Skip to main content
. Author manuscript; available in PMC: 2022 Dec 1.
Published in final edited form as: Obes Rev. 2021 Sep 1;22(12):e13335. doi: 10.1111/obr.13335

Table 4.

Data extraction for studies included in the systematic review assessing facilitators and barriers of children participation in nutrition, physical activity, and obesity interventions from the researchers’ perspective

Author
(s)		 Study name
or aim		 Type of
study		 Population Setting and
dates of study		 Ethics Outcome
(s)		 Methods Facilitators Barriers
Blanchet et al. (2015)36 Strategies and challenges in recruiting black immigrant mothers for a community-based study. Mixed methods (non RCT) 259 mothers of 6-12-year black immigrant children of African and Caribbean decent. Ottawa, Ontario, Canada. 2014 - 2015 IRB approval and consent & assent obtained from participants Diet Review of calling lists, consultation with recruiters, verification of emails, and participants’ calls.
Interviews were conducted at participants’ home in French or English

  • short time;

  • immediate and meaningful distribution of incentives;

  • convenient time and place (church, home, workplace).

  • inability to provide translation;

  • mistrust of white researchers advancing own career;

  • immigrants & refugees concerned about how their personal information would be used and shared;

  • afraid of being judged;

  • no interest.
Chang et al. (2009)50 Participant recruitment and retention in a program to prevent weight gain in overweight mothers. Mixed Methods (RCT) 129 low-income overweight young mothers with children 0-3.5 years Southern Michigan Woman Infant Children (WIC) programs, USA. 2007 IRB approval and consent & assent obtained from participants Diet, physical activity, stress management Identification of predictors from data review and recruiters' log notes.

  • emphasizing confidentiality;

  • video of procedures, protocols, and incentives;

  • culturally sensitive recruiters;

  • collaboration with WIC-university;

  • monetary incentives;

  • respect & rapport from staff;

  • speaking to one mother

  • lack of interest because of their previous failures with weight loss programs.
Croyden et al. (2018)51 Lessons learnt from the child obesity management program in Australia: PEACH™. Mixed Methods (RCT) 353 parents of children 5-17 years PEACH study. Queensland, Australia. 2011-2016 IRB approval and consent & assent obtained from participants. Obesity Narrative review of recruitment strategies and evaluation of study records.

  • Self-referral (via website and/or toll-free number) most effective;

  • Referral from health professional or hospital waiting list;

  • advertisements in school newsletters, media and print advertising

  • N/A
Cruz et al. (2014)44 Child Health Initiative for Lifelong Eating and Exercise (CHILE). Mixed methods (RCT) 1,879 children, 655 parents, 7 grocery stores and 14 healthcare providers from low-income communities in rural areas with high prevalence of American Indian 16 Head Start centers in New Mexico, USA. 2006- 2010 IRB approval and consent & assent obtained from participants. Tribe also reviewed protocols, agreements, and resolutions and provided a letter of support. Obesity prevention program Interviews conducted with parents being recruited for a multi-level, group RCT and review of study records.

  • Use of reminder calls the day before and the morning of the interviews

  • Spending more days at smaller sites to recruit from a smaller pool of potential participants

  • Over-recruiting in anticipation of participants failing to come to an appointment

  • Use of a physician member of the research team to contact healthcare providers directly increased participation.

  • Scheduling recruitment meetings over lunch and providing lunch was an efficient use of time and proved to increase participation rates.

  • Individuals who agreed to an appointment but did not show up for the interview

  • Work schedules and obligations

  • Timing of CHILE family events

  • Funding constraints.
Cui Z et al. (2019)38 Recruitment strategies for the Childhood Obesity Prevention and Treatment Research (COPTR) Consortium. Mixed Methods (RCT) 1745 parents and children (racially/ethnically diverse; many were recent immigrant families) family, school, clinic, churches, grocery stores, recreational centers in Cleveland, Minnesota, California, Tennessee, USA IRB approval and consent obtained from participants.
Inclusion of certificate of confidentiality or explicit discussion of the privacy of participant		 Obesity Data review of strategies used.

A group of parents preview the consent materials,

  • flexible study schedules (outside regular work hours);

  • clear detailed recruitment protocols (reading levels of the consent materials were <7th grade);

  • repeated contacts;

  • existing trustful relationships with the community;

  • use of community liaison;

  • tracking database (i.e. Redcap);

  • culturally sensitive staff;

  • face-to-face recruitment;

  • personal style of staff.

