Table 1.

Strategies used in our pilot study to facilitate recruitment and retention of a study population of underserved children and families.

Goal	Potential barrier	Strategy to overcome barrier
Elicit the perspectives of traditionally underserved children and families on the intervention of interest	Lack of end-user and community engagement in intervention protocol development	Conduct iterative, qualitative interviews with multi-level stakeholders (children and families, school nurses, clinical staff, etc.) to adapt intervention to meet needs of children and families
Recruit traditionally underserved populations into clinical trials	Medical practices without racial, ethnic, or income diversity	Select practices with higher percentage of children and families that are medically underserved for study participation
	Patients from minority groups prefer to learn about studies from providers of their own race or ethnicity	Recruit physicians from minority racial and ethnic groups to participate in clinical trial recruitment
	Medical provider without enough time to identify children at higher risk for asthma morbidity	Practice managers flag children with poorly controlled asthma, thus identifying a population disproportionally impacted by morbidity
	Mistrust in medical research and recruitment personnel	Allow the child’s pediatrician to initially introduce the study to families Emphasize the intervention partnership with trusted community members (i.e. school nurses) Maintain consistent study staff for longitudinal assessments with the family to build trust and rapport
Recruit Spanish-speaking populations	Lack of Spanish language study materials/services	Translate all study materials (consent, surveys, etc.) into Spanish Conduct phone assessments with Spanish-speaking study staff or interpreter
Retain underserved populations to study completion	Inadequate access to childcare, reliable transportation, and inability to miss work for in-person study assessments	Conduct surveys remotely, eliminating need for office visits
	Compensation occurs a long time after study involvement	Send out electronic gift cards immediately after follow-up surveys completed
	Compensation not useful to participants	Ensure payment occurs via electronic gift cards to retailers present in the community (e.g. Walmart or Target), asking the participants about their preference
Include populations without stable Wi-Fi	Lack of stable Wi-Fi	Conduct interactions with research staff via phone rather than video conferencing or email. Allow for sending of REDCap surveys using text links, as most families have text-enabled phones