Planning efficient recruitment

Based on EHES Manual, Part A Based on EHES Manual, Part A. Planning and preparation of the survey, 2nd edition, 2016. Available at: http://urn.fi/URN:ISBN:978-952-302-700-8 and EHES Manual, Part B. Fieldwork Procedures, 2nd edition, 2016. Available at: http://urn.fi/URN:ISBN:978-952-302-701-5 These slides can be used freely, translated and adapted to national use (e.g. concerning the recruitment practices).

Recruitment process Needs to be specified in each country according to: National and regional legislation Ethical acceptance Cultural norms Survey budget

Participation rate High participation is the basis for reliable results which represent the target population Participation rates have been declining Some groups are often under-represented (young adults, men and those from lower socioeconomic class) → Recruitment should be carefully planned, monitored during fieldwork and adapted whenever needed

Written materials Potential participants’ response to invitation highly depend on the contents and format of written materials Written materials may include Information leaflet Invitation letter Letter with instructions to participant Information sheet

Information leaflet Usually sent with the invitation letter Less formal Basic information in a concise form Interesting; pictures and colors Easy to understand Main goal is to raise interest and to motivate people to participate

Contents of information leaflets The leaflet should give answers: What is this survey about? Why is it needed? Why am I selected? Why is it important to participate? How do I benefit by participating? What measurements are included? Is my information really confidential? Is my participation compulsory? Where can I get more information?

Contents of invitation letters A personal invitation Short description of survey and selection of participants Description of measurements Pre-scheduled appointment time (with possibility to change time) or instructions for scheduling Importance of participation explained Benefits for participant Signed by a survey leader (or other notable person) Confidentiality explained Contact information

Instructions to participant Separate letter or in the invitation letter How to prepare for the examination visit, e.g. Instructions for fasting Need to show an ID-card Practical issues, e.g. Travel instructions and map of the examination site

Information sheet Includes detailed information on survey Must be provided to participants before obtaining informed consent Given at the examination site or sent home with the invitation

Inviting participants Invitation letter is usually the first contact attempt (pre-notice card may precede it) Invitation letter without appointment time Survey personnel call to schedule a visit or participant books time after receiving the letter Problems: Missing phone numbers, people not answering to phone calls, people who need more motivation to book appointment Invitation letter with appointment time Problems: If the appointment is not confirmed, many people will not show up, no possibility for extra motivation if needed

Scheduling appointments Personal contact and reminders increase participation Direct contact (phone call or home visit) Possibility to answer questions and to motivate people Possibility to change appointment times Reminders Reduce forgotten appointment times A day – one week before appointment by a letter/ card/ text message/ phone call / e-mail May include instructions for participants

Re-contacts Needed if previous invitations were not successful At least one re-invitation even if participation rate is high (70 % or over) At least two re-invitations if participation rate < 70% By letter or card, phone calls, e-mails, text messages, home visits Check accuracy of addresses, phone numbers Mailed and/or web-based non-participant questionnaire or phone interview offered for all who refuse to participate

The value of competent personnel Competent and well trained personnel Understand the importance of high participation Familiar with frequently asked questions Know how to motivate persons Have good social skills Motivating the personnel Satisfaction of staff is important for the work quality Positive work environment, supervision, support and feedback increase staff satisfaction

Other means to increase participation Local media campaigns before examinations To raise interest towards the survey TV and radio interviews, articles in newspapers, posters, social media etc. Pre-notification of the survey Flexibility in scheduling appointments Home visits, if participation is not possible otherwise Using several languages in information material and questionnaires

What motivates participants? Benefits Information on their own health Incentives or reimbursements of travel expenses Appreciation for serving public health and giving benefits for future generations

Improving participation through co-operation Discussions in focus groups with representatives of potential participants To gain information: what motivates participation Provide information to Health authorities and health professionals Local government, communities Co-operate with Hospitals, non-governmental organizations, research centers and universities Other places/groups which are important for the community

Acknowledgements Slides prepared by Sanna Ahonen, Katri Sääksjärvi, Päivikki Koponen, Hanna Tolonen Photographs by Hanna Tolonen with voluntary participants Experiences and feedback from the EHES network have been utilized in the preparation of these slides Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in 2009-2012 through SANCO/2008/C2/02-SI2.538318 EHES and Grand Agreement number 2009-23-01, and in 2015-2017 through Grand Agreement number 664691/BRIDGE Health

Disclaimer The views expressed here are those of the authors and they do not represent the Commission’s official position.