  • long wear of accelerometer;

  • lack of interest;

  • lack of understanding or knowledge of the research;

  • busy family schedules;

  • lack of transportation;

  • narrow eligibility criteria;

  • no value for obesity prevention;

  • long trial commitment;

  • low number of participants;

  • inaccurate phone numbers;

  • inability to reach caregivers.
Czymoniewicz et al. (2017)37 Patterns of participation in the Grow Face-to-Face and Grow Online parenting program. Mixed Methods (non-RCT) 111 parents with health children 5-10 years old Local YMCA in central Pennsylvania, USA. 2015-2017 Consent obtained from participants Obesity prevention Review of attendance records, surveys and semi-structured, in-depth interviews.

  • E-gift card incentives

  • time burden (no additional information was given).

  • too much to do;

  • lack of interpersonal interaction;

  • relevance of program content.
DeFrank et al. (2019)39 Recruitment and retention strategies and lessons learned from the Intervention INC trial. Mixed Methods (RCT) Black/AA and Latino children (ages 9–12 years) and their parent/guardian Community/school-based organizations in low-income neighborhoods. Harlem, New York, USA IRB approval and consent & assent obtained from participants Obesity prevention Review of recruitment strategies.

  • community & school events;

  • flyers in the community;

  • referrals from friends & other participants;

  • frequent reminders before appointments;

  • relaxed inclusion criteria;

  • partnered with community organizations, schools, etc.;

  • provided education and food;

  • extended recruitment period;

  • increased time in community;

  • Bilingual staff

  • outdated contact information from community partners;

  • short recruitment target time;

  • frequent no-shows and cancelations for baseline visits;

  • parents provided inaccurate estimates of child’s height and weight;

  • difficulty recruiting children in overweight/obese BMI percentile categories
Fleming et al. (2015)46 Evaluation of recruitment methods for a trial targeting childhood obesity: Families for Health RCT. Mixed Methods (RCT) 115 families with obese children aged 6–11 years Medical centers, schools, community, public events. West Midlands, UK. 2010-2014 IRB approval and consent & assent obtained from participants Obesity treatment Evaluation of study records and questionnaire and interviews with recruited parents/caregivers.

Recruitment: 24 months (2012-2013);
Data collection for 10 weeks; sessions 2.5 hours/wk on Saturdays;
Duration of focus interview: 20 minutes

  • targeted letter from healthcare professionals;

  • referrals from healthcare professionals;

  • Posters and flyers posted in schools, clinics, internet, etc.;

  • in-person interviews and q;

  • giving time to families to consider their participation;

  • unable to contact interested potential participants;

  • intervention activities scheduled only on Saturdays;

  • transportation issues

  • study too long (10 weeks; sessions 2.5 hours/wk).
Gerards et al. (2012)34 Barriers for health care professionals for referring parents of overweight children to an obesity prevention intervention. Qualitative 16 nurses, physicians and management staff from 11 clinics attending parents of overweight children aged 11 health clinics, Maastrich, The Netherlands. 2010 Consent obtained from participants Obesity prevention Semi-structured interviews to health care professionals.

  • appropriate center to reach youth

  • consistent messages from the different organizations;

  • involvement of different organizations (general practitioners, schools, day-care centers, etc.)

  • parents do not recognize their child as overweight;

  • lack of enough resources;

  • lack of time for physician to explain the study;

  • lack of involvement from nurses should be more closely

  • lack of study information to health staff;

  • lack of involvement from all relevant stakeholders
Guzman et al. (2009)40 Recruitment and retention of Latino children in a lifestyle intervention. Mixed Methods (RCT) 159 Latino parents and children Clinical setting in North Carolina, USA. 2005-2006 IRB approval and consent & assent obtained from participants. Consents were provided in English or Spanish. Lifestyle intervention Review of recruitment strategies.

  • referrals from community pediatric offices;

  • media efforts and community organization outreach;

  • family referrals;

  • wellness van

  • lack of time (to help with this, clinic time was changed to early evening and Saturdays);

  • family competing priorities;

  • transportation;

  • caring for other children;

  • lack of bilingual staff
Kafka et al. (2008)35 To explore children's motivations and barriers to nutrition research participation. Qualitative 35 children aged 7–10 years recreational and competitive
soccer players		 Indoor sports center. Acton, Massachusetts, USA. 2008 IRB approval and consent & assent obtained from participants Nutrition Focus group with children to learn how to make research better for children.

