rutten G: Who participates in diabetes self-management interventions?: Issues of recruitment and retainment. Diabetes Educ. 2007, 33 (3): 465-74. 10.1177/0145721707301491.CrossRefPubMed
Metadata
Title
Recruitment to a physical activity intervention study in women at increased risk of breast cancer
Authors
Larissa A Korde
Amy Micheli
Ashley W Smith
David Venzon
Sheila A Prindiville
Bart Drinkard
Nancy Sebring
Marcia D Smith
Jo Anne Zujewski
Jennifer Eng-Wong
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2009
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/1471-2288-9-27

Other articles of this Issue 1/2009

BMC Medical Research Methodology 1/2009 Go to the issue