Table 1.

Barriers to recruitment, retention and intervention delivery

Challenge	Description	Resolution
Recruitment
Maximizing patient enrollment	• Unpredictable patient arrival times • Limited funding for full-time staff coverage	• Use of online resources for patient tracking • Flexible staff schedules • Prompt enrollment of discharged patients
Optimizing patient approach	• Working with medical care providers • Visiting friends and family • Imminent discharge	• Consultation with physicians on research staff • Consultation with medical care providers in hospital • Maintain rapport with medical care providers and visitors • Frequent check-ins • Leave brochure for patient to review
Retention
Retaining unresponsive participants	• Housing instability • Frequently changing phone numbers • Limited cellular service or internet access • Poor communication affecting intervention delivery	• Frequent communication attempts • Try all available methods and contacts • Attempt to meet patients at scheduled medical visits • Support Specialist independently attempt contact • Provide incentives to help with phone service/transportation • Offer visits in the community
Retaining participants with limited time	• Good communication but low availability • Working hours conflict with research staffing times • Poor availability affecting intervention delivery	• Data collection via in-person, phone and online • Use text messages, email, and social media for contact • Contact outside of work hours (e.g., evenings and weekends) • Meet at scheduled medical appointments • Combine follow-up and intervention appointments
Intervention Delivery
Connecting participants with community resources	• No limits on the areas of concern for recovery • Some needed resources unavailable (e.g., housing)	• Use well-trained staff with social work background • Community-based advisory team to help identify resources • Build rapport by focusing first on available resources • Rapport building helps with problem solving to identify other needed resources
Communication between research staff and Support Specialist	• First contact with the Support Specialist ideally in-person and in-hospital. • Options needed for patients discharging quickly • Some patients may not want face-to-face contact due to nature of injuries	• Research staff able to accurately describe intervention • Notify Support Specialist well in advance of initial approach • Flexible scheduling • Use phone-based delivery of the initial contact, if needed • Short intro video to familiarize patient with Support Specialist, if needed