Main study objectives: examine how the nutrient density
and antioxidant content of 3 snacks
affected exercise intensity,
fatigue, blood glucose (finger prick before and after the match), and other biochemical
marker (saliva).

  • financial incentives;

  • reduce trepidation by "showing them finger pricks;

  • Eating the study snack;

  • being tested

  • anxiety over finger pricks before and after the match for blood glucose
McCullough et al. (2016)25 Barriers to Recruitment in Pediatric Obesity Trials: Comparing Opt-in and Opt-out Recruitment Approaches. Quantitative RCT Investigators of 3 trials in children 2-7 years (CHIRP & LAUNCH) and children 8-12 years (E-FLIP) 10 rural communities in North Central Florida, USA. 2009-2015 Consent obtained from participants Obesity treatment Review of opt-in strategies (parents contact researchers in response to mailings) and opt-out strategies (parents send decline postcard in response to mailings).

  • in the opt-out strategy, families were more likely to have contact with the study staff, be phone screened, and be randomized.

  • In the opt-in strategies, families were less likely to contact the study and be phone screened, agree to in-person screening, consent to be in the study, meet inclusion and enroll, and be enrolled.
Metayer et al. (2018)26 Recruitment of new immigrants into an RCT: The Live Well Experience. Quantitative RCT New immigrant mothers and children from Brazil, Spanish-speaking Latino or Haitian descent with over 10 years in the US and with a child 3-12 years Community Centers in Somerville, MA, USA. 2009-2011 Consent obtained from participants Lifestyle intervention Review of recruitment data to inform ongoing process evaluation.

  • adjustments in eligibility criteria;

  • broadening outreach to nearby communities;

  • shorter intervention;

  • more community staff (trusted and familiar) for recruitment;

  • highlight of staff experience;

  • flexible schedule;

  • childcare provided;

  • culturally appropriate food;

  • community partnerships & immigrant organizations

  • use of posters and flyers;

  • monetary incentives;

  • reminders of recruitment visit;

  • recruitment subcommittee

  • stress surrounding childcare arrangements
Nicholson et al. (2006)27 Recruitment and retention strategies in longitudinal clinical studies with low-income populations. Quantitative RCT 306 mothers 15-42 years of age (AA, non-Hispanic Whites and Hispanics) Low Income, ethnic neighborhoods in Columbus, Ohio, USA. 2005-2006 Consent obtained from participants Nutrition Description of specific strategies employed to successfully recruit and retain participants.

  • study viewed as part of standard clinical care and not as an experiment;

  • nurse leaders oversaw leaders and interviewers, integrating research into clinical process and helped to form relationship between research staff, clinical staff, and participants.

  • some mothers felt rushed to get to their appointment;

  • some mothers were busy attending to children;

  • one clinic underwent slow recruitment due to infrastructure change.
Raynor et al. (2009)28 Evaluation of active and passive recruitment methods used in randomized controlled trials targeting pediatric obesity.\ Quantitative RCT 164 families with overweight children 4-9 years Community health centers, children’s health centers, schools, Internet, radio, newspapers and TV in Massachusetts, USA. 2005-2007 Consent & assent obtained from participants Weight management Review of enrollment numbers and cost-effectiveness of active (physician referrals, targeted mailings) vs passive (adds and flyers, word of mouth) recruitment methods.

  • active strategies (largest number of enrolled and randomized families);

  • passive recruitment methods (less families recruited but better retention from enrollment to randomization)

  • parents do not identify overweight in their children;

  • inability to complete phone-screening due to phone disconnection;

  • no time to complete the screening;

  • no adults at home by the time of the call;

  • researchers did not identify if parents were contacted by one or several recruitment methods;

  • phone calls were not included in the costs;

  • used TV advertisements for a short period due to cost.

RCT: randomized clinical trials; UK: United Kingdom; USA: United States of America; CHIRP: Community Health Lifestyle Intervention for Rural Preschoolers; LAUNCH: Learning about Activity and Understanding Nutrition for Child Health; E-FLIP: The Extension Family Lifestyle intervention project for Kids