Research in Gerontological Nursing

Special Focus: Recruitment Challenges 

Enrolling Older Adults with Cognitive Impairment in Research: Lessons from a Study of Tai Chi for Osteoarthritis Knee Pain

Pao-Feng Tsai, PhD, RN; Jason Y. Chang, PhD; Nupur Chowdhury, MA; Cornelia Beck, PhD, RN; Paula K. Roberson, PhD; Karl Rosengren, PhD

Abstract

Exercise is an adjunct intervention for treating osteoarthritis (OA) knee pain, but many older adults, especially those with cognitive impairment, refuse to participate because of their frailty. Tai chi is a gentle alternative to Western-style aerobic exercise. In this article, we report recruitment experiences based on older adults’ comments and on staff’s observations and reports in a pilot randomized controlled trial (RCT) using tai chi as an intervention to reduce OA knee pain in a population of older adults with cognitive impairment. Recruitment challenges included issues with retirement apartment site staff, the older adults, study criteria or study design, and insufficient research staff. Strategies included networking and staying connected with site staff, using various recruiting approaches, providing incentives/motivation, and using informal leaders or residents as a way to recruit participants. Finally, modifying strict study criteria, securing staff for recruiting, and considering alternative designs to the classical RCT can also help overcome recruitment challenges.

Abstract

Exercise is an adjunct intervention for treating osteoarthritis (OA) knee pain, but many older adults, especially those with cognitive impairment, refuse to participate because of their frailty. Tai chi is a gentle alternative to Western-style aerobic exercise. In this article, we report recruitment experiences based on older adults’ comments and on staff’s observations and reports in a pilot randomized controlled trial (RCT) using tai chi as an intervention to reduce OA knee pain in a population of older adults with cognitive impairment. Recruitment challenges included issues with retirement apartment site staff, the older adults, study criteria or study design, and insufficient research staff. Strategies included networking and staying connected with site staff, using various recruiting approaches, providing incentives/motivation, and using informal leaders or residents as a way to recruit participants. Finally, modifying strict study criteria, securing staff for recruiting, and considering alternative designs to the classical RCT can also help overcome recruitment challenges.

Authors

Dr. Tsai is Associate Professor, and Ms. Chowdhury is a Research Assistant, College of Nursing, Dr. Chang is Associate Professor, Department of Neurobiology and Developmental Sciences, Dr. Beck is Professor, Department of Geriatrics, College of Medicine, and Dr. Roberson is Professor and Chair, Department of Biostatistics, Colleges of Medicine and Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Dr. Rosengren is Professor, Department of Psychology, Northwestern University, Evanston, Illinois.

The authors disclose that they have no financial interests in any product or class of products discussed directly or indirectly in this study. This study was supported by the National Institute of Nursing Research (R21NR010003) and Alzheimer’s Arkansas. Without the research participants, facility administrator and staff, Catherine Doan, and Nola Ballinger, this study could not have been completed.

Address correspondence to Pao-Feng Tsai, PhD, RN, Associate Professor, College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #529, Little Rock, AR 72205; e-mail: TsaiPaofeng@uams.edu.

Received: April 20, 2009
Accepted: June 23, 2009
Posted Online: September 03, 2009

10.3928/19404921-20090731-03

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