of human research but is perhaps the most challenging element. Therefore, let’s consider how various parties are affected by recruiting problems.
First are the researchers. Many beginning researchers underestimate the effort and time required to recruit and enroll participants, resulting in budget and timetable issues. Severe problems with obtaining an adequate sample can be daunting to doctoral students, who may lose enthusiasm for the research enterprise as they struggle to locate the individuals who meet the detailed criteria they created in their proposal. Experienced researchers may wrestle with attrition in intervention or longitudinal studies, wreaking havoc with the predicted number of completed protocols. Although considerable attention has been paid to strategies for recruiting underrepresented and vulnerable groups, it provides little comfort when recruiting efforts are met with human resistance.
Second, agencies are rightly concerned about funded studies that do not result in adequate sample size. It is easy to spend awarded money without reaching the projected sample size. It is critical to demonstrate feasibility of recruiting and enrollment in pilot studies. Without pilot data, the question about whether the sample can, in fact, be obtained remains unanswered. With the use of power analysis in quantitative studies, researchers are easily able to tell whether there is a difference between groups or an association between variables and avoid a type II (i.e., false negative) error.
Third, dissemination of findings is at risk if sampling is inadequate. Representative sampling is required to generalize from the sample to the larger population of interest. Nursing science advances through systematic research studies that build on valid sampling. As Levkoff and Sanchez (2003) noted, “If recruitment lags, it is unlikely that results will be generalizable to the studied population; if retention lags, questions arise about the validity of conclusions drawn by study investigators” (p. 18). Underpowered studies are less likely to be published, possibly leading to a dead end for promising ideas. On the other hand, if journals publish underpowered studies, numerous reports of no effect or nonsignificance can lead to diminishing interest in clinical research.
A final concern is the burden that falls on the participants who willingly gave their time and effort. Would they have consented and participated if they knew the results would not be disseminated or published? This poses an ethical issue that is seldom discussed.
Despite their importance, the many areas critical to successful sampling are not given their just due in journals. The focus articles in this issue of Research in Gerontological Nursing are devoted to a number of issues germane to research sampling with older adults. All studies were funded and describe associated challenges and approaches to deal with the issues. Tsai et al. address issues encountered in recruiting vulnerable, older adults with cognitive impairment in a community setting and share strategies developed during their recruitment phase. Souder and Terry detail the challenges of recruiting Black adults in a southern state and how they found success by teaming with a member of the minority group who worked as a lay educator, with the goal of recruiting into a clinical study. Lefler discusses findings and challenges in using a faith-based approach to recruiting through churches, appropriately referring to her recommendations as the “ten commandments.” Cole, Doan, Ballinger, and Brown venture into the area of recruitment costs and point out the need for good management skills in documenting recruitment efforts. McSweeney, Pettey, Fischer, and Spellman identify issues relevant to longitudinal research that takes place across multiple sites and share experiences that facilitated participant and site retention.
I trust that these experiences from the trenches will guide others and spark your own creative analyses and strategies, and that, in turn, you will share your learning with other researchers.
Elaine Souder, PhD, RN
University of Arkansas for Medical Sciences
College of Nursing
Little Rock, Arkansas
- Levkoff, S. & Sanchez, H. (2003). Lessons learned about minority recruitment and retention from the Centers on Minority Aging and Health Promotion. The Gerontologist, 43, 18–26.